Resurgence of measles

So far in 2018, 107 individual cases of measles have been confirmed in 21 states and the District of Columbia. The states that have reported cases to Centers for Disease Control are Arkansas, California, Connecticut, Florida, Illinois, Indiana, Kansas, Louisiana, Maryland, Michigan, Missouri, Nevada, New Jersey, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, and Washington. A total of 118 cases were reported during 2017. While Tennessee does require children that enroll in child care facilities and public schools to have their measles vaccination, children can be exempted for medical or religious reasons. Doctors warn that not getting vaccinated could have serious consequences. Measles is a virus usually passed through coughing and sneezing.

The majority of people who got measles were unvaccinated. Measles is still common in many parts of the world including some countries in Europe, Asia, the Pacific, and Africa.Travelers with measles continue to bring the disease into the United States. Measles can spread when it reaches a community in the U.S. where groups of people are unvaccinated. Once quite common, measles can now almost always be prevented with a vaccine.

Also called rubeola, measles can be serious and even fatal for small children. While death rates have been falling worldwide as more children receive the measles vaccine, the disease still kills more than 100,000 people a year, most under the age of 5.Because of high vaccination rates in general, measles hasn't been widespread in the United States for more than a decade. 

Causes

Measles is a highly contagious illness caused by a virus that replicates in the nose and throat of an infected child or adult. Then, when someone with measles coughs, sneezes or talks, infected droplets spray into the air, where other people can inhale them. The infected droplets may also land on surfaces, where they remain active and contagious for several hours. You can contract the virus by putting your fingers in your mouth or nose or rubbing your eyes after touching the infected surface.About 90 percent of susceptible people who are exposed to someone with the virus will be infected.

Symptoms

Measles signs and symptoms appear around 10 to 14 days after exposure to the virus. Signs and symptoms of measles typically include:

• Fever
• Dry cough
• Runny nose
• Sore throat
• Inflamed eyes (conjunctivitis)
• Tiny white spots with bluish-white centers on a red background found inside the mouth on the inner lining of the cheek — also called Koplik's spots
• A skin rash made up of large, flat blotches that often flow into one another (appearing on the face first)

The infection occurs in sequential stages over a period of two to three weeks. The rash begins on the face and then spreads down the arms and trunk, then over the thighs, lower legs and feet. At the same time, the fever rises sharply, often as high as 104 to 105.8 degrees. The measles rash gradually recedes, fading first from the face and last from the thighs and feet.

Infectious period

A person with measles can spread the virus to others for about eight days, starting four days before the rash appears and ending when the rash has been present for four days.

Risk factors

Risk factors for measles include being unvaccinated. If you haven't received the vaccine for measles, you're much more likely to develop the disease. Traveling internationally. If you travel to developing countries, where measles is more common, you're at higher risk of catching the disease. Having a vitamin A deficiency. If you don't have enough vitamin A in your diet, you're more likely to have more-severe symptoms and complications.

Complications

Common complications of measles are bacterial ear infections, bronchitis, laryngitis and croup. Measles may lead to inflammation of your larynx (voice box) or inflammation of the inner walls that line the main air passageways of your lungs known as bronchial tubes. Pneumonia is also a common complication of measles. People with compromised immune systems can develop an especially dangerous variety of pneumonia that is sometimes fatal. About 1 in 1,000 people with measles develops a complication called encephalitis. This may occur right after measles, or it might not occur until months later. If you're pregnant, you need to take special care to avoid measles because the disease can cause preterm labor, low birth weight and maternal death.

Prevention

If someone in your household has measles, take these precautions to protect vulnerable family and friends:

• Isolation - because measles is highly contagious from about four days before to four days after the rash breaks out, people with measles shouldn't return to activities in which they interact with other people during this period.
• It may also be necessary to keep nonimmunized people -siblings, for example away from the infected person.
• Vaccinate - be sure that anyone who's at risk of getting the measles who hasn't been fully vaccinated receives the measles vaccine as soon as possible. This includes anyone born after 1957 who hasn't been vaccinated, as well as infants older than 6 months.

The first vaccination dose for infants is usually given between 12 and 15 months, with the second dose typically given between ages four and six years. If you'll be traveling abroad before your child is a year old, talk with your child's healthcare provider about getting the measles vaccine earlier.

Preventing a resurgence of measles

If you've already had measles, your body has built up its immune system to fight the infection, and you can't get measles again. Most people born or living in the United States before 1957 are immune to measles, simply because they've already had it.

For everyone else, there's the measles vaccine, which is important for promoting and preserving widespread immunity. Since the introduction of the measles vaccine, measles has virtually been eliminated in the United States, even though not everyone has been vaccinated. This effect is called herd immunity. Herd immunity may be weakening a bit, likely due to a decrease in vaccination rates. The rate of measles in the U.S. recently jumped from an average of 60 cases a year to 205 cases annually. Steady vaccination rates are important because soon after vaccination rates decline, measles begins to come back. 

When to see a healthcare provider

Call your healthcare provider if you think you or your child may have been exposed to measles or if you or your child has a rash resembling measles. Review your family's immunization records with your healthcare provider, especially before starting elementary school, before college and before international travel. Primary Care Clinic of Jackson is open 7 days a week to assist with all of your healthcare needs. Primary Care Clinic in Trezevant is open Monday thru Thursday but your records are available electronically seven days a week at the Jackson location also.  Appointments available at 731-265-6197 in Jackson and 731-669-3863 in Trezevant. Walk-ins welcome at both locations.