<html xmlns:v="urn:schemas-microsoft-com:vml" xmlns:o="urn:schemas-microsoft-com:office:office" xmlns:w="urn:schemas-microsoft-com:office:word" xmlns:m="http://schemas.microsoft.com/office/2004/12/omml" xmlns="http://www.w3.org/TR/REC-html40">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=Windows-1252">
<meta name="Generator" content="Microsoft Word 15 (filtered medium)">
<!--[if !mso]><style>v\:* {behavior:url(#default#VML);}
o\:* {behavior:url(#default#VML);}
w\:* {behavior:url(#default#VML);}
.shape {behavior:url(#default#VML);}
</style><![endif]--><style><!--
/* Font Definitions */
@font-face
{font-family:Helvetica;
panose-1:0 0 0 0 0 0 0 0 0 0;}
@font-face
{font-family:"Cambria Math";
panose-1:2 4 5 3 5 4 6 3 2 4;}
@font-face
{font-family:Calibri;
panose-1:2 15 5 2 2 2 4 3 2 4;}
@font-face
{font-family:"Brush Script MT";
panose-1:3 6 8 2 4 4 6 7 3 4;}
@font-face
{font-family:"\@Brush Script MT";}
@font-face
{font-family:Times;
panose-1:0 0 5 0 0 0 0 2 0 0;}
@font-face
{font-family:"Times New Roman \(Body CS\)";
panose-1:2 11 6 4 2 2 2 2 2 4;}
/* Style Definitions */
p.MsoNormal, li.MsoNormal, div.MsoNormal
{margin:0in;
font-size:12.0pt;
font-family:"Calibri",sans-serif;}
a:link, span.MsoHyperlink
{mso-style-priority:99;
color:#0563C1;
text-decoration:underline;}
span.EmailStyle17
{mso-style-type:personal-compose;
font-family:"Calibri",sans-serif;
color:windowtext;}
p.p1, li.p1, div.p1
{mso-style-name:p1;
margin-top:4.6pt;
margin-right:0in;
margin-bottom:0in;
margin-left:0in;
font-size:7.5pt;
font-family:Times;}
p.p2, li.p2, div.p2
{mso-style-name:p2;
margin:0in;
font-size:7.5pt;
font-family:Times;}
p.p3, li.p3, div.p3
{mso-style-name:p3;
margin-top:1.95pt;
margin-right:0in;
margin-bottom:0in;
margin-left:197.85pt;
font-size:7.5pt;
font-family:Helvetica;
color:#33414F;}
p.p4, li.p4, div.p4
{mso-style-name:p4;
margin-top:4.35pt;
margin-right:0in;
margin-bottom:0in;
margin-left:197.85pt;
font-size:7.5pt;
font-family:Helvetica;
color:#33414F;}
p.p5, li.p5, div.p5
{mso-style-name:p5;
margin-top:4.3pt;
margin-right:0in;
margin-bottom:0in;
margin-left:197.85pt;
font-size:7.5pt;
font-family:Helvetica;
color:#33414F;}
p.p6, li.p6, div.p6
{mso-style-name:p6;
margin-top:.4pt;
margin-right:0in;
margin-bottom:0in;
margin-left:0in;
font-size:5.5pt;
font-family:Helvetica;}
p.p7, li.p7, div.p7
{mso-style-name:p7;
margin-top:0in;
margin-right:0in;
margin-bottom:0in;
margin-left:3.75pt;
font-size:7.5pt;
font-family:Helvetica;}
p.p8, li.p8, div.p8
{mso-style-name:p8;
margin-top:2.35pt;
margin-right:0in;
margin-bottom:0in;
margin-left:0in;
font-size:7.5pt;
font-family:Helvetica;}
p.p9, li.p9, div.p9
{mso-style-name:p9;
margin-top:.6pt;
margin-right:0in;
margin-bottom:0in;
margin-left:14.7pt;
font-size:8.5pt;
font-family:"Calibri",sans-serif;}
p.p10, li.p10, div.p10
{mso-style-name:p10;
margin-top:0in;
margin-right:0in;
margin-bottom:0in;
margin-left:14.7pt;
font-size:8.5pt;
font-family:"Calibri",sans-serif;}
p.p11, li.p11, div.p11
{mso-style-name:p11;
margin-top:.1pt;
margin-right:0in;
margin-bottom:0in;
margin-left:14.7pt;
text-indent:28.9pt;
font-size:8.5pt;
font-family:"Calibri",sans-serif;}
p.p12, li.p12, div.p12
{mso-style-name:p12;
margin-top:.1pt;
margin-right:0in;
margin-bottom:0in;
margin-left:14.7pt;
font-size:8.5pt;
font-family:"Calibri",sans-serif;}
p.p13, li.p13, div.p13
{mso-style-name:p13;
margin:0in;
font-size:8.5pt;
font-family:"Calibri",sans-serif;}
span.s1
{mso-style-name:s1;
letter-spacing:3.0pt;}
span.s3
{mso-style-name:s3;
letter-spacing:-.1pt;}
span.s4
{mso-style-name:s4;
letter-spacing:-.15pt;}
span.s5
{mso-style-name:s5;
letter-spacing:-.25pt;}
span.s6
{mso-style-name:s6;
color:#467885;
text-decoration:underline;}
span.s7
{mso-style-name:s7;
color:#467885;
letter-spacing:-.1pt;}
span.s8
{mso-style-name:s8;
color:#467885;
letter-spacing:-.1pt;
text-decoration:underline;}
span.s9
{mso-style-name:s9;
color:#467885;
letter-spacing:-.15pt;
text-decoration:underline;}
span.apple-converted-space
{mso-style-name:apple-converted-space;}
.MsoChpDefault
{mso-style-type:export-only;
font-size:12.0pt;
font-family:"Calibri",sans-serif;}
@page WordSection1
{size:8.5in 11.0in;
margin:1.0in 1.0in 1.0in 1.0in;}
div.WordSection1
{page:WordSection1;}
--></style>
</head>
<body lang="EN-US" link="#0563C1" vlink="#954F72" style="word-wrap:break-word">
<div class="WordSection1">
<p class="p1"><img width="885" height="329" style="width:9.2187in;height:3.427in" id="Picture_x0020_2" src="cid:image002.png@01DB8C90.823210A0"><o:p></o:p></p>
<p class="p2"><o:p> </o:p></p>
<p class="p3"><b>JOSH STEIN • </b>Governor<o:p></o:p></p>
<p class="p4"><b>DEVDUTTA SANGVAI • </b>Secretary<o:p></o:p></p>
<p class="p5"><b>KAREN BURKES • </b>Acting Deputy Secretary for Health<o:p></o:p></p>
<p class="p4"><b>KELLY KIMPLE • </b>Acting Director, Division of Public Heal<o:p></o:p></p>
<p class="p6"><o:p> </o:p></p>
<p class="p7"><o:p> </o:p></p>
<p class="p8"><o:p> </o:p></p>
<p class="p9">To:<span class="s1"> </span><span class="apple-converted-space"><span style="letter-spacing:3.0pt">
</span></span>North Carolina Clinicians<o:p></o:p></p>
<p class="p10">From:<span class="apple-converted-space"><span style="letter-spacing:1.5pt">
</span></span>Zack Moore, MD, MPH, State Epidemiologist<o:p></o:p></p>
<p class="p11">Carrie Blanchard, PharmD,<span class="s3"> </span>MPH, Director, Immunization Branch Subject: Increase in Measles Cases in the United States (3 pages)<o:p></o:p></p>
<p class="p12">Date:<span class="apple-converted-space"><span style="letter-spacing:3.0pt">
</span></span>March 3, 2025<o:p></o:p></p>
<p class="p13"><o:p> </o:p></p>
<p class="p10"><span class="s3"><b>Background</b></span><o:p></o:p></p>
<p class="p10">This memo is intended as a reminder for North Carolina clinicians about measles reporting, testing, and vaccination, given recent increased<span class="s3">
</span>measles activity in<span class="s3"> </span>the United<span class="s3"> </span>
States and globally.<o:p></o:p></p>
<p class="p13"><o:p> </o:p></p>
<p class="p12">According<span class="s4"> </span>to<span class="s3"> </span>the<span class="s3">
</span>Centers<span class="s3"> </span>for<span class="s3"> </span>Disease<span class="s3">
</span>Control<span class="s4"> </span>and<span class="s4"> </span>Prevention<span class="s4">
</span>(CDC),<span class="s4"> </span>164<span class="s4"> </span>cases<span class="s4">
</span>of<span class="s5"> </span>measles<span class="s3"> </span>have<span class="s4">
</span>been<span class="s4"> </span>reported<span class="s3"> </span>from<span class="s3">
</span>nine<span class="s4"> </span>jurisdictions<span class="s3"> </span>in<span class="s4">
</span>2025<span class="s3"> </span>as<span class="s4"> </span>of<span class="s4">
</span>February<span class="s4"> </span>28,<span class="s4"> </span>2025,<span class="s3">
</span>including<span class="s3"> </span>recent<span class="s4"> </span>outbreaks<span class="s3">
</span>in<span class="s3"> <a href="https://www.dshs.texas.gov/news-alerts/measles-outbreak-feb-21-2025">
<span class="s6">Texas</span></a></span><span class="s7"> </span>and<span class="s4">
<a href="https://www.nmhealth.org/about/erd/ideb/mog/"><span class="s6">New</span><span class="s8">
</span><span class="s6">Mexico</span></a></span>.<span class="s3"> </span>There<span class="s3">
</span>has<span class="s3"> </span>been<span class="s4"> </span>one<span class="s4">
</span>death<span class="s4"> </span>associated<span class="s4"> </span>with<span class="s4">
</span>the<span class="s4"> </span>Texas<span class="s4"> </span>outbreak.<span class="s3">
</span>According<span class="s4"> </span>to<span class="s3"> </span>the<span class="s4">
</span>World<span class="s4"> </span>Health<span class="s4"> </span>Organization<span class="s3">
</span>(WHO)<span class="s3"> </span>an<span class="s4"> </span>estimated<span class="s4">
</span>107,500<span class="s3"> </span>people<span class="s4"> </span>died<span class="s4">
</span>from<span class="s4"> </span>measles<span class="s3"> </span>in<span class="s4">
</span>2023,<span class="s4"> </span>mostly<span class="s3"> </span>under<span class="s4">
</span>or<span class="s4"> </span>unvaccinated<span class="s4"> </span>children<span class="s4">
</span>under<span class="s3"> </span>the<span class="s3"> </span>age<span class="s4">
</span>of<span class="s3"> </span>five<span class="s4"> </span>years.<span class="s3">
</span>A<span class="s4"> </span>total<span class="s3"> </span>of<span class="s4">
</span>285<span class="s4"> </span>measles<span class="s3"> </span>cases<span class="s4">
</span>were<span class="s3"> </span>reported<span class="s4"> </span>in<span class="s4">
</span>the<span class="s3"> </span>U.S.<span class="s3"> </span>in<span class="s4">
</span>2024<span class="s3"> </span>from<span class="s4"> </span>33<span class="s3">
</span>jurisdictions<span class="s3"> </span>including<span class="s3"> <a href="https://www.ncdhhs.gov/news/press-releases/2024/09/09/first-measles-case-north-carolina-2018-ncdhhs-urging-vaccinations">
<span class="s6">one</span><span class="s8"> </span><span class="s6">case</span><span class="s9">
</span><span class="s6">in</span><span class="s9"> </span><span class="s6">North</span><span class="s9">
</span><span class="s6">Carolina</span>.</a></span><o:p></o:p></p>
<p class="MsoNormal"><span style="font-size:11.0pt"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt">Please see above “</span><span style="font-size:18.0pt">When the world comes to us”<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:18.0pt"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:18.0pt;font-family:"Brush Script MT";color:#4472C4">Dr. Joe<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt">Joseph D. Cacioppo DO<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt">Chair Community and Global Health<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt">Associate Professor Emergency Medicine<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt">Campbell University, J.M. Wallace School of Osteopathic Medicine-- <o:p></o:p></span></p>
<div>
<p class="MsoNormal"><span style="font-size:11.0pt"><img border="0" width="386" height="47" style="width:4.0208in;height:.4895in" id="Picture_x0020_1" src="cid:image001.png@01DB8C90.792F3DC0" alt="signature_4139245690"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:black">CONFIDENTIALITY NOTICE: This e-mail, including any attachments, is intended for the sole use of the addressee(s) and may contain legally privileged and/or confidential information. If you are
not the intended recipient, you are hereby notified that any use, dissemination, copying or retention of this e-mail or the information contained herein is strictly prohibited. If you have received this e-mail in error, please immediately notify the sender
by telephone or reply by e-mail, and permanently delete this e-mail from your computer system. There is no intent on the part of the sender to waive any privilege, including the attorney-client privilege, that may attach to this communication. Thank you.
IF YOU HAVE RECEIVED THIS IN ERROR, PLEASE CALL ME IMMEDIATELY AT 910-814-4973.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:black"> <o:p></o:p></span></p>
</div>
<p class="MsoNormal"><o:p> </o:p></p>
</div>
</body>
</html>