Measles in Washington State.

In 2000, the United States had been declared free of measles!

  • Since 2000, we have had several outbreaks, the highest being 667 infected individuals in the 2014 outbreak.
  • WHY are we seeing these outbreaks?
  • To answer that, we have to ask WHY we were able to eliminate measles in the first place?
    • The answer lies in the highly effective measles vaccine and a strong vaccination program.
  • Since 2000, vaccination rates have fallen.
  • This allows an imported case of measles to cause an outbreak.
    • For instance, a tourist with measles can pass along the Measles virus to unvaccinated and therefore, susceptible (vulnerable) people.

HOW does measles spread?

  • The act of coughing, sneezing, talking, laughing and breathing allows the infected person to release
    • moist droplets carrying live, infectious, Measles viruses.
      • these droplets can survive in airspace for 2 hours (outside the patient’s body)
  • Non-immune individuals breathe in these infectious droplets and
    • can in turn, become incubators of the Measles virus.
  • ONE PATIENT can infect 90% of unvaccinated individuals who are around him/her.

What are the symptoms that should ALERT YOU to measles?

  • fever, cough, runny nose & congestion, conjunctivitis and a high sensitivity to light (aka photophobia)
  • We suspect measles when Koplik’s spots appear 2 days later.
    • look like little grains of salt surrounded by a red zone
      • appear on insides of cheeks, across from molars
        • are a typical feature of measles
  • Measles rash appears within 24 hours of the Koplik’s spots.
    • The patient may also have high fever (104 F).
  • The rash begins on the head or hairline and
    • in 1 or 2 days, covers the entire body,
      • including palms of the hands and soles of the feet.
    • The rash begins as flat, red spots
      • with small, raised bumps on the flat, red spots.
      • These spots blend together as the rash spreads through the body.

What is the worst that measles can do to a person?

  • The illness can be more severe and prolonged in case of
    • Vitamin A deficiency and
    • malnutrition 
  • In developing countries, measles kills as many as 1 out of 4 infected patients.
    • It is also the leading cause of blindness in Africa. 
  • Measles patients also develop a generalized suppression of the immune system, which can last up to three years, leaving them vulnerable to other deadly infections.

How do you treat measles?

  • There are NO antibiotics or antivirals that will kill the Measles virus or help you recover quickly from measles.
  • The best treatment includes
    • reducing fever,
    • hydrating well,
    • resting and
    • administering vitamin A to patients with low levels of this vitamin.
  • Remember, measles suppresses the immune system!
    • If there are secondary bacterial infections, these will have to be treated with antibiotics.

Why do we want to prevent measles?

  • Pregnant women with measles may be at an increased risk of
    • miscarriages,
    • premature births or
    • low birth weight babies.
  • Approximately 30% of infected individuals develop one or more complications such as
    • pneumonia,
    • ear infections and
    • diarrhea.
  • One in every 1,000 children who develop measles will develop
    • encephalitis (inflammation of the brain), which can lead to
      • deafness or
      • intellectual and developmental disabilities.
  • One or two in every 1,000 children with measles, will actually
    • die from it.
  • If death doesn’t claim an ill child, the child is at risk of subacute sclerosing panencephalitis (SSPE).
    • a very rare, but fatal disease
  • According to research done in the United Kingdom:
    • 18 out of every 100,000 patients who are
      • under 1 year of age when they get measles,
        • will develop SSPE.
    • 1.1 out of every 100,000 patients
      • older than 5 years of age when they get measles,
        • will develop SSPE.
  • It may take anywhere from
    • 1 month to 27 years AFTER measles
      • for symptoms of SSPE to develop.
  • SSPE results in death 1 – 2 years after symptoms develop.
    • There is no cure for it at the moment.

Is there any RECOURSE for someone who is vulnerable and has already been exposed?

  • There are 2 options:
    1. measles vaccine given to immunocompetent individuals within 3 days of being exposed to measles
      • this is not always easy,
        • as patients are contagious 4 days before symptoms begin.
    2. a shot of pre-made antibodies against the Measles virus, within 6 days of being exposed to measles

What is our best prevention approach?

  • We need to build up our herd immunity,
    • our collective community immunity and
      • vaccination is the MOST EFFECTIVE way to achieve this.
  • Another approach we can all take, and should take, is to
    • cover our coughs and sneezes –
      • the idea is to trap any potentially infectious droplets (dispelled by the cough and sneeze) and
        • prevent them from infecting vulnerable individuals.
  • One last thing that can protect us against multiple infectious agents is to
    • have clean hands.
  • Saying No to infections is easy.
    • It starts with awareness.

One thought on “Measles in Washington State.

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