San Diego County is one of the hotspots in the nation’s measles outbreak: 13 of at least 107 cases of measles nationwide have been confirmed here.

The outbreak has added fuel to an angry, nationwide debate over “anti-vaxxers” — parents who don’t vaccinate their children because they believe doing so puts them at risk for autism. (It doesn’t.)

Here are five things to know about the measles in San Diego:

S.D. measles cases may have leveled off.

The San Diego outbreak may be waning. “The confirmed case count in this region has held at 13 for nearly two weeks, even as the statewide total has continued to grow, reaching 91 as of Friday,” U-T San Diego reported Monday.

According to updated figures from the Centers for Disease Control & Prevention, the state total is now at 92, up one from Friday. Orange County, home to Disneyland, has the highest number at 28, followed by Los Angeles County (21) and San Diego County (13).

Of the 92 cases, 59 have been linked to Disneyland: 40 in people who visited or worked there and 19 who were exposed to those people.

Measles is more than mildly contagious. “If someone with measles is in this room and that person leaves and you come in an hour later, you could still be exposed because of the airborne virus particles in the air,” a county medical official told NBC 7. But the U-T reports that no one outside of family members seems to have been sickened by the local people with measles even though infected people visited places like East County’s Parkway Plaza mall.

Measles is a serious disease.

“In the U.S., before a vaccine was introduced in 1963, there were 4 million measles cases with 48,000 hospitalizations and 500 deaths every year,” Vox reports. “By 2000, because of the vaccine, the virus was declared eliminated here: Enough people were immunized that outbreaks were uncommon, and deaths from measles were scarcely heard of.”

The nearly 600 diagnosed cases of measles in the U.S. last year was the highest number since 1996. An estimated 1 or 2 of every 1,000 measles patients will die, according to Vox, with the most vulnerable being the very young, adults over 20, and others whose immune systems are fragile. Children under 5 have the highest probability of death.

Plenty of local kids aren’t vaccinated.

The news outlet Inewsource finds that almost 8 percent of local kindergartners aren’t properly vaccinated for measles and other diseases. About half of those who haven’t been fully vaccinated have “personal belief exemptions,” meaning their guardians don’t want them to be fully vaccinated. This is more common at wealthy schools, Inewsource says, while kids at poor schools are much less likely to have this kind of exemption.

Indeed, a Washington Post map of vaccination rates statewide — which fell over the past 15 years during anti-vaccine hysteria — shows higher rates of vaccination in the poorer southern region of San Diego County. The Post also notes that personal belief exceptions are on the decline, possibly because the state now requires kids to see a health professional in order to get one.

The percentage of vaccinated kindergartners is 50 percent and under at several private and charter schools, including Dehesa Charter in Escondido (only 45 percent up to date on vaccines), San Diego French-American School in La Jolla (41 percent), Heritage Christian School of San Diego (48 percent), Learning Choice Academy in San Diego (50 percent), Academy of Arts and Sciences in El Cajon (32 percent) and Waldorf School of San Diego (44 percent).

At Santa Fe Montessori School in Solana Beach, only 1 of 11 kindergartners is up to date on vaccines. By contrast, 100 percent of the kids at many local schools are fully vaccinated.

The Post explains what the low vaccination numbers mean:

We need what’s known as “herd immunity” to keep these most vulnerable populations safe from infectious diseases. For measles, that immunity kicks in with vaccination rates somewhere between 83 and 94 percent, according to the CDC. So even letting 5 percent of the kids in your community skip the vaccine is inviting trouble.

S.D’s measles outbreak isn’t the first.

In 2008, a local 7-year-old boy came home from a Switzerland trip with an unwanted souvenir: a case of measles. As a report in the journal Pediatrics put it delicately, he was “intentionally unvaccinated.”

The boy went for treatment at a clinic in the Bird Rock neighborhood of La Jolla and sparked the biggest measles outbreak in the San Diego region since 1991. More than 800 people were exposed, and 11 other kids — all unvaccinated — became ill. Almost 50 kids were quarantined because they were too young to be vaccinated.

A 10-month-old baby was infected from just being in the pediatrician waiting room with the 7-year-old boy. The baby became very sick, and his family believed he wouldn’t survive.

Megan Campbell, the boy’s mother, told“This American Life”: “I just wondered how this family who had brought this into San Diego, what were they thinking? Were they thinking they were part of something that put that child there? Did they feel for us at all? Did they feel bad about it? … I have very close friends who don’t vaccinate their children. And it’s just something that we can’t talk about. We get too angry. We can barely speak.”

Local health officials received high praise for their work on the 2008 outbreak. “Even with the very high vaccine coverage that we saw in San Diego, if you have a community of vaccine refusers you can get an outbreak,” a CDC official told WebMD. “Had the local health department not been extremely aggressive in quarantining everyone who came in contact with a case who did not have immunity, the outbreak would have broadened.”

The 2008 outbreak produced false stats.

The cost of the 2008 measles outbreak — to businesses, government health agencies, medical facilities and families — was estimated at $179,000. A journalist’s estimate of a $10 million cost, which he repeated on CNN, was false.

So was a statement by anti-vaccine activist and former Playboy model Jenny McCarthy, who dismissed the 2008 outbreak two years later by writing this: “Yes, a wave of 12 children with measles in San Diego is a troubling thing. But, there are more than 20,000 children in San Diego with autism!”

McCarthy, like other anti-vaxxers, linked vaccines to autism despite a lack of scientific evidence. But there aren’t 20,000-plus kids in the city or the county with autism. Her statement was false.

Randy Dotinga is a freelance contributor to Voice of San Diego. Please contact him directly at and follow him on Twitter:

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