Le Bonheur expert recommendations in response to local measles cases
UPDATED 4/27/16: The Shelby County Health Department released a list of locations visited by measles patients during times when they were infected and could spread the illness to others. The list is available at www.schdresponse.com. If you or your child were at any of the listed locations during the times specified on the list, that does NOT mean you need to go to the hospital or an emergency department.
The Shelby County Health Department offers step-by-step instructions on what to do if you have been exposed at www.schdresponse.com. If you have questions or concerns about the measles, please call your pediatrician or call the Shelby County Health Department's measles hotline at (901) 222-9299.
So far, six cases of measles have been confirmed in Shelby County. Measles is a highly contagious virus that is spread through the air. The signs of measles include fever with cough, runny nose and red eyes followed by, after a few days, a rash starting on the head and spreading downward.
Le Bonheur Pediatrician in Chief Jon McCullers, MD, explains why this potentially fatal disease is recurring in the United States.
Measles is preventable with the MMR vaccine. The vaccine is very safe and highly effective. A critical mass of people need to be vaccinated in order to create community immunity to the virus and protect those who are unable to receive a vaccine, including infants, pregnant women and immunocompromised individuals. Dr. McCullers explains the importance of the vaccine below.
If you suspect your child has measles, it’s important to call ahead to the hospital or your pediatrician before you go anywhere. Measles can be detected through a simple cheek swab. Children younger than five are more likely to develop serious health complications from the measles, and there’s no way to know in advance the severity of symptoms your child will experience if they contract the virus.
More measles cases have been reported in the last few years compared with previous years, for a multitude of reasons. Le Bonheur Chief of Infectious Disease Sandra Arnold, MD, shares some important information regarding the disease and vaccination below.
A history of measles in the U.S.
Measles used to be a common childhood disease, until the vaccine came along and children were universally vaccinated against it. A measles vaccine was introduced in 1963. In 2000, measles was declared eliminated in the United States.
Since then, the annual number of people reported to have measles ranged from a low of 37 people in 2004 to a high of 667 people in 2014, according to the Centers for Disease Control and Prevention.
About the disease
Measles is an infection caused by a virus that leads to fever, cough, stuffy runny nose and a rash. Measles is so contagious that, when it was common, almost everyone had it by the time they were 20 years old. Most cases are benign.
Common complications include ear infections, pneumonia, croup, and diarrhea. The most common serious complications, encephalitis, or infection and inflammation of the brain, and death occurred in 1-3 of 1000 children. Rarely, a degenerative central nervous system disease characterized by behavior and intellectual deterioration and seizures called subacute sclerosing panenchephalitis (SSPE) can occur in 7-10 years after having measles infection. These complications were most likely to occur in children under 5 and children with depressed immune systems, such as those taking chemotherapy for cancer.
Measles vaccine today
The measles vaccine is now administered along with the vaccine against mumps and rubella (MMR) in a combined injection after a child’s first birthday. Five percent of those vaccinated do not have immunity after the first vaccination, which is why the second MMR is required at 4-6 years of age.
Infants who travel abroad where measles is endemic should be immunized prior to going overseas, but will still require the vaccinations at 1 year and 4-6 years of age.
Why is measles back?
There is no question that the vaccine has been enormously successful in decreasing the incidence of measles and its complications. Complications, such as SSPE, are virtually unheard of in the United States since widespread use of the vaccine.
However, this is being threatened by increasing refusal of the vaccine for philosophical or religious reason.
In 2015, 189 people from 24 states and the District of Columbia were reported to have measles, according to the CDC. In 2014, there were around two dozen outbreaks of measles in the U.S. with a record 667 cases from 27 states. This included a large outbreak of several hundred people in primarily unvaccinated populations in Ohio. There were also many associated cases from a large outbreak in the Philippines. This case number represents a substantial increase from 2013 when there were just fewer than 200 cases.
Most of these cases have occurred in children who have not been vaccinated, those who cannot be vaccinated due to young age or an illness that precludes vaccination and those who have chosen for their children not to be vaccinated.
The importance of the measles vaccine is clear.
Those who are infected are contagious four days before the appearance of the rash. Since the early symptoms are so similar to that of the common cold, infected people often don’t know that they’re infected and can pass it on to others who do not have immunity. This is not limited to those who refuse immunizations, but extends to those who can’t have the vaccine due to age or for medical reasons. Even when the infection is mild, measles results in missed school and work. Please, vaccinate your children against measles to continue protecting them and the community.
For more information about measles: