The West Virginia Department of Health yesterday announced the state's first measles case since 2009, which involves a patient from Monongalia County who was unvaccinated and had recently traveled internationally.

Officials said an investigation and contact tracing are under way. 

The case is part of a global and national rise in measles activity this year. In its latest update, the US Centers for Disease Control and Prevention (CDC) said it has received reports of 125 cases this year from 18 jurisdictions, up sharply from 2023.

England's measles cases highest in a decade

The UK Health Security Agency (HSA) said today that measles cases in England are at their highest level in a decade, and it urged people to ensure that they and their loved ones are up to date with the measles, mumps, and rubella (MMR) immunization.

We know some communities in London have very low MMR vaccination rates.

In the latest surveillance update, Vanessa Saliba, an HSA consultant epidemiologist, said numbers are rising across the country, especially in London in recent weeks. "We know some communities in London have very low MMR vaccination rates," she said. "Measles is extremely infectious and it only takes one case to get into these communities for this disease to spread rapidly, especially in schools and nurseries."

Undernourished household members are at triple the risk of developing tuberculosis (TB) disease after exposure, but not necessarily increased risk of infection with Mycobacterium tuberculosis, the bacterium that causes TB, according to a study today in Clinical Infectious Diseases. 

The study, based on body mass index (BMI), was conducted among household contacts (HHCs) of people with TB diagnosed within 2 months of the study date. The study took place in India, which had roughly 25% of the world's TB cases in 2022 and a high prevalence of undernutrition.

Of the 857 HHCs enrolled, 239 (27.9%) had a BMI of 18.5 kilograms per meter of height squared or less, which is considered underweight. The median age was 29 years, and 59% of contacts were female. The average follow-up time was 24 months. 

All cases linked to severe undernutrition

There were 18 new TB cases during follow-up, the authors said, and 10 cases were among contacts with a BMI of 18.5 or less. Four participants in the study developed early TB disease, all of whom were severely malnourished, with a BMI of less than 16, and 4 cases were excluded because they occurred within 1 week of enrollment and within 2 weeks of the index patients' diagnosis.

The researchers estimated a hazard ratio of 3.16 (95% confidence interval, 1.25 to 8.02) for TB disease in undernourished household contacts.

"The insight that undernourished individuals are at increased risk of progression, not infection is crucial for developing and refining transmission models of TB and for targeting interventions to mitigate the impact of undernutrition on the TB pandemic," concluded the authors.

The insight that undernourished individuals are at increased risk of progression, not infection is crucial for developing and refining transmission models of TB. 

"Our findings should prompt TB programs to promptly provide adequate rations for the entire household to prevent TB disease among household contacts in addition to TB preventive therapy," said first author Pranay Sinha, MD, assistant professor of medicine at Boston University, in a university news release.