Measles, a highly contagious respiratory infection that causes serious complications in about 3 of 10 people, has been grabbing headlines since last December’s outbreak at Disneyland. In January, the Centers for Disease Control and Prevention reported 102 cases of measles in 14 states. One unconfirmed case was just reported in New Jersey. Measured against the approximately 600 cases reported in 2014, this year is on track to set a record for a disease that was declared eradicated in the United States in 2000.
While concern surrounding the outbreak has focused on children and the anti-vaccine movement, more than 60 percent of the cases reported are among adults – a statistic that led the Centers for Disease Control and Prevention to urge adults to be vaccinated. This has many wondering: Am I protected?
Rutgers Today spoke with pediatric infectious diseases specialist Glenn Fennelly, chair of the Department of Pediatrics at Rutgers New Jersey Medical School, regarding the myths and facts about measles and its vaccine and how to protect yourself.
Rutgers Today: How does an outbreak like this occur after measles was considered eradicated in the United States?
Fennelly: The majority of people who are going to get measles are unvaccinated. Since measles continues to be common in other parts of the world, travelers can bring it back to the United States where it can spread in communities with pockets of unvaccinated people.
Rutgers Today: How contagious is measles compared to other diseases?
Fennelly: It’s highly contagious. If you are nonimmune and have contact with an infected person, there is a 90 percent probability that you will contract measles.
Rutgers Today: Who is most at risk, and what are the complications of contracting measles?
Fennelly: Children younger than one year old who are too young to receive the vaccine are most vulnerable to contracting measles and can suffer severe complications. Children younger than 5 years old and adults over age 20 have the highest rates of complications and death. Bacterial pneumonia is the most common complication. Often occurring against a background of malnutrition, it accounts for about 60 percent of all deaths due to measles worldwide. Other complications include ear infections, diarrhea, lung infections and acute encephalitis, or swelling of the brain, which can be very debilitating or fatal.
Measles can be deceiving since its initial symptoms appear to be like those of a cold or flu, such as high fever, cough, runny nose and watery eyes; however, two to three days later, white spots appear in the mouth, followed by a red, spotty rash.
Rutgers Today: Could something like the Disneyland outbreak occur at a public venue anywhere?
Fennelly: Absolutely. It can occur anywhere that nonimmune adults and children encounter someone who has measles – often a traveler from another country or someone who was exposed through an outbreak like the one in Disneyland. A parent’s decision not to vaccinate a child against measles puts infants everywhere at risk for this killer disease.
Rutgers Today: Which are the common misconceptions about the vaccine that prevents people from giving it to their child?
Fennelly: The most prevalent misconception is that the measles-mumps-rubella vaccine causes autism. However, there is no causal relationship between measles vaccination and autism. Period. The 1998 research paper that lead to this misconception was subsequently found to be fraudulent and was retracted by The Lancet, the British medical journal that originally published it.
Pediatricians recommend that children receive the MMR vaccine, administered in a two-shot series, at 12 to 15 months and between ages 4 to 6.
Rutgers Today: What adults are vulnerable?
Fennelly: People born before 1957 likely were already exposed to measles and are immune. Adults born between 1957 and 1971 could be at risk for contracting measles. During this period many people either were not getting the vaccine or received only one dose of a less effective version than is available now. This is particularly true for people born between 1963 and 1967, who received a vaccine that contained inactivated measles that was not as effective.
People vaccinated with that product or those who do not know their vaccination history should get it at least one live measles vaccine. Those who work in a health care facility are required to get a second shot. Those who work with children or in public places – like Disneyland – should strongly consider getting a second shot. This is one way to prevent future outbreaks. However, because women who are pregnant or people with certain conditions, such as immunosuppression, should not receive the MMR vaccine, people should speak to their physicians first.