With Infectious Disease Specialist Manuel Gordillo, MD
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Although the measles virus and the importance of vaccination have been in national news for months, measles cases continue to rise. In fact, more than 830 cases have been reported so far this year, putting the U.S. on pace to have more in 2019 than we’ve had in any single year for 25 years, according to the federal Centers for Disease Control (CDC).
With the summer travel season approaching — and along with it, heightened risk of getting or passing on the measles virus — SMH Healthe-Matters editors reached out to a local infectious disease expert for answers to some frequently asked questions about the measles virus and the measles, mumps and rubella (MMR) vaccine.
Infectious Disease Specialist Manuel Gordillo, MD, of Infectious Disease Associates of Sarasota, leads the Sarasota Memorial Infection Prevention and Control Department as medical director. In this “Ask An Expert” Q&A, he offers clear guidance on how to protect your family, yourself and your community from the measles, and why it’s so important.
Q: What is the measles virus and what are some symptoms of infection?
Measles is a highly contagious virus that can cause serious health complications and can be particularly dangerous for babies, young children and those with compromised immune systems. It spreads quickly through coughing and sneezing. Measles is so very contagious that one individual infected with the virus can quickly pass it on to 12 to 18 other people in an unvaccinated population.
Measles symptoms typically present about seven to 14 days after infection, making it easy to pass along the virus without realizing it. Virtually every case of measles produces symptoms like a high fever, cough, congestion, red eyes and a rash. Complications can include pneumonia, ear infections, brain infection/swelling and even death. Pregnant women who become infected with measles can pass it on to unborn children, causing premature birth and blindness or other birth defects.
Q: Is there a cure for measles?
There is no treatment for measles. There is no cure for measles. And there is no way to predict how severe a case will be.
There is only one way you can protect your friends, family and community from this highly contagious virus: Ensure that your family is up to date with MMR vaccinations, and encourage others to do the same.
The vaccine is so highly effective that if given to 95% of the population, it provides enough immunity to protect even the unvaccinated people around them.
Q: Why are there so many more measles cases in the US now?
Simply put, the increase in measles in recent years is due to a decline in vaccination rates. Most of the cases in the United States these days are linked to unvaccinated travelers visiting other countries and returning to communities with low vaccination rates.
More parents are choosing not to have their children vaccinated for MMR — based on an underestimation of the risks of the disease and an overestimation of the risks of vaccines in general.
In the 1950s, before the measles vaccine became available here, about 3 million cases were diagnosed annually, resulting in 48,000 hospitalizations for complications and about 500 deaths each year in the US.
The MMR vaccine was introduced in 1963, and in 2000, the virus was declared eliminated from the US. The vaccine was so effective that most physicians in practice today have never seen a case of measles in their medical career, and most parents with young children are too young to remember the time before the MMR vaccine was widely used.
Unfounded fears that the vaccine isn’t safe are fueled by a long debunked and fraudulent study published in 1998 by a British physician who has long since been discredited by the scientific community. Despite multiple studies that have proven there is no link between the MMR vaccine and autism, a vocal group of anti-vaccine activists and other science denialists persistently warn parents not to vaccinate children against these potentially severe and preventable infections.
It is indefensible that despite having such a safe and effective vaccine against this deadly virus, we have not truly eradicated it as we did with smallpox.
Unsure of Your Vaccination Status?
If you’re not sure whether you're protected agasint measles, ask your doctor to order a blood test to see whether you’re immune, or simply do what is more practical and still safe: Get an additional MMR vaccine.
Q: Who should be vaccinated for measles, and who may need an MMR booster?
Here are the latest CDC guidelines and recommendations, by age group:
- International travelers – Given the global rise in measles, the CDC recommends that adults and adolescents consider getting another dose of the MMR vaccine at least two weeks before traveling abroad. Infants 6 to 11 months old should receive one dose of MMR before traveling to other countries. Children 1 year and older should get two doses, administered at least 28 days apart.
- Born before 1957 – People born before 1957 do NOT need to be vaccinated because they are assumed to have been exposed to/infected with measles during childhood and to have developed natural immunity. However, this population should get an MMR shot if planning to travel internationally.
- Born 1957-1989 – People who received only one dose of the measles vaccine during childhood are at increased risk of contracting the disease and should consider getting another dose of today’s more effective vaccine. National recommendations changed in 1989 from one measles vaccination to two separate shots, improving the vaccine efficacy from 92% to 98%. Also, some people were vaccinated with an ineffective “killed” vaccine, rather than the “live” attenuated vaccine.
- Born after 1989 – Anyone vaccinated against measles since 1989 should receive two doses of the MMR vaccine. The first dose is normally given at about 12 months of age, and the second at 4 to 6 years old.
Q: Who should NOT be vaccinated?
There are some vulnerable people for whom the live vaccine is not recommended, including children younger than 6 months; pregnant women; people with leukemia, lymphoma or other cancers of the bone marrow or lymphatic system; and individuals with AIDS or other forms of primary or acquired immune deficiency. By vaccinating everyone around them, however, we can protect this vulnerable, at-risk population.
To learn more about measles and vaccination safety, please talk with your doctor or child pediatrician, or visit the CDC website. Have a question for Dr. Gordillo or another SMH expert? Send it to firstname.lastname@example.org.