March 20, 2024 – Each spring, around 30 million people descend on Florida’s beaches, cities, and theme parks for some fun in the sun. But this year as the state gets set for spring break, it’s also wrestling with a measles outbreak that’s leaving many travelers wondering whether it’s still safe to go.
Last month, the state reported 10 measles cases – nine in Broward County around Fort Lauderdale and one in Polk County near Orlando, with the earliest cases at Manatee Bay Elementary School in Broward County. According to the CDC, as of March 1, 41 cases of the measles had been reported in the U.S., a big number considering that 58 cases were reported in all of last year.
What’s more, the Florida Department of Health has been slow to release information about the outbreak, adding to travelers’ uncertainty. Neither the Florida Department of Health nor the Broward County Department of Health responded to requests for comment.
The response from Florida officials about the outbreak is disconcerting for Florida residents and tourists, said David M. Higgins, MD, a pediatrician and spokesperson for the American Academy of Pediatrics.
Florida’s public health officials are “responding to the outbreak in ways that run counter to decades of well-established public health recommendations,” he said of Florida Surgeon General Joseph Ladapo, MD, PhD. Ladapo has not recommended measles vaccination and deferred to parents as to whether to send kids exposed to the virus back to school.
Even so, traveling to Florida for spring break is safe for people who are vaccinated against measles, Higgins said, because the number of cases is still low enough. That view is shared by some other Florida health officials who note that the risk profile is currently low and numbers haven’t been increasing.
“Most people are vaccinated, and vaccinated people really have nothing to worry about,” said Nicole M. Iovine, MD, PhD, a clinical professor and hospital epidemiologist in the Division of Infectious Diseases and Global Medicine at the University of Florida Health in Gainesville.
If you’re not sure whether you’re vaccinated, check with your primary care provider. The pediatrics academy and the CDC recommend that children get vaccinated with measles, mumps, and rubella (MMR) starting at ages 12 to 15 months with a second dose given at ages 4 through 6. Teens and adults should also be up to date on their vaccinations. For those ages 66 and older, a vaccine is not necessary because nearly everyone born before 1957 was infected with the virus and has natural immunity. The vaccine is highly effective and safe, with just one dose providing 93% lifetime protection and two doses providing 97% protection.
People considering Florida travel who are unvaccinated may want to get vaccinated before their trip. “A single shot provides protection almost immediately and full protection within weeks,” Iovine said.
But if your child is too young to be vaccinated, or you or a family member has a compromised immune system, “you should be extremely cautious when planning a trip to any state with reported measles cases,” said Higgins.
Parents and others traveling to Florida with young kids might consider getting their child vaccinated early, said David Nguyen, MD, an internal medicine and pediatrics infectious disease doctor at Rush University Medical Center in Chicago. Before they're 6 months old, babies are generally thought to have some immunity to measles if their mother was immunized. But getting the vaccine as early as 6 months is safe. It’s usually recommended at age 1 only because that’s when it’s thought to work the best.
But choosing to leave your child unprotected is putting their health at risk, Nguyen said. “If you choose not to vaccinate your kids against measles, they are extremely vulnerable to one of the single most contagious infections in existence.”
Unvaccinated people who get measles face a real risk of hospitalization, with 20% of them diagnosed with serious complications like bronchitis, pneumonia, and encephalitis (swelling of the brain). In fact, the disease still kills 200,000 people annually around the world, most of them children.
“What people don’t realize is that measles can compromise your immune system for weeks to months after contracting it, making you susceptible to many other infections once you recover from the actual disease,” said Nguyen.
Immunocompromised people – who make up 3% of the population and are living with a weakened immune system as a result of certain diseases, cancer treatments, or recent organ transplants – are particularly vulnerable to the measles because they may not tolerate live vaccines like MMR and there are no antiviral therapies for the disease. Higgins suggests speaking with a doctor about your particular level of protection and whether it’s safe to travel to states with reported measles cases.
Nguyen, who treated a measles patient during the Disneyland outbreak in 2015, said that if you’re unvaccinated and considering traveling to tourist hot spots like Disney World in Orlando, it’s worth reconsidering because of the risk of coming across other people who might also be unprotected.
Beyond getting vaccinated, experts say that protecting yourself against the measles is largely futile. Things like washing your hands and wearing a mask are good practice in terms of other respiratory infections like COVID-19, but they won’t protect you from the measles if you’re unvaccinated. Measles is transmitted through droplets when an infected person breathes, coughs, or sneezes. These droplets can remain on surfaces or in the air and cause infection for up to 2 hours.
“Measles is airborne and highly infectious, so really the only way to protect yourself is to get vaccinated,” Iovine said.
If you’re exposed to the measles while traveling to Florida or elsewhere, the disease starts with flu-like symptoms: a fever, congestion, conjunctivitis, and coughing, said Carla Garcia Carreno, MD, medical director for infection prevention and control at Children's Medical Center in Plano, TX. She said that it’s important for patients who fear they’ve contracted the disease to let their doctor know because it's so contagious. The virus can spread days before a rash appears.
Still, according to experts, most of us are safe to visit the Sunshine State. So if you’re vaccinated, it’s OK to pack your bags because while you might bring home a sunburn, you’re unlikely to bring home a case of the measles.