Essentia Health pediatrician answers questions about measles

By Connie Wirta Essentia Health

Recent outbreaks of measles have parents asking questions about the disease that was once declared eradicated in the United States. With international travel and low vaccination rates in some areas, the viral disease has made a comeback.

Dr. Lori DeFrance, section chair of the Essentia HealthDuluth Clinic’s Pediatrics Department, answers some common questions from parents and caregivers.

HOW CONTAGIOUS IS THE MEASLES?

My fellow pediatricians and I say that measles is the “most exquisitely contagious” viral infection that can be prevented by a vaccine. If a person infected with the virus coughs or sneezes in a room, the virus can live for two hours in the air and infect any susceptible person who comes in contact with it.

WHAT HAPPENS IF YOU’VE HAD THE VACCINE AND ARE IMMUNE?

If you have an immunity, you can’t get the measles or spread the measles. We need to have 95 percent immunity in a community to prevent measles from spreading. This is called “herd immunity.”

WHY ARE WE HAVING OUTBREAKS?

High vaccination rates allowed us to declare measles eradicated in the U.S. in 2000. Since then, every outbreak in the U.S. can be linked to international travelers who were exposed to the virus in other countries. The disease was able to get a foothold because we have pockets of low vaccination rates in some communities.

WHAT DO YOU TELL PARENTS ABOUT THE MEASLES, MUMPS AND RUBELLA (MMR) VACCINE?

The MMR vaccine is safe, effective and saves lives. There’s been misinformation about the vaccine and that’s created fear. That fear has led to under-vaccinated populations. Instead of relying on the internet, I recommend parents talk to their pediatrician, family doctor or health care provider. Another reliable source of information is the American Academy of Pediatrics’ website, HealthyChildren.org.

WHAT ARE THE RECOMMENDATIONS FOR MMR VACCINATION?

Children should get their first vaccine at 12-15 months old with a second dose between ages 4 and 6, or at least 28 days after the first dose. If you are planning international travel with a baby between 6 and 12 months, you should get an MMR and then follow-up with the two routine vaccinations. The vaccine isn’t effective on babies younger than 6 months. They also don’t have immunity passed on from their mothers.

Students in college or trade schools who don’t have documentation of measles immunity need two MMR doses, with the second dose administered at least 28 days after the first one.

For adults, people born before 1957 should have immunity because measles was a widespread childhood disease before the vaccine became available in 1963. People born during or after 1957 who do not have documentation of immunity should get at least one dose of MMR vaccine. If you don’t have your vaccination records, you can get a blood test for measles immunity but it’s probably cheaper and easier to simply get another vaccination. There is no harm in getting one, even if it is your second or third MMR immunization.

HOW EFFECTIVE IS THE MMR VACCINE?

One dose of MMR vaccine is about 93% effective; two doses are approximately 97% effective.

HOW CAN I CHECK IMMUNIZATION RECORDS FOR MY FAMILY?

Contact your health care provider, who can look up your medical records. If you’ve moved or changed providers within Minnesota, you or your provider may be able to track down records in the Minnesota Immunization Information

Connection, which is offered by the state health department. If you’re an Essentia Health patient and have enrolled in MyHealth, you can log in and find the list of immunizations in your medical records.

WHAT ARE THE SYMPTOMS OF MEASLES?

The most common symptoms are a fever, cough, red eyes and a runny nose – which can be many illnesses. A red rash can also be many things, so I always ask where the rash began. In measles, the rash begins on the scalp and head and works its way down the body. It’s like a bucket of red spots was poured over the person.

HOW DO YOU TREAT MEASLES?

We don’t have a medicine to treat measles, we can only treat the symptoms. We can’t treat measles with antibiotics because it’s a virus and we don’t have an anti-viral medicine for measles.

WHAT ARE THE COMPLICATIONS FROM MEASLES?

Measles can be a serious illness for all age groups but children younger than age 5 and adults older than 20 are more likely have complications. Ear infections occur in about 1 out of every 10 children and can result in permanent hearing loss. Severe complications are pneumonia and encephalitis, which can require hospitalization. As many as 1 out of every 20 children gets pneumonia, which is the most common cause of death from measles in young children. About 1 child out of every 1,000 will develop encephalitis (a swelling of the brain) that can lead to convulsions and can leave the child deaf or with an intellectual disability. For every 1,000 children who get measles, one or two will die from it.

WHY IS THIS A PUBLIC HEALTH ISSUE?

We need to think about not only protecting our own families but protecting our community and those most vulnerable. Measles is a great example of a public health success in that we didn’t need to think about for a while in the United States. But now we have to again.