Getting a Wake-up Call – Local Measles Case Puts an Infectious Disease Back in the Spotlight

Sometimes it takes something to hit close to home before people sit up and take notice.
At one time, measles was a common childhood disease, with most contracting the illness before age 20. Thanks to the advent of a vaccine in 1963, the number of cases in the United States dropped to almost zero by the year 2000.
Now, for quite some time, we have been hearing about sporadic outbreaks of measles around the country. In the past month alone, 25 cases of measles have been reported in New York City, and 21 in Orange County, Calif., where the Orange County Health Department is calling it the worst outbreak in 20 years.
Closer to home, there were two cases of measles in Fairfield County, Conn., along with two in Middlesex County, Mass. So, it seemed only a matter of time before a case of the highly infectious virus would eventually be reported locally, which occurred in early April here in Springfield.
On average, about 60 cases of measles occur in the United States every year. That number rose sharply last year when 189 people were found to have the disease, and already this year there have been some 112 cases confirmed. According to the Centers for Disease Control (CDC), about one-quarter of those 189 people got measles in other countries, bringing the disease home with them and spreading it to others.
What is Measles?
Measles is an infectious disease caused by a virus that normally grows in the cells that line the back of the throat and lungs. It can sometimes lead to serious health problems, and is one of the leading causes of death among young children around the world. The disease is very easily spread through coughing, sneezing, or sharing food or beverages with another person. Because the disease travels through the air, you can get the measles even if the person with the virus doesn’t cough or sneeze directly on you. While there is no treatment for measles, the measles-mumps-rubella (MMR) vaccine can prevent it.
What Are the Symptoms and How Serious Is the Illness?
Symptoms of measles occur 10 days to two weeks after exposure, and may resemble a cold (with fever, cough, runny nose, and red eyes), but a rash occurs on the skin two to four days after the initial symptoms develop. The rash usually appears first on the head and moves downward. The rash typically lasts a few days and then disappears in the same order. Otherwise healthy people who get measles may be contagious up to four days before the rash appears until four days after the day the rash appears.
For school-age children, measles infection typically causes problems including pneumonia, croup, and diarrhea. Brain damage, resulting from a condition called encephalitis, occurs in 1 out of every 1,000 cases. Children less than five years of age are at the highest risk for developing this condition. They are also at the most risk for developing severe breathing difficulties leading to hospitalization or death. As the risk of these complications is highest in children less than five years old, it is extremely important that children receive their MMR vaccines at the recommended ages.
What happens when adults get measles?
Measles infections in otherwise healthy adults can cause a number of the same problems seen in healthy school-age children, including pneumonia and diarrhea. According to the CDC, measles infections in pregnant women can result in higher numbers of miscarriages, premature labor, and low-birthweight infants. Similar to children less than five years of age, adults with weakened immune systems are at increased risk for complications, including severe breathing difficulties, brain damage, or even death.
Why Are We Seeing These Spikes in Measles Around the Country?
The main reason we are seeing an increase in cases today is the fact that some parents refuse to have their children vaccinated because of the unfounded claim that the very safe MMR vaccine can cause autism. Unfortunately, erroneous research reported in the British journal Lancet in 1998 brought international attention to the subject through a study that suggested a link between vaccines and autism. The flawed study was retracted in 2010, but by that time the damage had been done — with many high-profile celebrities and others speaking out against immunization — causing many to lose confidence in this highly safe vaccine.
What Are the Vaccine Recommendations?
People who were born before 1957, have had measles in the past, or who have been vaccinated against measles in accordance with CDC recommendations are considered immune. The CDC recommendations are:
Children should receive their first dose of Measles-Mumps-Rubella (MMR) vaccine between the ages of 12-15 months. School-aged children need two doses of MMR vaccine, and the second dose should be given between the ages of 4-6 years;
Adults should have at least one dose of MMR vaccine. Certain groups at high risk need two doses of MMR, such as international travelers, health care workers, and college students. Adults born in the U.S. before 1957 are considered to be immune to measles from past exposures.
According to CDC officials, more than 95{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of those who received a first dose of the MMR vaccine develop immunity to the disease, while a second dose gives immunity to nearly all who don’t respond to the initial dose.
Since we know that measles is not going away anytime soon, and that this virus has now arrived in Western Mass., now is the perfect time for you and your children to get vaccinated. There is only one way to prevent the development of any major problems associated with the measles virus in you or your loved ones – by protecting yourself from being able to get measles in the first place. And, you will not only be protecting yourselves when you get the vaccine, but the community in which you live.
The Massachusetts Department of Public Health produced the following fact sheet on measles: http://www.mass.gov/eohhs/docs/dph/cdc/factsheets/measles.pdf. Anyone with concerns should call their healthcare provider.
For more information on Baystate Children’s Hospital, visit baystatehealth.org/bch.
Dr. J. Michael Klatte is a pediatric infectious disease specialist at Baystate Children’s Hospital.