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Measles on the Rise: What You Should Know

Posted Date: 4/7/2014
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     The number of reported measles cases in New York City has now reached 20, including both adults and children. Meanwhile, outbreaks have been reported in other cities as well, including Boston, Philadelphia, San Francisco and Los Angeles.
     Anyone — at any age — can get measles if they are unvaccinated and have never had measles. And measles can present a very real health challenge, according to Dr. Ernest Visconti, Pediatric Infectious Disease Specialist at Richmond University Medical Center. “It can be very serious,” he says. “There can be a lot of complications from measles and from secondary infections that can occur. And the measles itself is bad enough — there can be mortality, especially if there are other medical issues.”
      As many as one-third of people with measles will develop complications. They can include ear infections, bronchitis, seizures, pneumonia and brain inflammation. For pregnant women, measles can lead to low birth weight, preterm labor and even loss of pregnancy.
      Measles is likely to be most severe in infants, pregnant women, people with compromised immune systems and people older than 20.

Know the Facts
      Measles is a viral infection. It’s characterized by a dry cough, red eyes, sore throat, fever and runny nose, as well as an itchy rash that appears three to five days after first signs of illness. There is no treatment for measles, though treatment may be given for its symptoms.  Worldwide, measles still kills more than 160,000 people each year, most of them children.
      The measles virus is highly contagious: Once a person has it, their close contacts are at risk. That can start happening before the person even suspects measles. “The beginning of measles presents like an ordinary cold before the rash comes out,” Dr. Visconti says. The virus lives in the mucus of the infected person, who is contagious from four days before a rash appears to four days afterward; it’s possible to contract measles even two hours after an infected person has left the room (and left airborne droplets behind). Generally, symptoms appear about 10 days after exposure to the virus, but it can take as long as three weeks.
     In the U.S., measles had essentially been eradicated by 2000, due to widespread vaccination. Not having a vaccination is the major risk factor for contracting measles.

Measles Prevention
     The good news about measles? “It can be totally prevented,” Dr. Visconti says. “The vaccine is readily available at any physician’s office.”
     If you’ve ever had measles, you already have lifelong immunity. But if you haven’t had it, and you haven’t been vaccinated twice, see your physician for a vaccination.
Recommendations today are for two doses of the measles vaccine, which is now part of the MMR (measles-mumps-rubella) shot. This first dose is usually given to children at 12 to 15 months; that dose alone gives immunity to 95 percent of people. In the 1990s, a second shot became the recommended procedure, to protect the small percentage of people who didn’t respond to the first. Usually, this second dose is given to children between the ages of 4 and 6.
      In light of the current increase of cases, the New York City Health Department, and Dr. Visconti, advise those who live in the affected communities get their second dose immediately, regardless of whether they fall within that age range.
     For those who are unsure about their vaccination history, a physician can determine that with a simple blood test. In fact, getting that test may be a good idea even if you know have been vaccinated twice — there’s a small percentage of people who don’t respond to the vaccines and never make the antibodies, and some people, who do initially respond and develop immunity to measles, will lose that immunity later on. “Even with the vaccine, the effects can wear off,” Dr. Visconti says. Those people may believe they have immunity, but they do not.
      The vaccine itself is very safe, and side effects are rare. A few people might experience some mild side effects that could include fever, a mild rash or soreness at the site of the injection.