Fri, Jun 7, 2019 at 07:00 PM

Measles - what you need to know and do

Precautions and education are key to protecting yourself and your family from the highly contagious disease.

With measles showing up in states across the U.S., hospitals are taking precautions to prevent local outbreaks. Marshall Medical Centers has put in place the following guidelines for all facilities: 

• Ensure all employees, physicians and volunteers have immunity to measles. 
• Provide education to all employees about measles; how to care and treat patients, signs and symptoms, etc. 
• Screening everyone entering the emergency department to ensure they have not had measles or have not been exposed to anyone with measles.
• Providing education on measles to all patients and encouraging them to follow up with their physician to ensure they have immunity to measles.
• Working with the Alabama Department of Public Health and will notify them if anyone reports exposure or actually has measles.

“The bottom line is the CDC states that if you have had two MMR vaccines or have had the measles, then you have immunity,” said Gloria Clemons, RN and Infection Preventionist at Marshall Medical. “If you’re not sure, then check with your physician for a recommendation. If you have no immunization records, then taking another vaccination will not hurt at all.”

As of late May, the Alabama Department of Public Health had conducted 174 measles investigations this year with no confirmed cases.  
 
By now it is well known that vaccination is the best way to prevent measles. Two doses of measles vaccine are recommended for all children. The first dose of the measles-mumps-rubella vaccine (MMR) should be given at 12–15 months of age and the second dose before a child enters kindergarten (4–6 years of age). Two doses of MMR vaccine are about 97% effective at preventing measles; one dose is about 93% effective. 

Adults also should get a vaccination if they don’t know whether they have immunity. You have immunity if you have previously received two shots of the MMR vaccine. If you’ve had measles, that gives you lifelong immunity and no booster dose is ever needed. It is extremely important to know whether you have immunity and whether your family does. If you don’t know, follow up with your physician.

During the 1950s virtually every child got measles by age 15, so the CDC considers people born before 1957 likely to have had measles as children. 

Is the measles vaccine really safe?

The measles vaccine is extremely safe and effective. The MMR vaccine was first licensed in 1971. Individual vaccinations for measles, mumps and rubella vaccines had been previously licensed in 1963, 1967 and 1969 respectively. In 1986, only one dose of MMR was offered to children 12 months of age and older. In 1996, a 2nd dose of MMR vaccine was introduced at 18 months as part of the routine schedule.

Small numbers may get a mild fever, rash, soreness or swelling after a vaccination, according to the CDC. Adults or teenagers may feel temporary soreness or stiffness at the injection site. Contrary to misinformation that some anti-vaccine activists continue to repeat, the vaccine does not cause autism.

Anyone without immunity could get measles.

“Almost everyone who has not had the MMR shot will get measles if they are exposed to the measles virus,” the CDC states.

How many people haven’t been vaccinated?

Only a small number in scattered pockets of the United States have not been vaccinated. Measles immunization in the U. S. is stable and high — more than 90% — according to CDC tracking.

Aren’t parents required by law to vaccinate their children?

Every state has these laws. Three states allow only medical exemptions: Mississippi, West Virginia and, more recently, California, following the Disneyland outbreak. The rest grant exemptions for personal, philosophical or religious beliefs as well.

Measles cases this year have already doubled last year’s count. Children under 5 years account for half of the cases.

What to look for if you suspect measles:

• Symptoms appear 7 -14 days after exposed beginning with high fever, cough, runny nose and red watery eyes.
• 2-3 days after symptoms begin, tiny white spots (Koplik spots) may appear inside the mouth.
• A person can spread the virus as early as seven days after exposure before being diagnosed
• 3-5 days after symptoms begin, a rash appears
• Flat red spots appear at the hairline and spreads downward to the neck, trunk, arms, legs and feet
• Small raised bumps may appear on top of the flat red spots and they may become joined together
• When the rash appears the fever spikes, up to 104 degrees. During the next 24 hours the rash spreads over the back, abdomen, entire arms and thighs. As it reaches the feet on the second and third days, the rash on the face starts to fade. Rashes may have a slight itch. Sufferers are still contagious and can spread measles during the rash

Complications:

Children under 5 and adults more than 20 years more likely to have complications, such as:

• Diarrhea
• Vomiting
• Ear infections – hearing loss
• Severe Complications include:
• Pneumonia
• Hepatitis
• Encephalitis
• Eye Issues, leading to blindness
• Heart issues
• Cognitive Issues

The measles virus is spread through the air, or by direct contact, through infectious droplets. The infected droplets may also land on a surface, where they remain contagious for several hours. You can contract the virus by touching these surfaces and then putting your fingers in your mouth or nose or rubbing your eyes. The measles virus can remain in the air for up to two hours after a person with measles has occupied the area.

There is no specific treatment for measles. Treatment focuses on relief of symptoms as the body fights the virus. This may include fluids and medications to control fever or pain. Because measles is a virus, antibiotics are not effective against the virus, but may be prescribed to treat secondary infections from bacteria.

Call your doctor if you think you may have been exposed to measles or if you have symptoms corresponding to measles. Follow the instructions given by your health department if you have been exposed and/or are currently being tested. If you have not received a measles vaccine, and you come into contact with an infected person, receiving MMR within 72 hours after exposure may be effective in preventing infection.