What you need to know about measles

Measles has come to Pennsylvania.

The Allegheny County Health Department in western Pennsylvania on Tuesday reported the state’s first case of measles this year in an adult resident, who was treated and released from the UPMC Shadyside emergency room. The person was reportedly not vaccinated and had recently traveled internationally.

The Centers for Disease Control and Prevention said more than 700 cases have been reported, making this the worst year for measles in the United States since 1994, when 963 cases were reported.

The high number of cases, the CDC said, is primarily the result of a few large outbreaks — one in Washington state and two large outbreaks in New York that started in late 2018. The outbreaks in New York City and New York state are among the largest and longest lasting since measles elimination in 2000.

A suspected case of measles near State College two weeks ago was a false alarm after tests came back negative.

“Because there are outbreak areas in New York and New Jersey, which are adjacent to us, there was no good reason to think that at some point, it would not come to Pennsylvania,” said Dr. Jeffrey Jahre, St. Luke’s University Health Network infectious disease specialist. “Viruses don’t respect state borders.”

Exposure to measles

Jahre said anyone born before 1957 has likely been exposed to measles naturally and is immune, while anyone born after 1991 likely received two doses of the vaccine, which gives them a 97 percent chance of being immune. Anyone born between 1963 and 1991 likely only received one dose of the vaccine, and a booster shot is recommended. Having only one dose of the vaccine gives a person a 90 percent chance of immunity.

Experts advise that people in that gray area of 1957 to 1963 should check with their doctor and consider a booster vaccine.

“With measles, as with any disease, prevention is far better than the cure,” Jahre said.

According to the CDC, recent outbreaks started through importation. Measles is imported when an unvaccinated traveler visits a country where there is widespread measles transmission, gets infected with measles, and returns to the United States and exposes people in a community who are not vaccinated.

When measles is imported into a community with a highly vaccinated population, outbreaks either don’t happen or are usually small. However, once measles is in an under-vaccinated community, it becomes difficult to control the spread of the disease.

“This current outbreak is deeply troubling and I call upon all health care providers to assure patients about the efficacy and safety of the measles vaccine, said CDC Director Robert Redfield. “And, I encourage all Americans to adhere to CDC vaccine guidelines in order to protect themselves, their families, and their communities from measles and other vaccine preventable diseases. We must work together as a nation to eliminate this disease once and for all.”

Symptoms

Measles starts with fever, runny nose, cough, red eyes, and sore throat. It’s followed by a rash that spreads over the body. Measles is highly contagious and spreads through coughing and sneezing.

“We’re really encouraging anyone who has those symptoms and especially those who have traveled to an area where measles is prevalent to not ignore that as the common cold and get to the family doctor right away,” said Dr. Tibisay Villalobos, Lehigh Valley Health Network pediatric infectious disease specialist.

“We are seeing a lot of common colds with the seasons changing, but if you wait and you’re four to five days into the measles disease, you’re already contagious.”

Vaccines

All school-age children are required to receive the MMR vaccine. The CDC recommends two doses: the first at 12 to 15 months and the second at 4 to 6 years old.

“With the outbreak, the threshold has been lowered and children can get that first dose as early as 6 months old and the second dose as early as a month later,” Villalobos said. “We are seeing a lot of parents take advantage of those early doses, which is good news.”

Exemptions from the immunization requirement exist for anyone who has a pre-existing health problem that conflicts with the immunization requirements, a religious objection to vaccines, or a philosophical exemption to vaccines, which is characterized in law as “a strong moral or ethical conviction similar to a religious belief.

Pennsylvania is among 17 states that allow parents to declare a philosophical exemption to excuse a child from being vaccinated for any reason.

The Pennsylvania Department of Health tracks the number of students in kindergarten and seventh grade who receive required immunizations.

In Carbon County for 2017-18, six kindergarten and seventh grade students had a medical exemption from receiving the immunizations, nine had a religious exemption and 17 had a philosophical exemption. In Schuylkill County, seven students had a medical exemption, 19 had a religious exemption and 20 had a philosophical exemption. In Monroe County, 18 students had a medical exemption, 62 had a religious exemption and 80 had a philosophical exemption. In Lehigh County, 43 students had a medical exemption, 91 had a religious exemption and 72 had a philosophical exemption.

Leach’s bill would eliminate the religious exemption and the “philosophical” exemption. Leach’s bill would not affect the medical exemption.

Staying safe

“The law requires us all to get vaccinated to attend school because that’s the only way we can protect the health of students who are medically unable to get a vaccination,” Leach said. “Vaccines are safe. The recent outbreak of mumps and measles reminds us that vaccines are absolutely essential to public health.”

“At the end of the day, our top priority has to be keeping our citizens safe,” he added. “And when assessing how to best do that, we have an obligation to respect the scientific consensus and act rationally. All of the science says that vaccines save many lives and stop the spread of easily preventable but deadly diseases. It would be legislative malpractice not to do all we can to ensure that our children are protected.”

Jahre said that the perceived connection between the MMR vaccine and autism has been debunked multiple times.

“The author of the report actually retracted that,” Jahre said. “There were 10 large studies after that the showed absolutely no connection between this vaccine and autism.”

St. Luke’s will be conducting what Jahre called a tabletop exercise, which goes through possible scenarios in preparing for the possibility of the measles outbreak reaching Pennsylvania.