You may be seeing the signs on hospital doors and doctors offices-
“Stay home if you’ve been exposed to measles and call your provider for guidance. “
That’s because the U.S. is currently grappling with the worst measles outbreak of the century with no end in sight. Measles cases in the United States have now exceeded the highest number on record (695 cases in 22 states) in a single year since the disease was eliminated in 2000. Before the widespread use of vaccines began in 1963, it infected millions every year in the United States, killing several hundreds.
This past week brought about the latest in the Measles outbreak making its way through the country. In California, two universities began quarantine procedures for roughly 700 people. In an effort to stop the disease from spreading, county health officials are working to identify people who may have been exposed to Measles and notify them by means of legal orders that they are to stay home and avoid contact with others. Since people that may have been exposed to the disease may not show symptoms for weeks, going the route of legally-backed quarantine is a significant step towards preventing the spread of the disease.
Despite California having one of the strictest laws requiring school-aged children that attend public or private school to be fully vaccinated, exemptions can be obtained if a doctor confirms there is a medical reason to limit the amount of shots or completely skip them. This is in contrast to the approach in other states, where parents can opt out of vaccinating their children for religious or personal beliefs. The unfortunate reality is that a significant amount of misinformation is available and is being continuously shared by people opposed to vaccines (anti-vaxxers). This is leading to a decline in those that are vaccinated, putting the general public at risk for outbreaks, just as with the Measles. According to the World Health Organization, 95 percent of a population needs to be vaccinated to provide “herd immunity,” a form of indirect protection that prevents infection in people too young or sick to be vaccinated.
Measles is a highly contagious virus that lives in the nose and throat mucus of an infected person. According to the Centers for Disease Control Measles is spreading quickly because of several factors:
- It can spread to others through coughing and sneezing.
- The measles virus can live for up to two hours in an airspace where the infected person coughed or sneezed.
- If other people breathe the contaminated air or touch the infected surface, then touch their eyes, noses, or mouths, they can become infected.
- Measles is so contagious that if one person has it, up to 90% of the people close to that person who are not immune will also become infected.
New York is yet another large metropolitan area that is in the throes of a measles outbreak, highlighting how important it is to prevent the spread of the disease; population density, the nature of how it is transmitted, and the delay of symptoms are all factors that are contributing to the spread. The CDC said misinformation about the safety of the vaccine is “a significant factor contributing to the outbreaks in New York.” The agency said some organizations, which it did not name, are “deliberately targeting these communities with inaccurate and misleading information about vaccines.” Because of the risk of further spread of the disease, last month, the city of New York ordered mandatory measles-mumps-rubella (MMR) vaccinations in certain areas of Brooklyn, where the outbreak had spread. That was the first time the city had ever imposed mandatory vaccinations.
The anti-vaxxer movement has gained ground due to the spread of misinformation. The threat of diseases that were previously considered eliminated or controlled making a comeback is so severe that the World Health Organization has included “vaccination hesitancy” as one of the threats to global health in 2019. Vaccines currently prevent 2-3 million deaths a year, and a further 1.5 million could be avoided if global coverage of vaccinations improved. Here is an overview of some common questions and concerns regarding vaccines.
One commonly heard counter point to needing the Measles vaccine is that in previous generations, people were commonly exposed to German Measles and the impact was (supposedly) minimal. Families often coordinated play dates in an effort to expose their kids to the illness and avoid potentially experiencing several occurrences of illness as it spread through a family with multiple children. But that kind of casual exposure with a virus like the Measles could prove deadly. While some symptoms are similar, such as the rash, German Measles (the virus Rubella) is a more mild virus compared to Measles (the virus strain Rubeola). This isn’t to say that there aren’t complications with German Measles (pregnant women are especially at risk for complications including birth defects), but the rate of transmission as well as the symptoms are considered mild when compared to Measles.
Measles is not just a rash, and can have life-threatening complications, including pneumonia and encephalitis, an inflammation of the brain that can have long-term consequences, especially among young children, adults with weakened immune systems and the elderly.
According to the Centers for Disease Control:
- People vaccinated in the United States since 1989 would most likely have received two doses of the combined measles, mumps and rubella (MMR) shot under federal guidelines, and that is still considered the standard for protection.
- Anyone vaccinated between 1963 and 1989 would likely have received only one dose, with many people immunized in the earlier years receiving an inactivated version of the virus.
- Americans born before 1957 are considered immune as they would have been exposed to the virus directly in an outbreak.
Even those that have received two doses of the vaccine can contract Measles because immunity can wane over time. Dr. Michael Phillips, chief epidemiologist at NYU Langone Health, said in kids, “the vaccine is really effective,” but in some adults, memory T-cells, which recognize and attack germs, do not fight the virus as effectively as they once did. He recommends that if there is any doubt about your immunity, to speak to your provider and ask if another dose is a good choice for you.
While the main concern is for the health and safety of the public, Measles also has a significant economical cost of approximately $50,000 per case, extrapolating that number for the confirmed 695 individual cases in 22 states, the economic cost totals out somewhere close to $30 million. The need to address the Measles outbreak diverts a significant amount of funds and personnel where they could otherwise be channeled to different areas of need.
If you have any questions or concerns regarding Measles or other vaccines, please reach out to your provider to ensure you receive accurate information. While the internet is a wonderful resource, the amount of misinformation available often clouds the facts. Some of the assertions made by those opposed to vaccines are meant to cause fear- but choices related to the health and safety of you and your loved ones should only be made as informed decisions.
- Main image provided by: franciscanhealth.com