custodio01-web.jpgThe United States is currently experiencing a large, multi-state outbreak of measles linked to an amusement park in California. This year, 159 people from 18 states and the District of Columbia were reported to have measles. Roughly 90 percent of cases occurred in patients that were unvaccinated, or had no documentation or unknown vaccination status. Of the unvaccinated patients, two-thirds were intentionally not immunized due to personal beliefs.

Measles is a highly contagious viral disease acquired by inhaling infectious droplets produced when an infected person coughs or sneezes. The virus can remain floating in the air for approximately two hours.

Dr. Haidee Custodio, assistant professor of pediatrics at the University of South Alabama College of Medicine and a pediatric infectious disease physician with USA Physicians Group, said anyone can contract measles, regardless of age. “That is why vaccines are recommended for everyone not protected – those who are not vaccinated or have no history of infection,” she said.

Measles can spread when it reaches a community in the U.S. where groups of people are unvaccinated. “It is one of the most infectious viruses – much more infectious than smallpox – causing infections in nine out of 10 unprotected individuals,” Dr. Custodio said. “This is the reason why whenever someone is suspected to have measles, isolation and special air precautions are undertaken right away.”

The symptoms of measles are very similar to many other viral illnesses, according to Dr. Custodio. “Affected patients may initially just present with high fever, runny nose, congestion and pink eye,” she said. “As the disease progresses, a rash appears, usually starting on the face and spreading to the rest of the body. Affected individuals look and feel miserable.”

Measles is infectious four days before and after the rash appears. It may initially be very similar to other illnesses and may not be diagnosed right away. “Although the majority of affected individuals – young children and adults – recover from it without problems in a week, there are complications that we worry about,” Dr. Custodio said. Complications include pneumonia, ear infections, encephalitis and diarrhea.

The disease remains one of the leading causes of death among young children globally, despite the availability of a safe and effective vaccine. In the Global Burden of Disease Study 2013 recently published in Lancet, more children one to 59 months of age died because of measles than from AIDS or road injuries. “It is very important to get vaccinated because this is the best defense we have against a very infectious, and at times, fatal disease,” Dr. Custodio said. “There is no treatment for measles.”

Measles vaccine, usually given with mumps, rubella and chicken pox vaccines, is a live vaccine that is given during routine childhood immunizations scheduled at 12-15 months of age. Another dose is given at 4-6 years of age because approximately 5 percent of children may not respond to the first dose and, therefore, may not be protected.

Some parents may have concerns that vaccines in children are linked to autism spectrum disorder (ASD), a group of development disorders that affect communication and social interactions. Vaccine safety experts, including experts at the Centers for Disease Control and Prevention and the American Academy of Pediatrics agree that measles, mumps and rubella (MMR) vaccine is not responsible for increases in the number of children with autism.

Dr. Custodio said persons born during or after 1957 are also recommended to be vaccinated if they do not have evidence of protection, either by documentation of adequate immunization or by laboratory confirmation. One dose is the usual recommendation, and two doses one month apart are recommended for those who are considered high risk, such as international travelers or health care personnel.

In addition, in the early 1960s, another type of measles vaccine called “killed measles vaccine” was used but later was found to be ineffective. People who were vaccinated between 1963 and 1967 with either inactivated (killed) measles vaccine or measles vaccine of unknown type should be revaccinated with at least one dose of live attenuated measles vaccine.

If an adult person is not sure if he received measles vaccine at all, or what type was given, a simple blood test can be done. If there is no evidence of protection, then vaccination is recommended.

Dr. Custodio said those who were born before 1957 are more likely to be protected as they are more likely to have been exposed and infected during the many measles epidemics prior to that year.

Because the measles vaccine is a live vaccine, not everyone is eligible to receive the immunization. Pregnant women and individuals who have weak immune systems – including those who are on chemotherapy or other medications that weaken the immune system – cannot get live vaccines. By vaccinating people around them, these individuals will be indirectly protected as well.

Dr. Custodio emphasized that measles – just like smallpox – has the potential to be eradicated. “Measles only affects humans, not animals. It is a disease that resolves on its own after a week and has no long-term infectivity period after a patient gets infected. We also have safe, effective and long-lasting vaccines available,” she said. “For these three reasons, measles has the potential to be eradicated.”

If you think you or your child has measles, Dr. Custodio said is important to be evaluated by your doctor. She also recommends calling the doctor first so that they can make arrangements to accommodate you while at the same time limiting exposure to other individuals.

To make an appointment with any USA physician, call (251) 434-3711.

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