This map shows the 25 U.S. counties most at risk for measles outbreaks – MarketWatch

Conditions in Los Angeles, Miami and Queens are ripe for measles outbreaks, according to a new report mapping out the counties most at risk of seeing the once-eradicated disease going viral on their turf.

Researchers at The University of Texas at Austin and Johns Hopkins University identified the 25 U.S. counties that are most at risk of measles outbreaks due to low vaccination rates being compounded by the high volume of international travel in the area. They include West Coast cities such as Los Angeles, San Diego and San Mateo in California; Tarrant, Travis and Harris, Texas; Queens, N.Y.; Essex, N.J.; and Miami-Dade, Hillsborough, Broward and Orange counties in Florida. Utah’s Salt Lake and Colorado’s Denver counties also made the list, as did Suffolk, Mass. and King, Wash.

But while some of the most at-risk areas near international airports, such as Travis County in Texas, Honolulu County, Salt Lake County and multiple counties in Florida, haven’t reported measles cases yet, the researchers warn that it is only a matter of time.

Travel from countries such as India, China, Mexico, Japan, Ukraine, Philippines and Thailand poses the greatest measles risk, according to the report. And the U.S. has already seen measles cases in travelers from Ukraine, Philippines and Thailand.

What’s more, the team’s measles risk analysis correctly predicted the major outbreaks that have been reported in the Pacific Northwest, Los Angeles and New York this year, while 30 of the 45 counties that have reported measles cases to the Centers for Disease Control and Prevention are also on the list, or they are adjacent to a county included on the list. The CDC reported Monday that more than 800 measles cases have been confirmed across 23 states — the most in more than 25 years — with the majority of cases among unvaccinated people in Orthodox Jewish communities in New York.

“We have long known that vaccine avoidance is a critical public health issue in the U.S. and Europe. Our results show how travel from regions elsewhere compounds this risk,” said the study’s lead author, UT Austin’s Sahotra Sarkar, in a statement. Sarkar also warned that, “for the first time since the 1980s, we may expect infant deaths from measles in the U.S.”

Measles was declared eradicated in the U.S. in 2000, but declining vaccination rates have spurred a resurgence in the highly contagious virus, according to Unicef (which has reported a 300% spike in global measles cases over last year) and the CDC. “The measles virus will always find unvaccinated children,” Unicef’s executive director recently warned.

Pockets of unvaccinated children have risen as the proportion of young kids who aren’t getting inoculations like the MMR (measles, mumps and rubella) vaccine has roughly quadrupled over the past 15 years, according to the CDC. Approximately 110,000 people died from measles in 2017, according to the World Health Organization, and most were children under five.

The health crisis has become a political issue. President Trump recently declared that people ‘have to get the shots’ to stop measles outbreaks, and Robert F. Kennedy Jr.’s siblings and niece recently penned an op-ed calling him out for helping to “spread dangerous misinformation” about vaccines.