WiseCare Patient Alert – Measles Cases & Outbreak 2018

Measles cases and “Outbreak 2018” is currently in the news as 11 states have been affected thus far: Arkansas, California, Illinois, Indiana, Kansas, Michigan, New York, Oklahoma, Pennsylvania, Tennessee, and Texas. This is the greatest number of cases since measles elimination was documented in the U.S. in 2000.  What does this mean for our local community?  Measles can spread when it reaches a community in the U.S. where groups of people are unvaccinated.

Protect yourself, you family, and your community with the measles-mumps-rubella (MMR) vaccine. With two medical centers in Anne Arundel County, WiseCare is here to help you stay healthy. Go to www.wisecaremd.com to easily book your vaccine appointment or call 410.255.7900.

How do I get Measles?

Measles is one of the most contagious of all infectious diseases; approximately 9 out of 10 susceptible persons with close contact to a measles patient will develop measles. The virus is transmitted by direct contact with infectious droplets or by airborne spread when an infected person breathes, coughs, or sneezes. Measles virus can remain infectious in the air for up to two hours after an infected person leaves an area.

• The majority of people who got measles were unvaccinated.

• Measles is still common in many parts of the world including some countries in Europe, Asia, the Pacific, and Africa.

• Travelers with measles continue to bring the disease into the U.S.

• Measles can spread when it reaches a community in the U.S. where groups of people are unvaccinated.

Who is at High Risk?

People at high risk for severe illness and complications from measles include:

• Infants and children aged <5 years

• Adults aged >20 years

• Pregnant women

• People with compromised immune systems, such as from leukemia and HIV infection

Why You Need Measles Vaccine

Do I have Measles?

Measles is an acute viral respiratory illness. It is characterized by a prodrome of fever (as high as 105°F) and malaise, cough, coryza, and conjunctivitis -the three “C”s -, a pathognomonic enanthema (Koplik spots) followed by a rash that usually appears about 14 days after a person is exposed. The rash spreads from the head to the trunk to the lower extremities. Patients are considered to be contagious from 4 days before to 4 days after the rash appears. Of note, sometimes immunocompromised patients do not develop the rash.

Complications from Measles:

Common complications from measles include otitis media, bronchopneumonia, laryngotracheobronchitis, and diarrhea.

Even in previously healthy children, measles can cause serious illness requiring hospitalization.

• One out of every 1,000 measles cases will develop acute encephalitis, which often results in permanent brain damage.

• One or two out of every 1,000 children who become infected with measles will die from respiratory and neurologic complications.

• Subacute sclerosing panencephalitis (SSPE) is a rare, but fatal degenerative disease of the central nervous system characterized by behavioral and intellectual deterioration and seizures that generally develop 7 to 10 years after measles infection.

Vaccine Recommendations:

Measles can be prevented with measles-containing vaccine, which is primarily administered as the combination measles-mumps-rubella (MMR) vaccine. The combination measles-mumps-rubella-varicella (MMRV) vaccine can be used for children aged 12 months through 12 years for protection against measles, mumps, rubella and varicella. Single-antigen measles vaccine is not available.

One dose of MMR vaccine is approximately 93% effective at preventing measles; two doses are approximately 97% effective. Almost everyone who does not respond to the measles component of the first dose of MMR vaccine at age 12 months or older will respond to the second dose. Therefore, the second dose of MMR is administered to address primary vaccine failure.

Children: CDC recommends routine childhood immunization for MMR vaccine starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age or at least 28 days following the first dose.

Students: At post-high school educational institutions without evidence of measles immunity need two doses of MMR vaccine, with the second dose administered no earlier than 28 days after the first dose.

Adults: Born during or after 1957 who do not have evidence of immunity against measles should get at least one dose of MMR vaccine.

International Travelers: 6 months of age or older who will be traveling internationally should be protected against measles. Before traveling internationally:

• Infants 6 through 11 months of age should receive one dose of MMR vaccine.

• Children 12 months of age or older should have documentation of two doses of MMR vaccine (the first dose of MMR vaccine should be administered at age 12 months or older; the second dose no earlier than 28 days after the first dose).

• Teenagers and adults born during or after 1957 without evidence of immunity against measles should have documentation of two doses of MMR vaccine, with the second dose administered no earlier than 28 days after the first dose.

Healthcare Personnel: Should have documented evidence of immunity against measles.

Source: Centers for Disease Control and Prevention