The measles outbreak that started at Disneyland continues to spread in California, particularly in Orange County. With the official count now at 51, and with more cases likely, officials are rethinking about whether or not to allow people the option not to get the vaccine.

At least 41 of the people who were infected with the measles virus were not vaccinated. Because measles can be fatal for some people, and because it can be so contagious, the issue of permitting people to make the decision about vaccination is being re-evaluated.

Part of the problem is that some of the same efforts that are required to control Ebola in western Africa are needed to get and keep control of the measles. Once people have been identified as having measles, health officials need to treat them, and track them as they go to various public places. Then those who may have come in contact with them have to be notified of the possible contact.

Health authorities realize that the above tactics to try and control a measles outbreak are certainly costly and time consuming. The key factor that permits measles to spread so fast this time is the fact that people are not vaccinated.

Matt Zahn, who is the medical director of the Epidemiology and Assessment for the Orange County Health Care Agency, has observed that the rate of those who are immunized becomes less as you go from the north to the south. He also shows that there is a connection in economic levels, too, with poorer people having higher vaccination rates than the rich.

Another aspect of the vaccination issue that needs to be considered is that patient zero was a woman who was not vaccinated. She is in her 20’s and became sick while at the Disneyland theme park, on December 28. She went from there by plane to Washington State and stayed there a few days. Then, on January 7, she returned to California.

The advantage of getting the measles vaccine is that it is 99 percent effective, the CDC reports. They also reveal that as many as 90 percent of the unvaccinated people who come within the proximity of someone with the measles will get the infection. The measles virus can survive for up to two hours on a surface.

California may be the largest unvaccinated state, and Orange County is currently ground zero. San Diego County has 13 cases so far, and Los Angeles County has eight. Six more people have been identified as having the measles, and they had never been to Disneyland. Orange County health officials stated that this means there are more cases in the county than are known.