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Measles outbreak prompts physician recommendations, support for vaccinations

By Savannah Koplon
UAB News

University of Alabama at Birmingham infectious disease and primary care experts urge the public to know their vaccination status and educate themselves on the dangers of the measles, as continued outbreaks in more states are anticipated in the coming weeks.

Today, the Tennessee Department of Health reported to the Alabama Department of Public Health that an individual with a confirmed measles case traveled through Alabama on April 11 and made two stops during the infectious period, raising the likelihood that measles could appear in the state. So far in 2019, 626 cases of the measles have been reported in 22 states, according to the Centers for Disease Control.

Just 20 years ago, measles was deemed eliminated by the CDC; but a rise in anti-vaccination support and rhetoric has experts highlighting the correlation with growing cases.

William Curry, M.D., associate dean for Primary Care and Rural Medicine at UAB, and Jeanne Marrazzo, M.D., MPH, division director of Infectious Diseases at UAB, share statistics, evidence and their professional recommendations on the measles with the hope and intention of educating publics and vulnerable populations as the disease spreads.

What is the measles?

Measles is a highly contagious, serious, viral respiratory illness that lives in the nose and throat of infectious people. The measles is spread through coughing and sneezing, and the virus has the ability to live in the air for nearly two hours after an infected person coughs or sneezes, thus infecting mass numbers of defenseless people in a short period of time.

“Measles is one of the most infectious agents we have in the infectious diseases pathogen world,” Marrazzo explained. “Measles is so infective that if you take 10 people who don’t have protection and put them next to an infectious person, nine — or 90 percent — will get infected.”

Why are we hearing about the measles now?

Due to the anti-vaccination movement both in the United States and globally, measles cases are being reported in vulnerable populations, including unvaccinated children. In 2000, the CDC declared measles eradicated in the United States due to the invention and administration of a safe and effective vaccine, so the current rise in cases can be traced to growing rates of unvaccination.

“[The measles] is a very infectious and effective virus,” Curry said. “Once it gets started in a vulnerable population, it will spread quickly. If we have neighborhoods of people who are not immunized, we are likely to see more than one case.”

Since the measles has been nearly eliminated in modern medicine, many physicians like Marrazzo have never even seen a case to treat.

“I’ve never seen a case of measles. Why? We were on the verge of eradicating it,” Marrazzo said. “Tons of physicians out there have never seen a case of measles, and they need to be aware of the epidemiology of the disease.”

What are symptoms?

A person can present no symptoms of measles for nearly four days while infected. When symptoms present, they include high fevers, coughing, a runny nose and red, infected eyes.

Two to three days after symptoms arise, tiny white spots may appear inside one’s mouth.

Three to five days after symptoms arise, a rash of flat red spots appears across the body.

How can measles be prevented?

The best protection against the measles is receiving the measles, mumps, rubella (MMR) vaccine.

“The MMR vaccine is a great example of changing trajectory of an infectious disease with an effective vaccine,” Marrazzo added.

The MMR vaccine is most commonly given to children between 12 and 15 months of age, and the second dose between 4 and 6 years of age. Two doses prove to be up to 97 percent effective in preventing measles.

The CDC recommends, if you do not have evidence of vaccination and you were born after 1957, you can receive at least one course of vaccination. You cannot be over-vaccinated, so experts recommend getting an additional dose of MMR if you are unsure of your status.

A person should not get the vaccine if they are severely immune-compromised, are pregnant or have experienced an allergic reaction to a previous MMR vaccine. They can talk with their health care provider about options for their specific situation.

Currently, there is no antiviral drug to treat the measles, adding to the severity of the disease.

Where is the MMR vaccine available?

“The MMR vaccine is available in most primary care practices, at the public health department and at many pharmacies,” Curry shared. “Vaccines are available in a very accessible way these days.”

To see where you can get the MMR vaccine in your community, visit www.vaccinefinder.org.