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For the second week in a row, U.S. health officials added dozens of new reports to the year’s list of confirmed measles cases, bringing the total to 465 — already the highest number in the past five years. It’s another significant milepost on the road to what will probably become a record outbreak after vaccines led to the disease’s “elimination” in the United States. The number of people sickened by the highly contagious, occasionally deadly disease climbed by 78 during the first week of April, as four more states reported their first cases of 2019. Now, measles has been found in more than a third of U.S. states — up and down both coasts, and across the plains, the Midwest and the South — with most of the illnesses occurring in children. (Thebault, 4/8)

Most of the cases involve children, the agency said. And though the cases span 19 states, many are tied to an outbreak among Orthodox Jews in New York City. The twin developments suggest the measles virus, which authorities declared eliminated in the U.S. in 2000, has surged as a result of exposures overseas and then been transmitted among populations that have shunned vaccinations. Health authorities are now trying both to halt the virus’s spread and correct misperceptions about vaccinations. (McKay, West and Abbott, 4/8)

Outbreaks have hit several states, including California, Michigan and New Jersey. New York City accounted for about two-thirds of the U.S. cases reported last week. The Centers for Disease Control and Prevention updated the numbers Monday. Roughly 80% of the cases are age 19 or younger. The CDC recommends that all children get two doses of measles vaccine. It says the vaccine is 97% effective. (Stobbe, 4/8)

Measles symptoms appear roughly seven to 14 days after a person is infected and initially include a high fever, cough, runny nose and conjunctivitis. Tiny white spots, called Koplik spots, typically appear inside the person’s mouth two or three days later, followed by a rash of flat, red spots that most people typically associate with measles. The person’s fever sometimes spikes, and conditions including ear infections, diarrhea and more severe and potentially long-term complications can also emerge. (Abbott, 4/8)

A panel of Missouri lawmakers on Monday considered enacting a ban on discrimination against unvaccinated children, an effort that comes as other states look to increase immunization amid disease outbreaks. Parents testified to lawmakers that their unimmunized children were turned away from daycares and doctors. Republican Rep. Lynn Morris, a pharmacist from southwest Missouri, said parents are being pressured to vaccinate their children. (Ballentine, 4/8)

A ban on unvaccinated children in public places in Rockland County, New York, was put on hold by a state judge on Friday. The controversial ban went into effect late last month in an effort to contain an outbreak of measles that began in October. Nearly 170 cases have been confirmed in the county. Judge Rolf Thorsen scheduled a hearing for April 19 and said the county is temporarily blocked from enforcing the ban. (Sanchez and Almasy, 4/5)

The number of measles cases in the country spiked by nearly 100 in the past week, reaching a high of 465, the Centers for Disease Control and Prevention (CDC) said Monday. This is the second greatest number of cases reported in the U.S. since measles was eliminated in 2000, the agency said. The worst year for measles since then was 2014, when there were 667 cases. (Weixel, 4/8)

In Florida, children have to be vaccinated to attend public or private schools. There are two exceptions: parents can get a doctor to say a vaccine would be medically dangerous, or they can opt out of vaccines on religious grounds. That religious exemption has been granted with greater and greater frequency in the past decade, according to state data reviewed by the Tampa Bay Times. Between 2011 and 2018, religious exemptions shot up each year from about 6,500 students to almost 25,000 — an increase of about 375 percent over those years. (Wilson, 4/8)