Measles cases are already in four districts of São Paulo

Of the total, six occurred in women and five in men, aged between five months and 53 years.

The majority involve babies under one year of age, who do not yet have an indication for vaccination according to the current calendar. Two other cases occurred in one-year-old children.

Of the adults affected by the disease, only one had a complete vaccination schedule, two were not vaccinated and one had received only one dose of the triple virus (measles, mumps and rubella).

The first two cases, with symptoms starting in February and March, were classified as imported - one from Bolivia and the other from Guatemala.

The remaining cases, identified between June and July, presented the D8 genotype, compatible with the lineage currently predominant in the Americas.

According to the Department of Health, epidemiological investigations continue. The ministry states that it is permanently maintaining actions to intensify vaccination with the MMR, in accordance with the guidelines of the PNI (National Immunization Program) and epidemiological surveillance strategies.

"Measles is returning", says infectious disease specialist Thaís Guimarães, member of the board of directors of SBI (Sociedade Paulista de Infectologia). For the specialist, the return of the disease was expected due to school holidays and trips to the World Cup.

"Regardless of travel to the Northern Hemisphere, cases are occurring in unvaccinated people. The case that traveled abroad is imported. From the moment this case passes to a person who has not traveled, it is a secondary case, which is already autochthonous. Measles is one of the infectious diseases with the highest rate of secondary transmission", explains the doctor.

The disease is respiratory transmitted. According to Thaís Guimarães, one person is capable of transmitting it to nine others. Infectious viral particles remain in suspension, in aerosols.

"The virus stays in the sick person's oropharynx. Coughing, runny nose and conjunctivitis are frequent signs of measles. When the person coughs, they expel these aerosols that contain the measles virus that remain in the air. Anyone who is in the same environment as this patient, if they are not vaccinated, could become infected", he warns.

In November 2024, PAHO (Pan American Health Organization) recertified Brazil for the elimination of measles, rubella and congenital rubella syndrome. It was the second time that Brazil received the certificate for eradicating the disease. The first had been delivered in 2016, but lost in 2018 after factors such as migratory flow from neighboring countries, reintroduction of the virus in Brazil and new outbreaks.

Certification may be lost again after one year of sustained transmission of the disease. The most effective way to stop the increase in measles cases is vaccination.

"We have measles again due to low vaccination coverage. Of course, there are other measures to prevent transmission, such as, for example, isolating the patient during the contagious phase. But measles can be transmissible even before the little red spots appear, so the person is transmitting it without having signs of the disease yet. Only vaccination is capable of containing the spread", reinforces the infectious disease specialist.

The São Paulo State Department of Health recommends the application of a zero dose of MMR for babies who are between 6 months and 11 months and 29 days old and who live in São Paulo, Guarulhos and São Bernardo do Campo, in ABC.

In Guarulhos, the recommendation is due to its proximity to São Paulo and the daily flow of trips to the capital and the airport.

The city of São Bernardo do Campo confirmed two cases of people who had contact with an infected person in the capital of São Paulo. Patient profiles were not provided.

The zero dose does not replace the routine schedule provided for in the National Vaccination Calendar. Even children who receive it need to take the first dose of triple viral at 12 months, and the second, preferably with the tetraviral, at 15 months.

WHO SHOULD GET VACCINATED AGAINST MEASLES

Zero dose

Children aged 6 months to 11 months and 29 days living in the municipalities of São Paulo, São Bernardo do Campo and Guarulhos.

Routine

The vaccination schedule recommended by the Ministry of Health provides for two doses: the first at 12 months, with the triple viral vaccine (measles, mumps and rubella), and the second at 15 months, with the tetraviral vaccine (which includes chickenpox).

People aged 1 to 29 should have two doses of the triple virus, while adults aged 30 to 59 should have at least one. Healthcare professionals need to prove two doses regardless of age.

Data from the Ministry of Health show that MMR vaccination coverage in the capital of São Paulo (until June 1st) is 48.65% in the first dose and 44.17% in the second. The goal is to immunize at least 95% of the target audience.

The United States is experiencing its worst measles outbreak in three decades. The increase is also attributed to reluctance to get vaccinated.

"It's a parallel. In this anti-vax fad, due to countless problems, they are living with the outbreak. That's why we're concerned. The World Cup games were in the United States, Mexico and Canada, where major measles epidemics are being reported. We don't want that to happen here", concludes the doctor.

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