The measles epidemics are back

In 2000, the United States declared that measles had been eliminated from the country. According to the Centers for Disease Control and Prevention, this means that measles is no longer endemic – or constantly present – and that there has been no continuous transmission of the disease for 12 months or more.

The highly infectious disease now holds the country's attention as outbreaks spread throughout the northwestern Pacific and the east of the country. Since the beginning of the year, more than 35 cases of measles have been confirmed in Washington, prompting state health officials to declare the state of emergency.

Given the growing footprint of measles, VCU News spoke with Michelle Doll, MD, VCU Health Epidemiologist in the Division of Infectious Diseases, what did measles look like, what can you do to prevent it from contracting and what does it look like? to do if you get it.

What is measles?

Measles is a highly contagious viral disease that causes a high rate of complications. But it is effectively prevented by vaccination.

It is a disease both world-wide and old. It is thought that it has been circulating around the world for at least 2,000 years. Before the widespread availability of vaccines, no periodic epidemic was spared in the country. Today, the disease is rare in the United States because of high vaccination rates, but it is more common in other countries where vaccination rates are lower.

How do you know if you have measles?

The initial symptoms in measles patients are very non-specific, which means that the symptoms would be similar to those of other viral respiratory infections. For example, we clinicians are looking for the three C's: cough, coryza (runny nose) and conjunctivitis.

Another early sign of measles is the appearance of tiny pale bumps surrounded by redness called Koplik spots on the back of the mouth. They look like grains of sand.

Finally, a red and uneven skin rash will appear when the person is most contagious. This rash is quite unusual as it starts on the top of the head, on the face, and enters the body trunk to the ends. Measles is one of the only diseases whose type of eruption is similar to this one. In fact, in my medical student textbooks, the measles outbreak was represented by images of people with red paint poured over their heads to dramatically remind us of this unusual peculiarity.

How is measles transmitted?

Measles is one of the most contagious infectious diseases that exists. It's a nightmare of infection control.

This virus can spread in many ways, including by airborne transmission. This means that a person can be infected simply by sharing the same air in a room where a person with measles is or was sitting recently.

The epidemics we see in the United States are mainly caused by a returning traveler who may have been exposed to the virus in countries where he travels more routinely. Once back home, people susceptible to the virus – either because they have not been vaccinated, or because they have immune system problems – can be infected and pbad the virus to other members of the community. It is important to note that imported cases are epidemiologically linked to returning travelers who are by far residents of the United States and, to this day, generally not people in the course of immigration or migration.

Say I have measles. What should I do?

Anyone suspected of contracting measles should immediately consult their doctor by phone for instructions.

Depending on their risk factors, such as vaccination status, travel history or the status of an outbreak in their community, the doctor may bring them for badessment or contact the health service. The treatment against measles is beneficial, which means that there is no specific treatment for the measles virus itself.

How can you prevent it from contracting?

Measles cases often result in complications such as pneumonia and meningitis or encephalitis and, as I mentioned, there is no specific treatment for the disease. Therefore, prevention is essential.

Vaccination against measles is included in the [measles, mumps and rubella] vaccine that children should receive at the age of 12 to 15 months and again aged 4 to 6 years. Because it's a live vaccine – that is, it contains a weakened version of the virus – some people can not contract it. For those we call "immunocompromised", there is a risk that even the weakened virus will cause them a problem; it is therefore not recommended for certain specific conditions or for immune problems.

Anyone with incomplete vaccination records can receive the vaccine even after childhood, and the CDC recommends that anyone planning to travel abroad make sure that their measles vaccines are up-to-date.

Why have there been so many measles outbreaks in the United States?

Measles prevention is an individual and community effort. Outbreaks are due to the number of susceptible hosts that the virus can infect in the community.

A small part of the population will inevitably be susceptible to the measles virus. These could include people using immunosuppressive therapies for other treatments and conditions, or children who have not yet been fully immunized.

As a community, if enough of us are vaccinated against measles, we are protecting not only ourselves, but our vulnerable neighbors as well. However, if enough people choose not to be vaccinated, this leaves enough holes in the vaccine coverage for the virus to find and spread to susceptible hosts.

In the area of ​​infectious diseases and public health, we have enormous respect for measles. Vaccination is essential for personal protection, infection control and the protection of our communities against this truly terrible disease.

Provided by
University of the Commonwealth of Virginia