Are You Safe During the Measles Outbreak?

The CDC Explains It All
By RICK MELLERUP | May 01, 2019

Ocean County, NJ — Newspapers and television networks and stations have spent much time reporting about the measles outbreak in the United States for the past several months. But despite all that coverage, do you know if you and your family are safe? You almost certainly have your toddlers’ immunization records. But were your teenagers or college-age children vaccinated? More than 700 students and staff at two California universities who could not prove they had been vaccinated were quarantined last week after being exposed to the disease.

What about you? If you got a measles shot when you were a toddler, you probably don’t remember it. Chances are you long ago lost your childhood medical records, and, to boot, have likely changed doctors several times over the course of your life. It can be almost impossible to track your immunization records down.

Before launching into the latest advice from the Centers for Disease Control and Prevention, let’s see just how bad this year’s measles outbreak has become.

The CDC reported on Monday that there had been 704 confirmed cases of measles this year in 22 states as of April 26. That was an increase of 78 cases from the week before and is the greatest number of cases reported in a calendar year in the U.S. since measles was declared eliminated in 2000. Current outbreaks – defined as three or more confirmed cases in an approximate catchment population of 100,000 people in a month – are taking place in six states, including New Jersey and New York.

Taking a wider view, the World Health Organization said in April there had been over 110,000 measles cases in the world in the first three months of the year, a 300 percent increase in the number of cases worldwide as compared to the similar time period in 2018. And the measles situation worldwide last year was more than bad enough.

Let’s zoom in on one geographic area for an example of just how frightening measles can be. WHO said measles killed 72 children and adults in its European Region in 2018 and 82,596 Europeans overall contracted measles in 2018.

Let’s zoom even further, on Ocean County. As of April 2, when the Ocean County Health Department issued its last advisory, there had been 39 confirmed cases in the county since October 2018. True, 33 of those cases came during the county’s first outbreak, which ran from October 2018 to mid-January 2019. But six additional cases appeared this spring before the OCHD’s last update. Yes, most of the cases took place among unvaccinated residents of Lakewood, but not necessarily all. In December The SandPaper reported 86 county residents might have been exposed to measles in a invitation-only event about which the county health department did not release details.

When The SandPaper was reporting on the original outbreak last autumn, the OCHD’s advice was for residents to review the vaccination history for themselves and their children. Now the CDC is offering much more detailed advice.

The CDC considers you protected from measles if you have written documentation showing at least one of the following:

• You received two doses of measles-containing vaccine and are a school-age child in grades K-12 or an adult who will be in a setting that poses a high risk for measles transmission, including students at post-high school education institutions, healthcare personnel and international travelers.

• You received one dose of measles-containing vaccine and you are either a preschool-age child or an adult who will not be in a high-risk setting for measles transmission.

• A laboratory confirmed you had measles at some point in your life.

• A laboratory confirmed you are immune to measles.

• You were born before 1957.

The last case is interesting. Why should 1957 be the cutoff? Because the measles vaccine wasn’t developed until 1963, meaning just about everybody in the United States born before 1957 had the disease, which left them with lifelong immunity.

You do not need a booster shot if you received two doses of measles vaccine as a child. If you were born after 1957 and received only one vaccination, you need at least one dose of measles vaccine unless a lab confirmed you had a past measles infection or are immune to the measles.

If you are unsure whether you’re immune to the measles, try to find your vaccination records. You can have your doctor test your blood to determine if you are immune, but that requires two doctor’s visits. It is easier to simply get another dose of MMR vaccine because there is no harm in getting the shot if you may already be immune to measles (or mumps or rubella).

Fewer than a million people were vaccinated with a killed measles vaccine, an earlier version of today’s vaccine that is no longer is use, from 1963 to 1968. If you’re unsure whether you fall into this group, get tested or, just as good, get a dose of the MMR vaccine.

The MMR vaccine isn’t 100 percent effective against measles. It is, though, very effective, with about a 97 percent success rate at preventing measles after two doses. The success rate drops to 93 percent if you received just one dose. But the good news is that people who received even one dose would likely have a milder illness.

If you aren’t sure you have been properly vaccinated and know you have been exposed to someone who has the measles or show symptoms – especially the rash associated with the disease – call your doctor and make special arrangements to have your situation evaluated so you don’t put other patients and medical staff at risk by just showing up at a doctor’s office or emergency room. If it turns out you do indeed have the measles, stay at home for at least four days after the rash appears; cover your mouth and nose with a tissue when you cough or sneeze and put the used tissue in a trash can; wash your hands often with soap and hot water; avoid sharing drinks and eating utensils; and disinfect frequently touched surfaces.

The CDC says that before the measles vaccination program started, an estimated 3 million to 4 million people got measles each year in the United States, of which 500,000 cases were reported. Among reported cases it was common for 400 to 500 people a year to die from measles while another 48,000 would have to be hospitalized and approximately 1,000 people a year would develop encephalitis (brain swelling) from measles.

Proof, indeed, that the measles are nothing to mess with!

— Rick Mellerup

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