What Parents Need To Know About the Measles Outbreak
Michael Neely, MD, a pediatric infectious diseases specialist at Children's Hospital Los Angeles, helps explain the facts about measles, how parents can prevent further outbreak, and what CHLA can do to help prevent infection and to treat those who have already been infected.
How did this certain outbreak occur?
Michael Neely: This measles outbreak started in December 2014 in Disneyland.
How did it spread there?
MN: The feeling was that it was an international visitor and unfortunately measles is highly contagious.
How does it spread?
MN: Measles can spread by any contact with an infected individual. It can be spread through direct touching contact or it can even be spread through the air by an infected contact. Those who are infected are typically coughing with measles and can spread the virus through the air.
How is this particular outbreak unique and what is causing it to be so broad and newsworthy?
MN: The main thing that is causing this outbreak to be unique is the high number of cases. The California State Department of Public Health states that as of Feb. 4th, 2015, we have 99 confirmed cases in the state of California—the majority of which are in the three major counties: Los Angeles County, Orange County and San Diego County. There are also additional cases that have spread throughout the United States, so in total we have over 100 cases already just in the first month of 2015. Typically, we have about that many cases within the U.S. in the entire year. So, we are well on our way to the largest outbreak that we have had in years, ever since the vaccine has been introduced.
Can you describe how the anti-vaccine movement can be contributing to this outbreak?
MN: The anti-vaccine movement has led to the highest number of people who have not been vaccinated against measles since the vaccine has been introduced. So we have a larger percentage of our population now who are unfortunately susceptible to this infection. Again, because it is so infectious, it is easy for anyone who does not have an immunity against this virus to become symptomatic to develop this disease when they encounter this virus.
How does the statistic show this?
MN: The statistic would suggest that the majority of patients who have become infected are not vaccinated.
Where are children potentially at risk?
MN: Children are more at risk at in areas of high density, high population. So, schools, daycares—that’s why Disneyland was the epicenter of this outbreak, because it is a highly populated area, especially during holiday time. And again, because this virus is so contagious, the contact does not have to be ongoing and sustained as you would have for some other viruses. Very casual contact like, being in the same room, breathing in the same air as an infected individual who is coughing, is enough to transmit the infection.
How long can the virus live?
MN: The usual incubation period, so from the time you were exposed to the virus to the time you develop your first symptoms, generally is about a week or so. The initial symptoms that happen are usually not specific to measles so it can be a little hard to recognize that someone has measles. These symptoms can be
- Muscle aches
- Red eye
- Runny nose
Then typically within a few days of the onset of those symptoms, you would develop a rash. It is when the rash happens is when people think this might be measles. Unfortunately, you begin as an infected person to shed the virus and able to spread it about 4 days before the rash shows up and continue to transmit the virus about 4 days after the rash has appeared.
What can parents do if their child has not been vaccinated yet or are there any precautions parents should take?
MN: If you think your child has been exposed to a case of measles, we do vaccinate as young as 6 months of age. Unfortunately, the immunity that you develop when you are vaccinated before the typical age of a year the immunity is not as strong or durable. So it does not count in the standard series of vaccinations, which is two vaccines: one starting at about a year of age and the second at about 4 to 6 years of age.
Also, try to avoid contact with sick people. So, even if a certain individual doesn’t have measles, but has a cough, you generally want to keep your child from this individual.
Some children, due to their medical condition or a compromised autoimmune system, cannot be vaccinated. What should parents in that situation do then?
MN: Children who have immunological conditions, such as cancer, cannot receive the measles vaccine, because it is a live vaccine. Parents with these children should always check with their provider or specialist on the status of whether or not they can be vaccinated. If they cannot be vaccinated, a general rule of thumb is to avoid people who are sick.
If you think your child with a compromised autoimmune system has been exposed to measles, we do have products that can be given safely, even to these children. It would consist of an immunoglobulin preparation that can be given, which provides immediate protection against developing active disease.
Why is the anti-vaccine movement harmful to children?
MN: The anti-vaccine movement is incredibly dangerous to the health of children. We thought we had eradicated most these diseases, and in fact, we had. Now, we are seeing a resurgence in not only measles, but chickenpox and other vaccine-preventable illnesses. Many of the so-called evidence for this movement was based on a paper that was published many years ago that claimed to find a link between MMR vaccine and autism. Unfortunately, that paper was extremely damaging and false. The investigator who published the paper had his license stripped and he has lost repeated cases in court trying to recover that license.
Can a child get vaccinated at anytime?
MN: If your child has not been vaccinated and you wish to do so, you can always talk to your doctor. The vaccine is licensed to any patients over the age of 12 months, so that would include adolescents and adults as well.