As a registered nurse working in Occupational/Employee and Travel health, I wanted to respond to a February 26, 2014 article written by Chelsea Rice of the Boston Globe regarding the recent measles exposure in Framingham, Massachusetts. Vaccine preventable illnesses are still transmissible within the community.
Each year about 60 people in the United States are reported to have measles and in 2013, 189 people have been reported to have the disease. While measles is almost gone from the United States, it still kills an estimated 164,000 people each year around the world. Measles is still common throughout the world, including some countries in Europe, Asia, the Pacific, and Africa, increasing the risk of transmission.[i] Those at risk are people that have not been immunized or those that practice herd immunity. Herd immunity occurs when most of an isolated group (herd) has been immunized, thus providing a measure of protection for individuals who have not developed immunity.
Measles (rubeola) is a highly contagious respiratory disease caused by a virus that spreads through the air by breathing, coughing or sneezing in confined area. It is so contagious that children, older adults or individuals with insufficient immunity may get the disease if exposed to it. Symptoms develop about 7-14 days after exposure and include fever, runny nose, cough, red watery eyes, and a blotchy rash all over the body.
If you were born after 1954, chances are you may not remember the devastating effects of the measles virus due to the success of the nation’s current immunization program. Historically, the virus that causes measles was isolated in Boston, Massachusetts, by John F. Enders and Thomas C. Peebles in 1954. Before the availability of the measles vaccine, nearly all children got measles by the time they were 15 years of age. Each year in the United States about 450-500 people died because of measles, 48,000 were hospitalized, 7,000 had seizures, and about 1,000 suffered permanent brain damage or deafness.[ii] If vaccinations were stopped, each year about 2.7 million deaths from measles worldwide could be expected. Complications of the Measles virus are; ear infection, pneumonia, encephalitis, or even death. Measles may also cause a premature birth or miscarriage of a pregnant woman.[iii]
As stated in a recent interview with a Physician certified in Travel Medicine and Immunizations; “People die annually from infection with the measles virus. Those especially at risk are young children, older adults, and those with weakened immune systems. The public cannot rely on isolated communities providing herd immunity any longer. Herd immunity was once effective, however, is now diluted due to the increase of global travel, placing people at risk of exposure” (personal communication, March 5, 2014).
The measles vaccination is supplied in an individual dose vial, combined with rubella (German measles) and mumps. The Advisory Council on Immunization Practices (ACIP) and the Center for Disease Control and Prevention (CDC) recommend 2 doses of the vaccination to provide immunity. I would advocate for everyone to speak with their health care provider and ask questions regarding risks of getting the disease.
[i] Center for Disease Control and Prevention (2014). Measles outbreaks. Retrieved from http://www.cdc.gov/measles/outbreaks.html
[ii] Center for Disease Control and Prevention (2014). Overview of measles. Retrieved from http://www.cdc.gov/measles/about/overview.html
[iii] American Academy of Pediatrics (2012). Facts for parents about vaccine safety. Retrieved from http://www2.aap.org/advocacy/releases/autismparentfacts.htm