How Today's Measles Outbreak Compares To Another In NYC In The Early '90s

The nationwide measles outbreak is the largest in recent memory. But back in the early 1990s, thousands of people, mostly in large cities, got measles and nearly 100 died.

ARI SHAPIRO, HOST:

The measles continues to spread throughout the country. Last week saw 75 more cases of the disease, bringing the total to 839 so far this year. They're spread across a lot of the U.S., but about half of these cases are in New York City. The last time New York had a big outbreak of the measles was in the early 1990s, when the circumstances were very different. WNYC's Gwynne Hogan has this look-back.

(SOUNDBITE OF SONG, "STEP BY STEP")

NEW KIDS ON THE BLOCK: (Singing) Step by step...

GWYNNE HOGAN, BYLINE: In the summer of 1990, New Kids On The Block were at the top of the charts, and New York City was in the middle of a massive measles outbreak.

IRWIN REDLENER: Children were dying.

HOGAN: That's Dr. Irwin Redlener. A few years earlier, he'd founded the Children's Health Fund to bring health care to New York City's poorest areas.

REDLENER: It was like all hands on deck. It was really - the city, the not-for-profit organizations were all focused on the same mission with the enthusiasm of parents.

HOGAN: The outbreak hit poor black and Latino communities the hardest - Central Brooklyn, Upper Manhattan and the South Bronx. According to news reports then, the courts halted criminal proceedings when inmates at Rikers Island, the city's notorious jail, got sick. There were outbreaks on college campuses and in homeless shelters. Redlener says one defunct hotel turned into a shelter was so overcrowded it was an outbreak waiting to happen.

REDLENER: The conditions in the hotel and the lack of access to care, you have basically set up a scenario that is very conducive to the spread of a disease like measles.

HOGAN: The outbreak continued that fall, into the next year and through the summer of 1991. By the end, there were more than 5,000 cases and at least 21 deaths. It wasn't just New York City either, but also Chicago, Los Angeles, Houston, Philadelphia. According to the CDC, almost 100 people died across the country, the highest number in more than a decade. Why? One reason had to do with President Ronald Reagan's budget cutbacks that had started a decade earlier.

(SOUNDBITE OF ARCHIVED RECORDING)

RONALD REAGAN: This plan is aimed at reducing the growth in government spending and taxing.

HOGAN: Immunization rates peaked during Reagan's early years in office and declined as he slashed the federal budget, which produced funding for immunizations among other health services. By the time the outbreak hit in the '90s, the CDC estimated that about half of all inner-city toddlers had not been vaccinated. Without access to preventative care, kids who got really sick with measles ended up in the hospital.

JOEL FORMAN: A lot of kids with measles and pneumonia, measles and croup.

HOGAN: That's Dr. Joel Forman, who was just starting his pediatric residency at Mount Sinai Hospital in New York in 1990. Years later, one of Dr. Forman's patients died from an extremely rare complication from measles called subacute sclerosing panencephalitis.

FORMAN: When he first was sick with measles, he was 7 months. I remember that. And then he recovered uneventfully, and only presented again years later with a lethal complication.

HOGAN: In the summer of 1991, the city and state redoubled their efforts. One immunization drive featured Michelangelo from the Teenage Mutant Ninja Turtles...

(SOUNDBITE OF MUSIC)

UNIDENTIFIED PEOPLE: (Singing) Teenage Mutant Ninja Turtles. Teenage...

HOGAN: ...Who emerged from a sewer at the South Street Seaport to encourage kids to get the vaccine. Shots were given to kids at parks and beaches and outdoor concerts, including one featuring Latin jazz icon Tito Puente.

(SOUNDBITE OF TITO PUENTE PERFORMANCE)

HOGAN: All the efforts eventually paid off. The outbreak petered out. On the federal level, things were changing, too. In 1993, newly elected President Bill Clinton pledged to raise childhood immunization rates.

(SOUNDBITE OF ARCHIVED RECORDING)

BILL CLINTON: In fact, the $300 million in our stimulus program will help us to immunize 1 million children this summer and to show that this is a campaign of words and deeds.

HOGAN: Over the next few years, federal funding increased sevenfold. Measles vaccination rates climbed above 90%, where they've remained. The idea of a booster shot caught on. Now, the current measles outbreak is much smaller than the one 30 years ago, and the reasons behind it are very different. Here's Dr. Redlener again.

REDLENER: Then, it was people who couldn't get access to health care.

HOGAN: But everyone has access to vaccines now. What's changed is that misinformation about vaccine safety has led some parents to opt out for their kids. For NPR News, I'm Gwynne Hogan in New York.

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