Strategies for mitigating recent measles surge

For the first time in decades, measles outbreaks are making headlines across the country, worrying public health officials in cities and towns large and small.

By June 20, 1,077 measles cases had been confirmed in 2019 in 28 states, including two in Massachusetts, according to the U.S. Centers for Disease Control and Prevention. This is the highest number since 1992.

Measles is extremely contagious and can be fatal. The disease typically begins with a high fever, cough, runny nose and irritated eyes, followed by a skin rash, but complications can include swelling of the brain, pneumonia, ear infections, vision loss, severe diarrhea and dehydration. Babies, children and those with weak immune systems are at increased risk of contracting measles.

Measles had faded from public attention in recent years due to the successful implementation of the MMR (measles, mumps and rubella) vaccine. In the U.S., the CDC declared measles eliminated in 2000.

Vaccine-preventable diseases such as measles, however, are at risk of spreading when vaccination rates fall below 95 percent, and the recent rise of measles and other vaccine-preventable diseases threatens the health of populations around the world.

Factors driving measles outbreaks
The CDC reports that one of the main vehicles for measles outbreaks is an increase in the number of unvaccinated travelers who contract measles abroad and bring it to the United States.

“Measles is so contagious,” the CDC states, “that if one person has it, up to 90 percent of the people close to that person who are not immune will also become infected.”

Travelers are advised to visit the CDC’s website (wwwnc.cdc.gov/travel) when going abroad to find out about proper vaccines and medical treatment before and after a trip. The CDC routinely updates the site with all aspects of international travel health information, including vaccinations and disease precautions.

Another factor in the rise of measles – and one of today’s top 10 threats to global health, according to the World Health Organization – is the culture of “vaccine hesitancy.” The WHO says this “reluctance or refusal to vaccinate despite the availability of vaccines” threatens to reverse progress made in tackling vaccine-preventable diseases.

The reasons why people choose not to vaccinate are complex, according to a WHO vaccines advisory group, which has identified factors including complacency, inconvenience and lack of confidence in vaccines.

Misinformation, particularly on social media platforms, is also a factor. The American Medical Association recently wrote to the CEOs of six leading social media and technology companies in the U.S. and urged them to ensure that users have access to accurate, timely and scientifically sound information on vaccines.

Immunizations are critical
Diseases that used to be common in the United States and around the world – including polio, measles, diphtheria, whooping cough, rubella (German measles), mumps, tetanus and rotavirus – have been largely eradicated due to vaccinations.

The U.S. Food and Drug Administration states: “The overwhelming scientific evidence shows that vaccines are among the most effective and safest interventions to both prevent individual illness and protect public health.”

Vaccinating against measles, mumps and rubella not only protects the general public, it protects people who cannot be vaccinated, including children whose immune systems have been compromised due to illnesses such as cancer.

The CDC’s immunization schedule is designed to capitalize on the optimal window when immune systems are most effective in learning how to fight off viruses and bacteria. Research shows that the most effective time to administer vaccines to prevent diseases is when children are most vulnerable to contracting them.

Doctor H. Cody Meissner, chief of pediatric infectious diseases at Tufts’ Floating Hospital for Children and a national expert on vaccinations, said it is important not to prolong the immunization schedule, which has been carefully developed and revised over many years by the CDC and the American Academy of Pediatrics.

Deadly diseases that seem to have been almost eradicated have the ability to make a comeback when immunization rates drop. Everyone shares the responsibility to adhere to vaccine schedules and recommendations to protect themselves and loved ones, as well as those who are immunocompromised or unable to receive vaccines for medical reasons.

In a recent briefing, U.S. Health and Human Services Secretary Alex Azar said, “Vaccine-preventable diseases belong in the history books, not in our emergency rooms. We are reminding all Americans to talk to their doctors and ensure they are up to date with the CDC’s recommended vaccination schedule.”

Immunization and infectious disease resources
The Massachusetts Department of Public Health’s Immunization Division recommends visiting its website (www.mass.gov/immunization-division) for general information on vaccines and important updates for health care and public health professionals.

State public health officials rely on local boards of health, health care providers, and other public health personnel to report the existence of notifiable diseases, as required by law. Information on surveillance, reporting and control of infectious diseases in Massachusetts can be found at www.mass.gov/infectious-disease-surveillance-reporting-and-control.

For urgent questions about measles or the reporting of or suspicion of measles, call 617-983-6800, which is available 24/7 for emergency calls and infectious disease reporting.

To learn more about contraindications, or to find out if you or your children are up-to-date on vaccines, contact your physician or local or state health department.

Written by Tira Hanrahan, MIIA Wellness Representative.