Monday Medical: measles is very contagious and preventable
MMR vaccination recommendations from the CDC:
All children should receive two doses of the MMR vaccine: one at 12 to 15 months and one at 4 to 6 years old.
College students who do not have evidence of immunity should have two doses of the MMR vaccine, separated by at least 28 days.
Adults who do not have evidence of immunity should have at least one dose of the MMR vaccine.
Health care workers should receive two doses of the MMR vaccine, separated by at least 28 days.
For international travelers: Infants 6 to11 months old should receive one dose of the MMR vaccine, then two more doses, separated by at least 28 days, after they turn 1; children 1 or older should receive two doses of MMR vaccine, separated by at least 28 days; teens and adults who do not have evidence of immunity should have two doses of the MMR vaccine, separated by at least 28 days.
Considered the most contagious virus today, measles can live on a surface or in the air for up to two hours.
That means that if an infected person coughs into a room then leaves, a susceptible person could walk in that room an hour later and catch the virus. And, about 90 percent of non-immune people who are exposed to the virus will become infected.
Those facts highlight the importance of being vaccinated for the virus, said Janice Poirot, public health nurse with the Northwest Colorado Visiting Nurse Association.
The measles outbreak that originated in California’s Disneyland at the end of last year has resulted in 125 measles cases in seven states so far, with one case in Colorado.
Though measles was considered eliminated in the U.S. in 2000, the virus is still common around the world, including in Europe. Measles is frequently brought back to the U.S. by travelers. People will leave for vacation then return home sick.
“People don’t even think about making sure they have the measles vaccine before they go (to Europe),” Poirot said.
And they should. The Centers for Disease Control and Prevention recommend all international travellers get vaccinated.
Pregnant women, immunosuppressed people and infants are most susceptible to the virus. Measles is also harmful to children, and according to the World Health Organization, it is one of the leading causes of death among young children globally.
About 30 percent of measles cases result in one or more complications including pneumonia, diarrhea, encephalitis (swelling of the brain) and seizures. Before the measles vaccine, the U.S. population experienced an average of 3 to 4 million cases of measles per year. Those cases resulted in 48,000 hospitalizations, 4,000 cases of encephalitis and 500 deaths annually.
After contracting measles, it can take up to two weeks to develop symptoms, which include fever, cough, runny nose and pink eye at first. Then, a few days later, a full-body rash appears. There is no specific treatment or antiviral therapy for measles.
“You become contagious four days before the rash,” Poirot said. “So (initially), you think you’re dealing with a cold.”
Vaccination is the best way to prevent measles. However, as with all vaccinations, there is a threshold necessary to keep the virus from spreading. For measles, that means a vaccination rate of 92 to 95 percent.
Once an area drops below that threshold, “you no longer have an effective barrier between the infected person and the susceptible person,” Poirot said. “So we’re pretty vulnerable in Colorado.”
Colorado was estimated to have only about 82 percent of kindergarteners immunized for measles, mumps and rubella, or MMR, for the 2013-14 school year, according to the Centers for Disease Control and Prevention. The median for the nation was about 95 percent.
Colorado’s low vaccination rate is especially worrisome for parents of children who can’t be vaccinated due to conditions like leukemia. “That’s a big fear among families that have these children,” Poirot said.
A recent Steamboat Today article estimated that about 96 percent of students in the school district had received the MMR vaccination. In Colorado, children are required to have two doses of the MMR vaccine to attend school and college. However, Colorado allows exemptions from vaccines for medical, religious and personal reasons.
The vast majority of exemptions Poirot has encountered are for personal reasons — people often cite fear of potential negative impacts from vaccines. But within the scientific community, those fears are considered unfounded.
“I think there’s comfort in knowing that every health authority in the world recommends these vaccines and deems them safe and effective,” Poirot said. “We have decades of safety data on vaccines.”
For parents concerned about vaccines, Poirot recommends talking with your doctor and researching reputable websites.
“Don’t just Google ‘vaccines,’” she said. “You’ll get a lot of very poor science. It’s presented as science, but it’s not, so be careful what information you’re taking as truth.”
Susan Cunningham writes for Yampa Valley Medical Center. She can be reached at firstname.lastname@example.org.
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STEAMBOAT SPRINGS — After almost four years of providing service to the community as a standalone, full-service emergency department, Steamboat Emergency Center will end its operations April 30.