What’s going on?

Every time you turn on the news, it seems that the measles outbreak is continuing to spread at an alarming rate as more people are being infected across the country. Why is this happening? How bad are measles to have? Should you be concerned? What can you do?


0527 Measles Outbreak TNMeasles, or rubeola, is a highly contagious virus and is still common in some parts of the world. The first description of measles differentiating it from smallpox and chickenpox came from the Persian physician Rhazes, who lived from 860 to 932. It’s estimated that between 1855 and 2005, measles has killed about 200 million people worldwide. As of last year, measles remains the leading cause of vaccine-preventable deaths in the world, killing more than 100,000 people a year with most being under the age of 5. The first year the Center for Disease Control (CDC) starting tracking the number of measles cases in the US was 1942. From then until 1962, about half a million new cases were reported every year. Since most cases weren’t reported, the CDC estimates that up to 4 million people actually caught it every year. Starting in 1963, that changed because the measles, mumps and rubella (MMR) vaccine was available and the number of measles cases started plummeting. Before the MMR vaccine, almost every American child contracted measles. There was a resurgence in the number of cases during the late 1980s and early 1990s, which led health officials to recommend babies get two doses of the MMR shot instead of the previously recommended one. This resurgence also made them realize that some children weren’t getting vaccinated because they were uninsured or underinsured and their parents couldn’t afford it. This led to the creation of the Vaccines for Children Program in 1993 that permits children whose families can’t afford vaccines to get them for free. Due to these changes, the CDC declared measles eliminated from the US in 2000, which means the disease was no longer a constant presence within the population, even though outbreaks would still happen via travelers coming from countries where measles are still common. As a result, people no longer saw the measles as a threat. So, more parents haven’t vaccinated their children against it, even though health officials stress immunizations are the best form of protection against the measles. Recently there has been an upsurge in the number of cases. The World Health Organization (WHO) stated that there has been a 300% increase in the number of cases in the first three months of this year compared with the same time last year. The CDC has confirmed 940 new cases in 26 states have occurred so far this year with the majority of them being unvaccinated children. It’s important to know that because of the highly contagious nature of measles, an outbreak of geographically related cases isn’t considered over until 42 days, or two back-to-back 21-day incubation periods, has gone by without any new cases being reported in that area.

Despite health officials’ recommendations, why are more parents not vaccinating their children against measles? There are several reasons. One idea is the concept of “herd immunity.” This means that if everyone around you is vaccinated, they have a lower chance of getting the disease. So, if the majority of people don’t get the disease due to being vaccinated, then you won’t get the disease regardless of not being vaccinated. The problem is that the number of people avoiding vaccines has gotten out of hand, which means the “herd” isn’t protected. The other big reason is that British physician Dr. Andrew Wakefield released a study in 1998 that claimed the MMR vaccine caused autism. This study has since been withdrawn, but it’s largely credited with giving birth to the anti-vaxx movement. Since Dr. Wakefield’s report, 18 studies from seven different countries have proven that children who receive the MMR vaccine are at no greater risk of getting autism than those who don’t receive it, but the fear still exists.

In order to prevent yourself or those you care about from contracting the measles, it’s important to know how the virus functions, what the symptoms are, any complications and who’s at high risk. Measles viruses can linger in the air for up to two hours. While this is normal, the rate of infection is high. For instance, if someone has the flu, they might infect one or two other people. If someone has the measles, the average number of people they infect is 18. The symptoms of a measles infection appears around 10 to 14 days after you’ve been expose and typically starts with a mild to moderate fever, often accompanied by a persistent dry cough, runny nose, inflamed eyes (conjunctivitis), sore throat and tiny white spots with bluish-white centers on a red background found inside the mouth on the inner lining of the cheek (Koplik’s spots). This part of the illness may only last two or three days. The well-known rash appears next and consists of small red spots, some are slightly raised, giving the skin a splotchy red appearance. Usually, your face breaks out first and, over the next few days, the rash spreads down the arms and torso, then over the thighs, lower legs and feet. While this is happening, your fever rises sharply, often as high as 104 to 105.8 F. The rash gradually recedes from your face and follows the same path in which it appeared. It’s important to know that a person with measles can spread the virus for about eight days. This period starts four days before the rash appears and ends when the rash has been present for four days. Measles can lead to severe complications like pneumonia, middle ear infections that can result in hearing loss, loss of eyesight, problems with your muscles, bronchitis, laryngitis, croup, pneumonia, encephalitis (swelling of your brain tissue), heart issues and death. If a woman is pregnant, measles can cause miscarriage, stillbirth, low birth weight and premature labor. If your immune system is compromised, you’re undergoing chemotherapy, you’ve inherited some form of immunity issue or you’ve been diagnosed with HIV/AIDS, you’re at a higher risk of developing complications from measles.

Unfortunately, there isn’t a specific treatment for the measles because it’s a virus and antibiotics won’t work against it. The goal is to treat the symptoms. This means taking over-the-counter fever reducing medications, such as acetaminophen or ibuprofen. Also, make sure to get plenty of rest and avoid busy activities. Drinking plenty of water, fruit juice and herbal tea will help to replace fluids lost by fever and sweating. To soothe your sore throat and cough, use a humidifier. Some people with measles find bright light bothersome, so keeping the lights low, wearing sunglasses and avoid looking at TV or electronic screens can reduce the discomfort. Sometimes, you might develop a bacterial infection, like pneumonia or an ear infection, so you’ll need an antibiotic to treat it. If someone in your house has measles, there are certain steps you should take to protect your family and friends from contracting it. The infected person shouldn’t interact with other people during the contagious period, which means keeping nonimmunized people, like siblings, away from them. If anyone hasn’t been vaccinated and is at risk of getting the measles, they need to get the MMR vaccine as soon as possible. Anyone is not immunized, including infants, may be given the vaccination within 72 hours of exposure. If the person still develops measles, they usually have milder symptoms and it lasts for a shorter period of time. Pregnant women, infants and people with weakened immune systems who are exposed to the virus may also get an injection of proteins (antibodies) called immune serum globulin. If they are given within six days of exposure, they can prevent measles or make symptoms less severe. If you’ve already had measles, your body has built up its immune system to fight the infection, which means you can’t get it again.

In order to help stop this epidemic from getting worse, the CDC has issued a set of protocols. If you were born before 1957, you were probably exposed to or had the measles at some point in your life and developed immunity, so you’re probably covered. If you were born after 1957 but before 1968, they recommend that you have a blood test done to check your titers, which will show your level of immunity. If your titers are low, it’s most likely due to the fact that the vaccine offered back then wasn’t as strong as the one we have now or you never received the vaccine. What this means is that you need one dose of the current MMR vaccine. The current vaccine is 93% effective after one dose and 97% effective after two. The CDC recommends that babies between 6-11 months get one dose of the MMR vaccine and children 12 months or older get at least two doses with them being given at least 28 days apart. Typically, pediatricians usually give infants the first dose between 12-15 months and the second dose between 4-6 years old. If you’re going to be traveling abroad with your child and they are 6-11 months old, talk with their doctor about getting the measles vaccine earlier. If your child is older and didn’t get the two doses at the recommended times, they may receive the two doses now, but given four weeks apart. The CDC also recommends that you get the vaccine as an adult if you have an increased risk, like attending college, traveling internationally, working in a hospital environment or you don’t have proof of immunity.

Some state and local health officials are concerned enough about the spread of the current measles epidemic that they’ve consulted with the CDC about the possibility of preventing individuals from flying to prevent transmission because there has been a significant increase in the number of investigations of passengers flying with measles. The “do not board” list has been in place since 2007 and is used by the federal government before to prevent an infectious person from flying while sick. It has been used for patients who have tuberculosis and twice before for patients with measles. If state or local health officials are unsuccessful at trying to dissuade a passenger who is sick and contagious from traveling on a plane, they may contact the CDC to request assistance. The agency then verifies that attempts have been made to prevent the individual from traveling and that the person still has flight reservations. Next, the CDC speaks to the airline to arrange for any fees related to canceling the trip to be waved and then, they work with the Department of Homeland Security to place the person on a public health do not board list, which tells the airline not to issue a boarding pass. If a person does travel and it comes to light afterward that they have measles and those that they traveled with could’ve possibly been exposed, the CDC works with the airline to inform the other passengers of the possible exposure. Some states are taking steps to protect their citizens. On May 10, Washington State passed a law, that takes effect in July, that no longer allows parents to claim a “philosophical exemption” to getting the MMR vaccine for schoolchildren. New York state has also followed suit. Some areas are trying to take a proactive approach. At this year’s Indianapolis 500, fans were able to get measles vaccines at the track’s infield medical center.

The measles are a high contagious disease that can cause significant problems for those who contract it. The good news is that there is a solution—the MMR vaccine. We need more people to get the vaccine to reduce the chances of spreading the disease. Considering the fact that the singular report stating the MMR vaccine is unsafe has been proven untrue numerous times and retracted, there isn’t a reason for not getting it.