Maryland Measles Cases Hit 31 After Just Three All Last Year

Maryland has confirmed 31 measles cases this year against three in all of last year, and 27 of them arrived after July 15 among residents who were not vaccinated.

The state declared outbreaks this week in Cecil, Carroll and St Mary's counties, each of which sits above the state average for nonmedical vaccine exemptions.

Statewide coverage is about 96 percent, ahead of the national 93, but 96 is also the threshold that keeps the virus from spreading freely.

Esther Liu, who chairs pediatrics at University of Maryland Baltimore Washington Medical Center, said the state is teetering on that line and that children under 5 face the worst complications.

St Mary's has the most cases at 13, and its kindergarten exemption rate more than doubled in a year to 3.5 percent.

Health officials say there is no evidence yet of widespread community transmission, with most infections still confined to household contacts.

An average is a poor shield, because measles travels through the gaps an average conceals. The sharper warning is one state north. CIDRAP reports two unvaccinated people dead in Lancaster County, Pennsylvania, that state's first measles deaths in 35 years, with 185 cases in the county and 393 statewide, the third highest tally in the country. CNN reports one of the dead was an infant, too young for a first dose and dependent on everyone else's. Kindergarten exemption filings for the coming year are the next number worth watching.