There is a misguided notion that measles is a relatively harmless childhood disease that has been eradicated long ago.
The opposite is true.
The Centers for Disease Control (CDC) reports nationwide there are 2,260 measles cases so far this year, and contrary to the belief that measles has been eradicated – it never has been.
The disease in 2000 was declared “eliminated” in the United States – meaning there were no homegrown cases of our own because of the successful use of the vaccine – but now, measles is rearing its ugly head again.
It’s now spreading throughout unvaccinated populations with 34 new outbreaks reported across the country.
Misinformation and declining vaccination rates are fueling the resurgence, causing the highest number of measles cases in over 25 years.
Currently, over 90% of reported cases stem from those who are unvaccinated or have an unknown vaccination status.
On Tuesday, the Los Angeles County Department of Public Health (DPH) issued an advisory after confirming a traveler passing through LA International Airport (LAX) on July 16 was confirmed infectious with measles.
Caused by a virus, it spreads easily through the air and settles on surfaces. It can spread when an infected person coughs, sneezes or just talks. Even after the infected person has left an area, the virus can remain in the air or on surfaces for hours. Those who are unvaccinated and exposed to the disease could develop symptoms seven to 21 days after exposure, and if you believe you have been exposed to the virus, it is recommended to monitor yourself.
During a recent news briefing held by American Communication Media (ACoM), Patsy Stinchfield, past president of the National Foundation for Infectious Diseases (NFID), said one case can potentially infect up to 18 people, who in turn can keep spreading the disease.
“That’s how contagious it is. Measles didn’t come back because the virus got stronger,” Stinchfield said. “The virus is the same as it has been. It came back because we let our guard down.”
Measles Must Be Taken Seriously
Another incorrect notion is that measles is “just a rash.”
While its impact can be mild, it can also cause complications and be deadly. Stinchfeld described the internal pathways a measles infection can take.
“It enters through the lining of your nose and throat. Think of that lining like an on-ramp on a highway that gets into the depths of your lungs, and once in the lungs, it replicates quietly and reproduces there, and then gets into your body’s highway, known as the lymph system, and then sometimes even in our blood system; it can go anywhere from there.
“More into the lungs, causing pneumonia; more into the gut, causing severe diarrhea and dehydration; even into the brain. So measles can be a disease of the brain and the nervous system, so it’s a gamble to go unvaccinated.
“When many of these organs can be infected, and one can have very severe disease. For some, a brain infection could lead to a loss of vision, loss of hearing, even rarely death.”
Even for those with mild cases, having the measles can be miserable, causing a high fever, runny nose, pink eye, loss of appetite, lethargy and could impact your immune system.
“It may take you years to recover from your own immune cells being wiped out to a certain degree of past infections you’ve had, meaning you’re going to recover from measles, but you might get other infections in the next year or two because of that impact to your immune system,” continued Stinchfeld.
“It’s a gamble to go without your vaccine. I don’t think any family wants to be out of school or work for weeks at a time, and depending on the cadence of infection in your household, it could even be several weeks,” she said.
With the vaccination rates slipping downward, it’s taking hold in pockets of communities that are under-vaccinated.
“Measles exploits the gap of the unvaccinated and replicates in an unimmunized person,” Stinchfeld explained.
Unvaccinated Pregnant Women Are at Great Risk
It’s not discussed enough – pregnant women are at a serious risk of getting very severely ill with measles and can jeopardize the health of their babies.
Dr. Andrew Pavia, the George and Esther Gross Presidential Professor at the University of Utah and chief of the Division of Pediatric Infectious Diseases, said if a woman is infected with measles in the last 14 days of her pregnancy, there is a chance of transmitting the disease to her infant.
“This can be very serious, even deadly,” said Pavia. “In Ontario, three infants died because their mothers had measles just prior to delivery. In Utah, we had 12 pregnant women who developed measles close to delivery; we were lucky. The children of these mothers all survived, but the next time could be far worse.”
Pavia emphasized that it’s critical that all women who are considering pregnancy should be vaccinated and immune to measles beforehand.
“You can’t get the vaccine when you’re pregnant, so you have to know whether you need it before you decide to become pregnant.”
Not only can measles be passed to the baby in the uterus during the last days of pregnancy, the baby can also be infected the minute they’re born.
“Measles is highly contagious. A pregnant woman [in labor] is breathing very hard. The delivery room is going to be full of the virus, and the baby’s first breath may be a mouthful of a lungful of measles virus,” said Pavia.
What Can You Do?
Review your immunization records. Two doses of the MMR vaccine are about 97% effective in preventing measles. The good news is that the measles vaccine, for most, lasts a lifetime. But if in doubt and you’ve lost immunization records, you can get an antibody blood test to check for immunity, especially if you’re immunocompromised or working in a high-risk area.
“At the same time, it doesn’t hurt to get another vaccine,” said Pavia. “My advice to all my colleagues and patients and their parents who don’t have their records is – don’t get a blood test. Just get another dose of vaccine if you’re uncertain,” he said.
“Why pay for the blood test, which costs more than the vaccine, which is generally free?” Pavia also points out the blood test isn’t perfect.
“It doesn’t measure all aspects of your immunity to measles. So it could give you a low antibody level, and you’re still pretty well protected by other parts of your immune system,” he said.
Vaccinations are crucial.
“Measles is one of the most contagious pathogens ever identified. And when vaccination coverage drops even a few percentage points below the threshold, we need community protections – measles is stealth,“ Stinchfeld warned.
“It will seek and find those unvaccinated individuals, and it will spread rapidly.”