Measles in Tennessee: Why we’re seeing more cases across the country

Measles in Tennessee: Why we’re seeing more cases across the country

More than 700 cases of measles have been confirmed in the United States this year – the most we’ve seen in decades.

Around 70 of those cases occurred in recent weeks, including three confirmed cases in East Tennessee, according to the Centers for Disease Control and Prevention.

This respiratory disease is highly contagious but also preventable with the MMR vaccine.  Here are a few important points about measles we would like parents to know.

What is measles?

Measles is an infection caused by a virus that leads to fever, cough, stuffy runny nose and a rash. The fever usually begins three to seven days before the rash begins to appear. The rash usually starts on the face and moves downward. 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 serious complications are encephalitis, or infection and inflammation of the brain, and death. These complications occur in 1-3 of 1,000 children. Rarely, a degenerative central nervous system disease characterized by behavior and intellectual deterioration and seizures called subacute sclerosing panenchephalitis (SSPE) can occur 7-10 years after having a measles infection. These complications are 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.

However, this is being threatened by increasing refusal of the vaccine for philosophical or religious reason. There is no link between MMR or any other vaccine or vaccine additive to autism.

The CDC, as mentioned above, has already reported the highest number of cases in the U.S. since the disease was declared “eliminated” in 2000.

So far, the high number of cases this year is primarily the result of a few large outbreaks – one in Washington State and two large outbreaks in New York that started in late 2018. The outbreaks in New York are among the largest and longest lasting since measles elimination in 2000. The longer these outbreaks continue, the greater the chance measles will again get a sustained foothold in the United States.

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 number of measles cases reported has decreased by more than 99 percent to 60 cases per year on average. About a third of these are imported from overseas, where measles has not yet been eliminated.

The importance of the measles vaccine is clear.

Those who are infected are contagious for four days before the appearance of a rash. Since the early symptoms are so similar to that of the common cold, infected people often don’t know  and can pass 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.

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.

For more information about measles:

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