Rates of Measles, Mumps Hit All-Time Lows in L.A. County

Rates of measles, mumps and other diseases that can be prevented by vaccines dropped to a “historic low” in Los Angeles County last year after intensive immunization campaigns, according to a new study.

But the number of children who are fully vaccinated against such diseases by age 2 remains significantly below target levels, keeping alive the possibility of outbreaks, the study said.

Only 15 cases of measles were reported last year, along with 49 of mumps and none of rubella--the lowest incidence of those diseases in a decade, according to the annual report of the county health department’s immunization program.

The number of measles cases has plummeted since an epidemic of the highly contagious virus killed 40 county residents, about half of them children, between 1988 and 1991. About 2,700 people were hospitalized. In 1990, the peak year of the outbreak, more than 4,000 cases were reported.

County health officials responded by distributing more than 600,000 doses of combined measles, mumps and rubella vaccine, known as MMR. Officials attribute the subsequent plunge in measles to that effort--and to the fact that those who recover from measles develop permanent immunity.

“It is a major accomplishment,” said Dr. Jim Cherry, a UCLA expert on pediatric infectious diseases. Measles is far more difficult to suppress in populations with high rates of poverty, low education and language barriers, he said.

Although most people recover completely from the fever, coughing and red skin spots of measles, some develop complications of pneumonia and encephalitis that can be fatal.

The dramatic falloff in measles locally reflects a nationwide decline that has brought the disease tantalizingly close to eradication.

In 1993, only 312 cases were reported in the United States--the fewest since measles vaccine was licensed for sale in 1963, according to the federal Centers for Disease Control and Prevention. The year before the vaccine came on the market, there were more than 481,000 reported cases in the U.S., including 408 deaths. Since 1992, no American has died of measles.

The county report said health officials are close to their goal of fully immunizing at least 98% of the children entering kindergarten against measles, mumps, rubella, diphtheria, tetanus, pertussis (whooping cough) and polio.

“Although vaccine-preventable diseases are at a historic low at this time, the danger of future outbreaks remains, as long as immunization levels remain as low” among children age 2 and younger, the report said. “It is therefore imperative that efforts to raise immunization levels in the county be continued or augmented.”

Dr. Shirley Fannin, the county’s chief of communicable disease control, said local immunization efforts receive sufficient funds from the federal and state governments--$5.3 million in the 1994-95 fiscal year--to keep a tight rein on vaccine-preventable maladies.

But she warned that turmoil in the Department of Health Services triggered by the county’s budget crisis could stall future immunizations drives, opening the door to rising levels of measles and other viruses.

Budget cuts in the department have reduced the number of clinics that administer vaccinations to 10 from 39, and the remaining clinics are not conveniently located for many people who need shots, she said. Although measles cases nationwide hit a record low in 1993, the number more than tripled last year, to 958 cases, according to the Centers for Disease Control.