Monday, April 9, 2018

Measles: Once Gone, Its Threat Has Returned

You may not have seen it or know anyone who has had it, but measles is a looming threat, especially for children who are not vaccinated. Measles — declared eliminated in the United States in 2000 thanks to vaccines — has returned to Texas and other areas. Physicians say the shot to prevent measles is the best defense against it. Unfortunately, declining vaccination rates have allowed the disease to return.

Measles is a virus that travels by direct contact or through the air. It is so contagious a person can catch measles just by walking into a room where a measles patient had been present and then left two hours earlier.

You don’t want to get this,” said Jason Terk, MD, a Keller pediatrician and member of Texas Medical Association’s (TMA’s) Be Wise — ImmunizeSM Physician Advisory Panel. “Besides making a child miserable during the illness, measles can lead to very severe complications like measles pneumonia, and brain inflammation that can appear years later.”

For some children, measles can be fatal.

Symptoms, which typically last seven to 10 days, start with a fever, followed by a cough, runny nose, and red eyes. About three to five days later, a person with measles will develop a rash that starts on his or her head and travels to the rest of the body. Someone with the disease can be contagious for up to four days before a rash appears — possibly before knowing he or she has measles. People with measles also are contagious after the rash appears.

Doctors can treat only the symptoms, not the illness. Treatment can include medicines to reduce fever and boost low vitamin A levels. Doctors may prescribe antibiotics for secondary bacterial infections.
A measles vaccine was developed in 1963. It is 97-percent effective at preventing the disease. The shot for measles, commonly called the MMR vaccine, also protects children against mumps and rubella. The Centers for Disease Control and Prevention (CDC) recommends two doses of vaccine for children — at 12-15 months of age and at 4-6 years. And even if someone who has been vaccinated gets measles, the illness should be milder.

Before the vaccine was developed, measles killed 2.6 million people annually, according to the World Health Organization. Measles remains a leading cause of death among children worldwide, claiming the lives of some 89,000 each year.

Once thought to be eradicated in America, measles seems to be making a comeback. In North Texas, 21 people, mostly children who were never vaccinated, came down with measles at a Dallas-area megachurch in 2013. The outbreak began when a man who contracted the virus on a trip to Indonesia then visited the church.

That scenario is becoming more common. Measles cases in the United States typically are imported from other countries where measles remains an active threat. When someone who hasn’t been vaccinated is exposed to measles during international travel, he or she can bring it back here with the potential to infect others.

This year, six people who had not been vaccinated were confirmed to have measles in Ellis County.

“Diseases like measles are kept at bay because a critical mass of people are vaccinated against them,” Dr. Terk wrote in a letter to The Dallas Morning News following the Ellis County outbreak. “Outbreaks occur when that critical mass is eroded.”

Even a small group of unvaccinated individuals can pose a risk for the population at large. A 2017 study published in JAMA Pediatrics showed a 5-percent reduction in measles vaccination coverage among 2- to 11-year-olds nationwide could result in a three-fold increase in measles cases across the United States.

Physicians urge the MMR vaccination to prevent unnecessary suffering, even death.

“There are very few viruses as contagious as measles,” said Edward Dominguez, MD, a Dallas infectious disease specialist, and member of the TMA Be Wise — Immunize Physician Advisory Panel. “We need to really focus on getting kids vaccinated to prevent it.”

Find more information on measles and vaccinations on the TMA website.

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