What world travelers should know about the current measles outbreaks.

U.S. reported measles cases by year. source: https://www.cdc.gov/measles/cases-outbreaks.html

From January 1 through May 10 2019 the US has reported 839 cases of measles from 23 states (including Arizona). This is the largest number reported since 1994, despite the year being only 1/3 complete. Measles is one of the most highly contagious diseases, and is spread from person to person by airborne droplets that occur when a person coughs or sneezes.

A person could contract measles simply by being in close proximity to someone who has the disease, and people are contagious beginning 4 days before they even start with symptoms.More than just a fever and rash, measles is a serious disease. Common complications of measles include ear infections, dehydration due to diarrhea and vomiting, pneumonia, and seizures.

Less common complications are infection of the membrane surrounding the brain and spinal cord (meningitis), and infection of the brain itself (encephalitis) both of which can lead to permanent brain damage. Measles can lead to hepatitis and even death. If a pregnant woman contracts measles she is at risk for miscarriage or premature birth. The risk for serious complications and death from measles is highest among children less than 5 years of age or adults greater than 20 years of age.

A vaccine to prevent measles was developed in 1963, and the US saw a dramatic decline in the number of measles cases once the vaccine was available. As a matter of fact, measles was declared eliminated from the United States in the year 2000. Since that time we have seen sporadic outbreaks, which occurred when an unvaccinated person traveled abroad and contracted the disease, then infected others when they returned home. These outbreaks were contained, and since 2000 measles has not had a permanent existence here is the United States. Now, there is great concern that due to low immunization rates, measles will spread, and again have a constant presence here. This could put the public health at risk, especially those who are unable to be vaccinated because they are too young, have immune system problems, or are pregnant.

Like the United States, the Philippines has also seen lowered immunization coverage among children, and in the first two months of 2019 the Philippines saw 12,700 measles cases with 203 measles deaths. Estimates are that fewer than 70% of Philippine children are immunized against measles.

Because measles is so highly contagious 95% of the population must be immune to prevent disease spread. But in some areas of our county school-aged children have immunization rates far below that. These low rates make an environment ripe for the spread of disease. The right of parent’s to refuse immunizations for their children is a very hot topic. Arizona recently passed legislation making it easier for parents to avoid immunizing their children. The bills allowed expanded exemptions for religious reasons, and also got rid of a requirement that parents or legal guardians sign a document stating they choose to opt out of vaccinations.

How can you know if you are immune to measles? People born before the year 1957 are presumed immune to measles due to the fact that they likely had the disease, and can’t contract it again. In the US those born between the years 1957 and 1989 were given one dose of the measles vaccine according to the guidelines of the day. We now know that many people who received one dose of measles vaccine do not remain immune for their lifetime, and it is now recommended that two doses of MMR vaccine be given to assure protection from measles disease. If you are not sure how many doses of measles vaccine you have received blood tests are available to determine whether or not you are immune. And if you need a dose of MMR vaccine we can provide it to you.

States which have reported measles cases in 2019. source: https://www.cdc.gov/measles/cases-outbreaks.html

References:

https://www.cdc.gov/measles/cases-outbreaks.html

https://www.popsci.com/current-measles-outbreaks-information-update

https://www.azcentral.com/story/news/local/arizona-health/2019/02/22/disregarding-warnings-arizona-lawmakers-move-forward-vaccine-exemptions/2942680002/