Measles: Blast From The Past

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The Centers for Disease Control and Prevention (CDC) received reports of 288 cases of measles in the United States between Jan. 1 and May 23, 2014. This is the largest number of measles cases in the United States reported in the first five months of a year since 1994. Nearly all of the measles (rubeola) cases last year were associated with international travel by unvaccinated people.
“The [2014] increase in measles cases was driven by unvaccinated people, primarily U.S. residents, who got measles in other countries, brought the virus back to the United States and spread to others in communities where many people are not vaccinated,” said Dr. Anne Schuchat, assistant surgeon general and director of CDC’s National Center for Immunizations and Respiratory Diseases.

Of the 288 cases, 280 (97 percent) were associated with importations from at least 18 countries.
This year, from Jan. 1 through Feb. 6, 2015, the CDC has reported 121 cases. According to the CDC, most of these cases [103 cases (85 percent)] are part of a large, ongoing multistate outbreak linked to Disneyland in California.
Measles is a highly contagious respiratory disease caused by a virus. It spreads through the air through coughing and sneezing. Measles starts with a fever, runny nose, cough, red eyes, and sore throat, and is followed by a rash that spreads all over the body. About three out of 10 people who get measles will develop one or more complications including pneumonia, ear infections or diarrhea. Complications are more common in adults and young children.

“We have not seen any measles cases at the North Shore-LIJ Health System for about two years,” said Bruce Farber, MD, director of infectious diseases at LIJ Medical Center and North Shore University Hospital. Farber urges people to make sure they are up-to-date on their vaccinations.
The large number of measles cases this year stresses the importance of vaccination. Healthcare providers should use every patient encounter to ensure that all their patients are up to date on vaccinations; especially, before international travel.

Timely vaccination is the best way to prevent measles. Infants and young children are at high risk of getting a serious case of measles. The CDC recommends two doses of measles, mumps and rubella (MMR) vaccine for everyone starting at age 12 months. For those traveling internationally, the CDC recommends that all U.S. residents older than six months receive MMR vaccine, if needed, prior to departure.
Very few people—about three out of 100—who get two doses of measles vaccine will still get measles if exposed to the virus. Experts aren’t sure why; it could be that their immune systems didn’t respond as well as they should have to the vaccine. But the good news is, fully vaccinated people who get measles are much more likely to have a milder illness, and they are also less likely to spread the disease to other people, including people who can’t get vaccinated because they are too young or have weakened immune systems.

People who received two doses of measles vaccine as children according to the U.S. vaccination schedule are considered protected for life and do not ever need a booster dose.
“Many U.S. health care providers have never seen or treated a patient with measles because of the nation’s robust vaccination efforts and our rapid response to outbreaks,” said Schuchat.

If you’re unsure whether you’re immune to measles, you should first try to find your vaccination records or documentation of measles immunity. If you do not have written documentation of measles immunity, you should get vaccinated with measles-mumps-rubella (MMR) vaccine. Another option is to have a doctor test your blood to determine whether you’re immune, but this option is likely to cost more and will take two doctor’s visits. There is no harm in getting another dose of MMR vaccine if you may already be immune to measles (or mumps or rubella).

For more information about the CDC’s report, please visit www.cdc.gov/mmwr.

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