With last week’s news that those infected with measles had recently traveled through the state of Florida, the reality of the national measles epidemic was brought home. What started out with a few cases tied to Disneyland has become an outbreak that is impacting more than 100 people, the majority of whom were unvaccinated, in 14 reported states.
Measles, a very contagious virus that enters the body through the nose, mouth and eyes, is known for its high fever, rash, conjunctivitis and runny nose. It infects 90 percent of those who have not been immunized, including babies too young to receive the vaccine. While most people will recover, some patients get pneumonia while others get measles encephalitis or even die from the virus. The very young and the unvaccinated, including pregnant women, are most at-risk.
Health officials — and even President Obama — have responded to this latest outbreak by encouraging people to get vaccinated and make sure their children are immunized. The most effective protection from the measles is through vaccination.
Children are typically vaccinated as part of their well visit schedule. The measles injection is administered through the measles, mumps and rubella vaccine (MMR) that is given twice, first between the ages of 12 and 15 months and again between 4 and 6 years of age. It is important to note that vaccines, including MMR, are eligible to all children, whether citizens of the U.S. or undocumented immigrants.
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So, if MMR has been proven effective, is part of the childhood vaccination schedule and available to all, why are people choosing to forgo it?
Unfortunately, MMR is often incorrectly cited as a vaccine that triggers autism in young children. While more than a decade of research has provided no scientific evidence to corroborate this misguided perception, fear lingers in parents who by trying protect their kids could actually be harming them when denying them the measles vaccine.
Physicians thought that the measles was eliminated from the United States in 2000, meaning that the disease was no longer native to our nation. But that designation was made with the understanding that the public would continue being vaccinated. Sadly, that has not been the case. When people, even small groups of people, stop vaccinating against disease, it creeps back in.
Measles is spread through direct contact and passage of respiratory droplets by a cough or sneeze. But germs left in the air or on a surface remain viable even hours after an infected person shares the virus. So, the contagious person may be gone from the area, but the invisible measles lives on.
People are contagious four days before until four days after the rash. Most do not realizing they have measles at least part the time they are contagious, which is partly why it can be spread to so many, so quickly.
Outbreaks of measles have become more common in the past decade, usually introduced by international visitors from areas where measles is still prevalent. But the disease is spread in our population by those choosing to forgo immunization. Last year we experienced an unprecedented 644 cases of measles in the United States, and we are on track to have another record number of cases this year.
While South Florida has yet to report any cases of the measles this year, the possibility for the introduction of the measles or other preventable viruses into our community is high due to our international presence. Deadly diseases may come from distant continents, or they may be common childhood diseases spread in our own parks, schools, houses of worship or even at kids’ birthday parties. In the case of measles and other vaccine-preventable diseases, we can stop these outbreaks by immunizing our children and ourselves, for our own health and those around us.
Without knowing it, unvaccinated children and the adults they grow into can pass disease to someone else’s child — perhaps a child who because of medical reasons is unable to be vaccinated. Instead of going vaccine free and potentially infecting your child and others while sitting next to them on an amusement park ride, at school or on a plane, choose to protect your health and that of your loved ones and neighbors. Make an appointment with your doctor to get your vaccines up to date.
Judy Schaechter, M.D., MBA, is interim chair of the Department of Pediatrics at the University of Miller School of Medicine and chairs Miami-Dade County’s Immunization Coalition. For more information, visit UHealthSystem.com/patients/pediatrics.