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Measles Outbreaks in Dallas, California, and Hawaii
By Vincent Iannelli, M.D.February 14, 2014
If it seems like you have been hearing a lot about measles outbreaks already this year, that's because there have been a lot of measles outbreaks this year.
The CDC reports 20 cases of measles for 2014. To keep that number in perspective, there were only 11 cases of measles at this point in 2011, which ended up having the highest number of measles cases since 1996.
Although it is impossible to predict what this means for the rest of the year, it is certainly shaping up to be a big year for this vaccine-preventable disease in the United States, especially when you consider that there are already many new cases to report:
An adult in Dallas County, Texas with no known source of infection and who is not linked to two pediatric cases in the North Texas area.
An unvaccinated student at the University of California, Berkeley who studied abroad in Asia and exposed others while attending classes and riding Bay Area Rapid Transit (BART) between Tuesday, February 4 through Friday, February 7.
A student at a Temecula, California elementary school, which has led to the quarantine of at least 10 other unvaccinated students.
An infant in Oahu, Hawaii who had just returned from the Philippines, where there has been a very large outbreak of measles in the last few years.
And if you are still thinking that measles is a mild disease, consider that among the 10,678 cases in Europe over the past 12 months, there were at least 8 cases of measles encephalitis and 3 deaths.
While the most simple take away message from this news should be to get vaccinated and protected against measles, at the very least everyone should:
get vaccinated if they are going to be traveling out of the country, keeping in mind that the MMR vaccine should be given to infants as young as six months of age if they will be traveling out of the United States. Children who are at least 12 months old should get two doses of MMR, separated by at least 28 days.
take immediate precautions if you are unvaccinated and there is any chance that you could have measles so that you don't expose other people, especially those who are too young to be vaccinated or who can't be vaccinated because they have immune system problems. That means becoming familiar with measles symptoms and calling ahead to your doctor or the emergency room if you think that you or your child has measles (or any vaccine-preventable disease). Even then, you don't just walk into the office or ER wearing a mask and say 'my kid might have measles.' A person with suspected measles is isolated from everyone who might be susceptible to measles.
As we are seeing many more cases of measles this year, health care providers should also become more familiar with measles. You still likely won't see a child with measles, but if you do, you want to make sure you diagnose them promptly. Some key things to remember when you have a patient with suspected measles is that you should consult your local or state health department as soon as you suspect the person has measles. Don't wait until your lab tests come back, as that can delay the immediate control measures that the health department does and can delay confirmation if the person really does have measles.
Health care providers should also remember that the measles virus can linger in a room for up to two hours. It is best to see patients with suspected measles at the end of the day, or at the very least, close off the room for at least two hours.
And remember to keep documentation of your measles vaccination in a handy place. In an outbreak setting, you are going to have to prove that you have been vaccinated.
Think this is just about the folks who aren't vaccinating their kids and you don't have to worry about these outbreaks? What if you vaccinate your kids on schedule, but brought your infant or preschooler to pick up your older child at that school in Temecula? What if your family member who is getting chemotherapy was riding the BART last week?
http://pediatrics.about.com/b/2014/02/14/measles-outbreaks-in-dallas-california-and-hawaii.htm
By Vincent Iannelli, M.D.February 14, 2014
If it seems like you have been hearing a lot about measles outbreaks already this year, that's because there have been a lot of measles outbreaks this year.
The CDC reports 20 cases of measles for 2014. To keep that number in perspective, there were only 11 cases of measles at this point in 2011, which ended up having the highest number of measles cases since 1996.
Although it is impossible to predict what this means for the rest of the year, it is certainly shaping up to be a big year for this vaccine-preventable disease in the United States, especially when you consider that there are already many new cases to report:
An adult in Dallas County, Texas with no known source of infection and who is not linked to two pediatric cases in the North Texas area.
An unvaccinated student at the University of California, Berkeley who studied abroad in Asia and exposed others while attending classes and riding Bay Area Rapid Transit (BART) between Tuesday, February 4 through Friday, February 7.
A student at a Temecula, California elementary school, which has led to the quarantine of at least 10 other unvaccinated students.
An infant in Oahu, Hawaii who had just returned from the Philippines, where there has been a very large outbreak of measles in the last few years.
And if you are still thinking that measles is a mild disease, consider that among the 10,678 cases in Europe over the past 12 months, there were at least 8 cases of measles encephalitis and 3 deaths.
While the most simple take away message from this news should be to get vaccinated and protected against measles, at the very least everyone should:
get vaccinated if they are going to be traveling out of the country, keeping in mind that the MMR vaccine should be given to infants as young as six months of age if they will be traveling out of the United States. Children who are at least 12 months old should get two doses of MMR, separated by at least 28 days.
take immediate precautions if you are unvaccinated and there is any chance that you could have measles so that you don't expose other people, especially those who are too young to be vaccinated or who can't be vaccinated because they have immune system problems. That means becoming familiar with measles symptoms and calling ahead to your doctor or the emergency room if you think that you or your child has measles (or any vaccine-preventable disease). Even then, you don't just walk into the office or ER wearing a mask and say 'my kid might have measles.' A person with suspected measles is isolated from everyone who might be susceptible to measles.
As we are seeing many more cases of measles this year, health care providers should also become more familiar with measles. You still likely won't see a child with measles, but if you do, you want to make sure you diagnose them promptly. Some key things to remember when you have a patient with suspected measles is that you should consult your local or state health department as soon as you suspect the person has measles. Don't wait until your lab tests come back, as that can delay the immediate control measures that the health department does and can delay confirmation if the person really does have measles.
Health care providers should also remember that the measles virus can linger in a room for up to two hours. It is best to see patients with suspected measles at the end of the day, or at the very least, close off the room for at least two hours.
And remember to keep documentation of your measles vaccination in a handy place. In an outbreak setting, you are going to have to prove that you have been vaccinated.
Think this is just about the folks who aren't vaccinating their kids and you don't have to worry about these outbreaks? What if you vaccinate your kids on schedule, but brought your infant or preschooler to pick up your older child at that school in Temecula? What if your family member who is getting chemotherapy was riding the BART last week?
http://pediatrics.about.com/b/2014/02/14/measles-outbreaks-in-dallas-california-and-hawaii.htm
