Tag Archives: measles

More on Measles (October 2026)

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Trisha Pasricha, Washington Post 10/5/26: Measles can erase up to 73 percent of your immune system’s memory

An excerpt:

“My sister says there’s no real difference between a child getting the measles vaccine and just catching measles, since either way the child ends up immune. Is she right?

I wouldn’t describe it as “just catching measles.” In the United States, about 1 in 5 unvaccinated people who get measles is hospitalized, and 1 to 3 of every 1,000 children infected will die, according to the Centers for Disease Control and Prevention…

Children with measles become more susceptible to other infections like ear infections or diarrhea. Today, the most common cause of death among young children with measles is pneumonia…

In a study published in Science in 2015, researchers analyzed decades of childhood mortality data from the United States, England and Wales, and Denmark. They noticed that in the pre-vaccine era, when measles cases spiked, deaths from other infections rose, too — and not just immediately but for the subsequent two to three years…When the measles vaccine arrived, and measles cases fell, deaths from other infectious diseases fell along with them. The scientists estimated that where measles was common, measles infections could have been implicated in as many as half of all childhood deaths from infectious disease.

Center for Infectious Disease Research and Policy, University of Minnesota: “Pennsylvania confirms more than 1,000 measles cases. Nationwide, the Centers for Disease Control and Prevention (CDC) reported 3,887 measles cases as of October 2… Health department officials in South Carolina also have said that the state likely had more measles cases this year than the official count of 997. Doctors in South Carolina aren’t required to report measles-related hospitalizations, according to a report from ProPublica.”

Measles: 99% of the cases (n=1004) are in the unvaccinated which represent 7% of Pennsylvania’s population. Graph courtesy of Neil Stone, MD (via X). All of the deaths have occurred in the unvaccinated.

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Audio-Recorded Gut-Directed Hypnotherapy for Disorders of Gut-Brain Interaction Plus Measles Update

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L Barash et al. J Pediatr Gastroenterol Nutr. 2026; doi.org/10.1002/jpn3.70545. The role of audio‐recorded gut‐directed hypnotherapy onsleep and abdominal pain: A pilot and feasibility study.

Background: Gut-directed hypnotherapy (GDH) is an evidence-based treatment that improves abdominal pain and quality of life in pediatric DGBI both in the short- and long term.3, 4 Home-based audio-guided GDH has shown comparable efficacy to in-person treatment, while enhancing access to care for families with logistical or socioeconomic barriers.5, 6 

Methods: This was a non-blinded randomized controlled trial with partial crossover. Treatment includes three 25-min audio sessions every 2 weeks and daily 10–20-min sessions, with a goal of ≥5 sessions per week. Out of 25 participants who initiated GDH 16 (64%), completed treatment. Reasons for dropout included side effects (nausea, n = 2), lack of improvement (n = 1), resolution of symptom (n = 1), and unknown (n = 5).

Key findings:

  • Combined abdominal pain scores significantly improved post-treatment with GDH, with a 40.2% reduction from baseline (p < 0.001; d = 0.9), compared to a 16.6% reduction in the standard medical therapy (SMT) group
  • The SMT group had no improvements in sleep-related impairment (SRI) (p = 0.90) … whereas those who completed GDH demonstrated significant improvements in SRI at both 4 weeks (p = 0.01) and at the completion of treatment (p = 0.01)
  • Two participants in our study discontinued due to worsening nausea. Many of the audio recordings included motion-related imagery, which may have contributed to symptoms in susceptible participants.

In a separate study (n=230) (JTW Snijkers et al. Gut Published Online First: 25 July 2026. doi: 10.1136/gutjnl-2026-338385. Open Access! In-person therapist-delivered hypnotherapy versus smartphone-based self-guided hypnotherapy in IBS: a multicentre three-armed randomised controlled trial), a self-guided smartphone hypnotherapy program did not meet the prespecified threshold for noninferiority to in-person hypnotherapy for abdominal pain response in patients with irritable bowel syndrome (IBS). At weeks 13-16, Food and Drug Administration-defined abdominal pain response rates were 48.1% with in-person therapist-delivered hypnotherapy, 33.3% with smartphone-based self-guided hypnotherapy, and 21.8% with online psychoeducation. 

My take (borrowed in part from the JPGN authors): “Providers may consider GDH as a low-risk, home-based therapeutic option for children with DGBI, particularly when sleep is also a concern.”

Rigorous pharmacologic studies show that medications, to date, recommended for patients with DGBIs have difficulty outperforming placebo. With hypnotherapy, having an adequate control group is problematic. It would not be surprising, though, for GDH to have difficulty outperforming pharmacologic agents/placebo despite its good response in patients with DGBIs. In this setting, the use of GDH or medications with a low incidence of adverse effects and plausible beneficial effects continue to have a role in improving symptom control.

From AGA Today: US Measles Outbreak Tops 3,000 Cases Reaching 35-Year High

NBC News (9/4, Edwards) reports, “A 6-week-old baby girl is one of two people with measles who died in Pennsylvania, the Lancaster County coroner said Friday, as the nation’s measles tally hit a new 35-year record of 3,134 cases. … At least 115 more people in Pennsylvania, mostly in Lancaster County, have been diagnosed with measles in the last week, the health department said Friday, bringing the state’s outbreak to about 577 cases within the last few months.” Experts say there are likely many more across the country who have contracted measles but have not gotten tested. NBC adds, “The new milestone, the highest number of confirmed cases since 1991, is yet another indication that the highly contagious virus is taking over, particularly in areas of the country with plummeting vaccination rates.”

Related blog posts (for DGBIs):

Related blog posts (for Measles)

Surprise, Surprise – Measles Cases in South Carolina Occurred Where Vaccinations Are Lowest Plus One

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EA Serman, B Witrick, L Rennett. NEJM 2026; DOI: 10.1056/NEJMc2604004.
Clusters of Concern — Spatial Link between Childhood Undervaccination and Measles Outbreaks in South Carolina

An excerpt:

As of April 8, 2026, South Carolina had 997 confirmed cases of measles, of which 95.3% were reported to be among unvaccinated residents.2 Of these cases, 90.8% occurred in children (<18 years of age).2 Thus, school-based vaccination patterns provide a reasonable indicator of local pediatric susceptibility in the communities where transmission has occurred…

Spartanburg County (population, 380,000) was identified as the dominant cluster, containing 27 of 109 hot-spot tracts (24.8%). Of the 997 reported measles cases in the state, 940 (94.3%) occurred in Spartanburg County…

The mean vaccination coverage was lower in the schools with reported measles cases (coverage, 83.9%) than in those with no reported cases (coverage, 92.9%)…The locations of the 30 schools with measles exposure were not uniformly distributed: 26 (87%) were located within or adjacent to undervaccinated hot-spot tracts

In other health news, there is a reason why milk is pasteurized:

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We Are Going to See More Measles Tragedies

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“One death is a tragedy; a million is a statistic.” This quote is often misattributed to Joseph Stalin but is likely derived from the German journalist and satirist Kurt Tucholsky. So much of the arguments for vaccines focus on the millions of lives that have been saved. Yet, it is the individual sad stories that are often much more powerful. I was thinking of this quote as I read a NY Times Commentary by Rebecca Archer (4/21/26): Measles Took My Daughter. This Is What I Want Everyone to Know.

An excerpt:

When my daughter Renae, my firstborn, was 5 months old she spiked a fever…At the hospital the doctors noted the red spots on her body and diagnosed her with measles.

This was 2013, and Manchester, England, where we lived, was experiencing a measles outbreak that resulted in more than 1,000 suspected cases. A 1998 study by a British doctor, Andrew Wakefield, linking the measles, mumps and rubella vaccine to autism had caused vaccination rates to plummet. The study was later retracted and Mr. Wakefield stripped of his medical license, but the damage had been done. In 2013, most of the cases were among school-age children whose parents had refused to give them the vaccine, which is not compulsory in Britain, or among babies too young to be vaccinated, like my daughter…

Within a week she seemed back to normal. What I didn’t know was that measles can cause long-term complications. A child can seem fine while the virus slowly replicates in her brain, poised to exact a terrible toll years later…

Toward the end of the summer [2023], … she had also started moving very slowly, almost robotically, and often seemed confused. We took her back to the hospital, where another M.R.I. showed the swelling in her brain had become much worse… Renae had subacute sclerosing panencephalitis, a rare complication of measles. The doctors told me it was fatal, and there was nothing else they could do…

Last year, the United States saw its highest rate of measles cases in more than three decades and the country may soon lose its measles elimination status as well. Despite this, Health Secretary Robert F. Kennedy Jr. said he doesn’t think the government should be mandating vaccines, and that they should be a matter of personal choice.

Parents must realize that refusing vaccinations doesn’t just put your own child at risk. It puts other children at risk. 

Related articles:

  • LA Bacheschi, et al. NEJM 2026; 394: 1662. Measles 2025. Subacute sclerosing panencephalitis “was not rare before vaccination, as shown by an account of 82 cases… in Brazil from 1961 to 1983.”
  • DN Durrheim, JK Andrus. NEJM 2026; 394: 1662-1663. Measles 2025. The “measles still kills more than 100,000 children worldwide each year.”

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Mount Fitz Roy, Argentina

In the News: FDA Approves 2nd Oral GLP-1, Another Vaccine Reduces Risk of Dementia, and Costs of Vaccine-Preventable Diseases

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Friday’s blog post (Position Paper: Expediting Drug Approval for Pediatric IBD) has been updated to reflect the recent approval of Stelara (ustekinumab) for the treatment of pediatric patients 2 years and older with moderately to severely active Crohn’s disease. Here’s a link: Johnson & Johnson (JNJ) Gains FDA Approval for Pediatric Crohn’s Disease Treatment. Thanks to Matthew Kowalik, MD, the Director (Acting) of Division of Gastroenterology for FDA/CDER/OND/OII, for bringing this to my attention.

Congratulatons to Rachel Rosen who is the pediatric gastroenterology recipient of  this year’s AGA Institute Council Section Research Mentor Award.

B Lovelace Jr, NBC News, 4/1/26: FDA approves weight loss pill from Eli Lilly

“The daily pill, called Foundayo [orforglipron], follows the approval of Novo Nordisk’s Wegovy pill in recent months. The lowest dose is expected to cost $149 a month for people paying out of pocket…Foundayo will be offered in six doses, with patients typically starting on the lowest dose and working their way up to reduce side effects. It can be taken at any time of day without meal restrictions — unlike the Wegovy pill, which must be taken on an empty stomach each morning…Phase 3 clinical trial data found that Foundayo helped people lose 12.4% of their weight, on average, at its highest dose after 72 weeks — similar to the Wegovy pill but less than injectable versions of Wegovy and Zepbound.”

The FDA has asked Lilly for more safety data. NBC News 4/14/26: FDA asks Lilly for more safety data on weight loss pill Foundayo

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Also, there was a recent article in Nature (Genetic predictors of GLP1 receptor agonist weight loss and side effects) showing that a genetic variant can predict whether GLP-1 response is more robust. Explainer: Why obesity drugs work better for some people: these genes hold clues

AS Bukhbinder et al. Neurology 2026; 106 (8) e214782. Open Access! Risk of Alzheimer Dementia After High-Dose vs Standard-Dose Influenza Vaccination

This was a retrospective study comparing the high dose influenza vaccine (H-IIV) compared to the standard dose (S-IIV) in 65+ patients. The H-IIV group included 120,775 unique participants (185,183 person-trials; mean age 74.4 years, SD 5.5; 57.3% female), and the S-IIV group included 44,022 participants (53,918 person-trials; mean age 73.0, SD 6.1; 56.4% female).

Key findings:

  • H-IIV was associated with significantly lower AD risk during months 1–25 postvaccination (minimum NNT = 185.2 at 25 months), with a stronger effect among women.

Also, infectious disease outbreaks are expensive. M Baker, American Action Forum 4/3/26. Vaccines Protect More Than Health – They Protect Economic Capacity

“Routine childhood immunizations in the United States from 1994 through 2023 are estimated to have prevented roughly 508 million illnesses, 32 million hospitalizations, and more than 1 million deaths. Those gains translated into approximately $540 billion in direct medical cost savings and nearly $2.7 trillion in total societal savings. Put simply, every $1 spent on childhood immunizations generated about $11 in savings…Adult vaccination also produces meaningful economic gains, particularly through reduced absenteeism, less presenteeism, and better labor-market continuity. Evidence suggests that adult immunization programs can return up to 19 times their initial investment.”

“In South Carolina, a 2025–2026 outbreak with 993 cases generated an estimated $35.5 million in costs, compared with $66,193 to vaccinate the same number of children through VFC. Those costs are only growing – the outbreak in South Carolina has not yet abated.”

Worsening Measles Outbreak

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From CNN: The US surpassed 1,100 measles cases in two months. Expect more deaths next

“According to the CDC, out of every 1,000 children who are infected with measles, one may develop encephalitis, ​which is a dangerous swelling of the brain. Up to 3 out of every 1,000 infected children will die.

The US is on track for another record-breaking year for measles: The number of measles cases reported in the first eight weeks of the year — ​1,136 as of February ​26, according to CDC data — is already six times more than typical for an entire year. A tracker from the Johns Hopkins University Center for Outbreak Response Innovation has tallied an even higher the annual case total than the CDC…

New measles cases have started to slow in South Carolina in recent weeks…[due to] ublic health groundwork that has helped rapidly identify cases and potential exposures and drive quarantine guidance…Improving vaccination coverage has also helped, she said. The state health department administered nearly 17,000 MMR vaccines in January, which was one of the most successful months for vaccination that the state has had in years. 

Related blog post: U.S. Measles Outbreak Is Not Slowing

MMR Vaccination Safety in Immunocompromised Kids with IBD and Liver Transplant

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A Keutler et al. Vaccine 2025; 59: 127288. Open Access! Safety and immunogenicity of the measles-mumps-rubella vaccine in immunocompromised children with inflammatory bowel disease, or after liver transplantation: An observational study

Background: “Measles is a highly contagious disease and, despite the availability of a safe and effective vaccine, remains still an important cause of childhood death worldwide [1,2]. The risk of severe illness in measles-naive individuals is particularly high in immunocompromised patients with inflammatory bowel disease (IBD) or after liver transplantation (LT) [3]…Ideally, vaccination with live attenuated vaccines (LAVVs) should be completed four weeks before organ transplantation or the initiation of immunosuppressive therapy (IST) to allow for the live vaccine’s incubation period and minimize the risk of vaccine-associated disease…LAVVs are considered contraindicated during IST due to safety concerns and limited experience.”

Methods: “In this prospective multicenter observational study (DRKS00014569) 22 children and adolescents with incomplete MMR vaccination status were identified… with stable immunosuppressive therapy in the last three months with no evidence of underlying disease activity…Sixteen patients were vaccinated against MMR, eleven after liver transplantation and five with inflammatory bowel disease. At the time of vaccination, four patients were receiving moderate (e.g., tacrolimus drug level below 5 ng/ml), eleven were receiving high-intensity immunosuppression (e.g. anti-tumor-necrosis factor agents, mycophenolate mofetil) and one child had previously discontinued immunosuppressive treatment.”

Immediately prior to the references, the authors provide a downloadable document detailing how they chose to categorize the degree of immunosuppression and their precise protocol, including immunologic pretesting and drug contraindications as noted below.

Key findings:

  • There were no serious adverse events or complications related to the vaccination
  • In children receiving immunosuppressive medications, the seroconversion rate for measles after the first MMR vaccination was 73.3 % (11/15) and after the second vaccination 80 % (12/15)

My take: In carefully-selected immunocompromised pediatric patients, the MMR vaccine may be safe. However, given the small numbers receiving vaccination in this study, the absolute safety is unclear. Even infrequent adverse effects would be problematic. This study’s protocol could be helpful for those considering vaccination in immunocompromised populations with a measles epidemic. For now, the most important approach is improving vaccination rates in those (especially family members) without contraindications.

Related blog posts:

Disclaimer: This blog, gutsandgrowth, assumes no responsibility for any use or operation of any method, product, instruction, concept or idea contained in the material herein or for any injury or damage to persons or property (whether products liability, negligence or otherwise) resulting from such use or operation. These blog posts are for educational purposes only. Specific dosing of medications (along with potential adverse effects) should be confirmed by prescribing physician.  Because of rapid advances in the medical sciences, the gutsandgrowth blog cautions that independent verification should be made of diagnosis and drug dosages. The reader is solely responsible for the conduct of any suggested test or procedure.  This content is not a substitute for medical advice, diagnosis or treatment provided by a qualified healthcare provider. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a condition.

Menetrier’s Disease in a Pediatric Patient Plus Measles and Influenza Updates

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X Wang et al. N Engl J Med 2025;392:1334. Ménétrier’s Disease

  • History: 16-year-old girl was admitted to the hospital with a 2-month history of leg swelling and hypoalbuminemia. She had no gastrointestinal symptoms.
  • Treatment: She was placed on a high-protein diet and medications to eradicate a concurrent infection with Helicobacter pylori. At a 3-month follow-up visit, the patient’s edema and hypoalbuminemia had resolved.

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Measles as of Friday May 2nd (per Caitlin Rivers): “According to CDC, a total of 935 confirmed measles cases have been reported by 30 jurisdictions. The previous high was 1,274 in 2019. So far this year, 121 cases (13%) have been hospitalized.”

AP News May 2nd: CDC reports 216 child deaths this flu season, the most in 15 years

“More U.S. children have died this flu season than at any time since the swine flu pandemic 15 years ago, according to a federal report released Friday…It’s a startlingly high number, given that the flu season is still going on. The final pediatric death tally for the 2023-2024 flu season wasn’t counted until autumn…There are likely several contributors to this season’s severity, but a big one is that fewer children are getting flu shots, added O’Leary, a University of Colorado pediatric infectious diseases specialist. The flu vaccination rate for U.S. children has plummeted from about 64% five years ago to 49% this season. Flu vaccinations may not prevent people from coming down with symptoms, but research shows they are highly effective at preventing hospitalizations and deaths, O’Leary said.”

U.S. Measles Outbreak Is Not Slowing

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These charts show measles data through April 7th. Some additional data through Apirl 11th is listed below.

For those interested in a deeper dive into the measles numbers, you can follow Caitlin Rivers substack. From her notes on April 11:

  • “Since my last update on Tuesday, Arkansas and Hawaii reported cases for the first time this year. At least five states have reported ten or more cases, which is very unusual. Texas continues to register the most cases, with 541 to date.”
  • “According to the CDC, 712 cases have been reported so far this year. 1 in 3 (32%) are under the age of 5, and 1 in 10 (11%) have been hospitalized.”

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