Measles is making a comeback in the United States. The disease had been eliminated, but outbreaks are becoming more common – attributed to failure of parents to vaccinate their children.
Dr. Iris Castillo of Akron Children’s Hospital Pediatrics, Ashland discusses the highly contagious virus and the need to protect children.
Most people in the United States haven’t seen first-hand a case of measles. What is the disease like, and how serious is it?
Measles is a viral illness that involves fever, malaise, cough, conjunctivitis, upper respiratory symptoms and a rash. About 2-4 days before the rash appears, the child develops a fever, fatigue and decreased appetite, then red eyes, congestion, oral lesions and cough. Fevers can get up to 104 degrees, but usually trend downward once the rash occurs. When the rash appears, it is typically red and bumpy, usually starts on the face and hairline, and then spreads downward to the trunk and extremities. It is a self-limited disease, meaning it has to run its course and will resolve without antibiotics.
Although the measles illness is a self-limiting illness, the complications can be quite serious and fatal. One complication is secondary bacterial infections such as pneumonia. The most feared complication of measles involves the brain and nervous system. The brain can become infected and inflamed, causing headaches, vomiting, stiff neck, meningitis, drowsiness, seizures, coma and even death. One specific disorder, known as subacute sclerosing panencephalitis (SSPE), is a progressive degenerative disorder of the brain and occurs years after the active infection.
The measles virus is highly contagious. It spreads through contact with a person with measles, as well as through respiratory droplets. The virus can remain viable in the air for hours and is, therefore, highly contagious in crowded areas such as schools and airplanes.
Are babies and young children most as risk?
Yes. Any child who has not received both doses of the series is at risk from acquiring the illness as well as the complications. Babies and young children have immature immune systems and do not have the proper antibodies to help them fight the infection.
If a pregnant woman were to contract measles while pregnant, she would be at risk for having a low birth weight infant, spontaneous abortion, fetal or maternal death or prematurity.
Do you see patient families who refuse to vaccinate? What do you tell them?
Yes. Vaccination refusal does happen. First, I try to identify their specific concerns and go from there. If they are concerned about the link to autism, I remind them that that allegation has been disproven multiple times. If they are concerned about side effects, I review the vaccine safety profile. I answer any and all questions that families might have about vaccines. I always try to remind families that vaccination is not only about protecting their children from illnesses and death, but it is also about protecting other people in the community who may not be medically eligible for vaccinations. For example, a child undergoing chemotherapy for cancer cannot receive the measles, mumps and rubella (MMR) vaccine – but could suffer from severe complications of measles if he or she contracted the virus.
Is Northeast Ohio vulnerable to an outbreak?
When vaccination rates decrease, there will always be a risk of having an outbreak in the community.
Vaccination is recommended for children 12-15 months, and a second dose between ages 4 and 6. But it’s not too late for older, unvaccinated children to be vaccinated, right?
That’s right. It is never too late to have your children vaccinated. The MMR vaccine can be given to older children. If your child has not received the full MMR series and they are over 12 months of age, the second dose in the series can be given 4 weeks after the first one.
Any other advice?
If you have any questions about vaccination safety or efficacy, please speak to your children’s primary care provider for information. You can also visit the CDC website for the most up-to-date information regarding vaccinations and their safety. They have a plethora of information for parents and patients regarding vaccines and the diseases they prevent.