Spotlight: Measles The return of this vaccine-preventable virus

Across the nation, at least 20 states have reported measles cases this spring in a widespread and somewhat unexpected outbreak, according to the Centers for Disease Control. This spring, the Maryland Department of Health confirmed a third measles case in the Pikesville area, and Baltimore-area parents started taking notice, too. In 2000, measles had been declared eliminated in the U.S. due to the effectiveness of routine immunizations, so why has this disease returned?

Spotting the problem
Measles is spread by contact with infected drops of mucus from coughing and sneezing or from touching contaminated surfaces and then touching the mouth, nose or eyes. The virus can even linger in the air for up to two hours after an infected person has been coughing or sneezing.

It usually starts with an acute respiratory illness, with two to four days of fever over 101, cough, runny nose and watery or red eyes. The telltale spots usually follow those earlier symptoms as a flat, red rash that typically develops about eight to 12 days after exposure, starting on the face and then spreading elsewhere on the body. Symptoms most often develop within 10 to 14 days after exposure (though they could be as early as seven days or as late as 21).

A person with measles is extremely contagious from four days before to four days after the rash first appears. The CDC notes that if one person has measles, up to 90 percent of people who come close to that person will contract the disease if they have not established immunity.

No small threat

People might not fear contracting measles because they haven’t personally seen it pose danger in their lifetime. Thanks to the tremendous success of the measles-mumps-rubella (MMR) vaccine, some people assume that it’s no longer a threat or that even if contracted, it’s a mild disease with few complications.

Yet, according to the CDC, measles can commonly bring on ear infections and diarrhea, which can lead to big problems for small children. Further, one in 20 children with measles will contract pneumonia, and one in 1,000 will develop encephalitis. One or two in 1,000 children who get
measles will die from it.

People who are not vaccinated or have not received two doses of vaccine, those with compromised immune systems and pregnant women are most vulnerable, and children under 5 or adults over 20 are more likely to suffer complications from measles.

If you suspect exposure

Healthy people who have received two doses of the MMR vaccine are already protected from measles. But if you may have been exposed to measles and you have not been vaccinated, or are not sure if you’ve received two doses of the MMR vaccine, call your doctor right away.

Do not go in to your doctor’s office or a walk-in clinic without first calling and letting them know you may have been exposed to measles — you could risk the health and safety of everyone in the office. Your doctor will be able to advise you on what to do next. The local health department may be able to arrange for you to have testing at home. You may need additional vaccine administration or immunoglobulin, a medication that can help strengthen your body’s natural defenses for fighting infection.

Not up to date on immunizations?

Consult your doctor if you or your child are not vaccinated or have not yet completed the two-dose schedule. There are also vaccine resources available through the Maryland Department of Health. They’ve even hosted some pop-up free clinics in high-risk areas to distribute immunizations to those in need.

The CDC’s immunization recommendations say that children should get a first dose at age 12 to 15 months and the second at 4 to 6 years. Children younger than six months are not given the MMR vaccine, but in some cases children ages 6 to 12 months may receive a dose early, for example, if a family will be traveling to a place with an active measles outbreak, where there is increased risk of exposure. If a child gets two doses of the MMR vaccine before age 1, a booster may be recommended at age 4.

Vaccines hold the key

“Vaccinating is the best way to keep kids safe,” says Dan Salmon, director of the Institute for Vaccine Safety at the Johns Hopkins Bloomberg School of Public Health. “What we don’t want to happen is what has happened in Europe, where tens of thousands of kids have measles, and kids are dying.”

Salmon stresses the importance of families having a doctor they can turn to with any questions. “Parents should find a pediatrician they can trust and talk to with any concerns,” he says, adding that there really is no more effective way to prevent measles than getting vaccinated according to immunization schedules, with two doses of the MMR vaccine.

“It is 97 percent effective, which means 3 percent are still vulnerable, but that’s a very high rate of effectiveness,” he says. “And the MMR vaccine is very safe. Any side effects are very minor or quite rare.”

Hesitancy and exemptions

“One in three people may be hesitant about vaccines, but only about 1 percent are actually against them,” Salmon says. If you look at legitimate scientific sources, it is nearly impossible to find factual evidence for opposing vaccines. “Pseudo science” is easy to come by, especially online, where it can be hard to tell fact from fiction, he says, but there is so much real, scientific information out there to calm the fears of anyone who is hesitant.

Some people have conditions that necessitate exemption from vaccines. Some individuals refuse vaccinations for religious reasons and Maryland does allow that exemption.

Protect everyone’s children

Barring the truly necessary exceptions, the bottom line is that people who can get vaccinated need to do so, ASAP. Salmon reminds parents to reflect on how “the decision you make affects not just your child, but others.” Consider vulnerable kids who cannot get vaccinated, he says, such as infants or children with leukemia — their safety relies on your choices, too, he says. “What you do impacts not just your child, but other, more vulnerable children.”

Want more info? Check out these additional resources:
Maryland Department of Health:
Institute for Vaccine Safety at Johns Hopkins:
Centers for Disease Control:

About Courtney McGee

Courtney McGee is a freelance writer, cancer warrior, runner/triathlete and compulsive Candy Crusher. She lives in Towson with her husband, their three children and their high-maintenance rescued hound dog.

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