Now That Measles Is Making A Comeback, We Need To Know Who’s At Risk

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Measles, a highly contagious respiratory illness once eradicated in the United States in 2000, is reappearing in various regions across the country.

Over the past month, outbreaks characterized by a distinctive rash have emerged in several states, indicating a concerning resurgence of the disease.

In Florida, health authorities in Broward County are investigating numerous cases reported at an elementary school.

Similarly, Ohio has confirmed at least four infections this year, while Michigan reported it first measles incident since 2019.

The virus has also been detected in states such as Arizona, California, Georgia, Indiana, Louisiana, Maryland, Minnesota, Missouri, New Jersey, New York City, Pennsylvania, Virginia, and Washington, highlighting its widespread impact across the nation.

Patricia Stinchfield, RN, a pediatric nurse practitioner and president of the National Foundation for Infectious Diseases, said, “We are very concerned about the spread of measles across the country right now. We have seen 35 cases already in the first two months of 2024, whereas last year for the whole year, there were 58 cases. So this is not a good trend.”

Recognized as one of the most contagious vaccine-preventable diseases, measles poses a significant risk to unvaccinated individuals. According to the Centers for Disease Control and Prevention (CDC), if one person contracts measles, approximately nine out of ten people in close proximity who are not immunized are likely to become infected.

Measle Vaccination Decrease May Likely Be to Blame

A potential contributing factor to the resurgence of measles is a decline in vaccination rates.

Dr. Mark Kline, an infectious disease expert and physician-in-chief at Children’s Hospital New Orleans, attributes the recent uptick in cases to a decrease in vaccinations, emphasizing the importance of maintaining high immunization levels to prevent further spread of the virus.

According to a CDC study conducted in the fall of 2023, the percentage of state-required vaccinations among kindergartners decreased 95 percent during the 2019-2020 school year to approximately 93 percent by the 2021-2022 school year.

Dr. Kline perceives this increase as a potential warning sign, likening it to a “canary in the coal mine,” suggesting that failure to take precautions may lead to more significant challenges in the future.

“I think it is time that we recognize that the protection that we’ve been afforded for measles by virtue of vaccines is really fragile and can be lost. Viruses like the measles are not gone forever — they can come back and are still capable of inflicting serious harm or even death,” he says.

Rising Travel Rates Could Be Contributing to Measles Transmission

The CDC cautions that the surge in international travel may lead to a rise in measles cases, as individuals may inadvertently import the virus into the U.S. from abroad. Global travel has surged, with more Americans venturing abroad following the pandemic’s restrictions.

Moreover, the escalating measles outbreaks outside the United States have heightened the risk of transmission. According to data released by the World Health Organization (WHO) on February 22, measles outbreaks in Europe saw a significant increase in 2023 compared to the preceding three years.

Dr. Kline highlights that two children treated for measles in New Orleans had contracted the virus during a trip abroad.

A Potentially Disabling and ‘Miserable’ Illness for the Unvaxed

According to Stinchfield, individuals afflicted with measles often experience intense discomfort. The CDCreports that approximately one in five unvaccinated Americans who contract measles require hospitalization.

Initial symptoms of measles include a high fever, reaching up to 104 degrees Fahrenheit, accompanied by a cough, runny nose, and red, watery eyes. Within two to three days of symptom onset, small white spots may develop inside the mouth.

Subsequently, a rash emerges within three to five days, typically beginning as flat spots on the face near the hairline and spreading downward to encompass the neck, torse, arms, legs, and feet.

The illness generally runs its course within 10 to 14 days. While there is no specific cure for measles, the National Foundation for Infectious Diseases suggests vitamin A supplementation as a potential method to mitigate complications.

Children under the age of 5 and adults over the age of 20 are at increased risk of experiencing complications, such as ear infections and diarrhea. In severe cases, measles can lead to pneumonia and encephalitis, an inflammation of the brain.

Stinchfield adds, “Measles patients can get dehydrated and may need IV fluids. Light often bothers their eyes, so they have to stay in a dark room. Some of them are so sick, they have to go on ventilators. One in 1,000 of them will have neurological problems like seizures, deafness, blindness, and if they survive, it can lead to a lifetime of intellectual disability.”

Preventive Measures to Reduce Transmission

The encouraging news is that both doses of the measles vaccine are approximately 97 percent effective in preventing infection. Even if you belong to the small percentage who still contract measles post-vaccination, the illness is likely to be mild, and the likelihood of transmitting the virus to others is significantly reduced.

As per CDC guidelines, it is recommended that all children receive two doses of the MMR (measles-mumps-rubella) vaccine. The first dose should be administered between 12 and 15 months of age, with the second dose administered between 4 and 6 years of age.

Although measles is commonly associated with children, it can affect adults as well. The World Health Organization reports that one in five cases in 2023 occurred among adults aged 20 and older. Stinchfield, suggests that a historical wave of vaccine skepticism, originating in the 1990s, may contribute to the vulnerability of unvaccinated adults. She advises all adults to verify their vaccination records to ensure they are up-to-date.

“This is a really good time for everyone to check their own vaccine status or their own measles disease history. If people have not had the measles vaccine, they really need to urgently go get one, especially if they’re in one of the states where measles is circulating,” says Stinchfield.

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