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Measles Outbreak Update - Pfister
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The ongoing nationwide outbreak of measles, and previous outbreaks in the US, demonstrates that unvaccinated persons place not only themselves but their community at risk and that high vaccination coverage is important to prevent the spread of measles after importation.
The latest outbreak started in California in December 2014. The initial confirmed case reported visiting Disneyland Resort Theme Parks in Orange County. At this time, no source case for the outbreak has been identified, but it is likely a traveler or travelers infected with measles overseas visited one or both of the Disney parks in December during their infectious period. Genetic analysis of the viruses from several Disneyland related patients identified that all of the viruses are identical to the type that caused the large measles outbreak in the Philippines in 2014.
The outbreak continued to intensify in January 2015 with over 100 cases reported from 14 states, including eleven confirmed cases in suburban Cook County, IL. With the exception of 2014, this is typically the number of cases reported for a whole year nationwide. The majority of the people who became ill were unvaccinated. In 2014, the U.S. experienced 23 measles outbreaks with 644 cases, including one large outbreak occurring primarily among unvaccinated Amish communities in Ohio. In 2013, there were 11 outbreaks reported nationwide. Again, most cases were in persons who were unvaccinated or had unknown vaccination status.
Measles is a serious respiratory disease caused by a virus (morbillivirus). It is highly contagious and spreads through the air primarily when an infected person coughs or sneezes. Before the U.S. measles vaccination program started in 1963, about 3-4 million people in the U.S. got measles each year; 400-500 of them died; 48,000 were hospitalized; and 4,000 developed encephalitis. The virus is extremely contagious: on average, 90% of those exposed to someone with the measles will get the disease themselves unless they've been vaccinated, or have had measles before. Patients who survive a case of the measles retain immunity to it for life.
The disease starts with a fever, followed by a cough, runny nose, and red eyes. Then a rash of tiny, red spots breaks out starting at the head and spreading to the rest of the body. The rash can last for a week, and coughing can last for 10 days. The virus and symptoms typically disappear within two to three weeks. Treatment is non-specific and focused on boosting the immune system and alleviating the symptoms. Even in developed countries like the U.S. for every thousand children who get measles, one to three of them die. About 28% of children in the U.S. who had measles required treatment in a hospital. Measles can also result in complications in children as they can develop pneumonia, lifelong brain damage or hearing loss.
MMR vaccine (measles/mumps/rubella) is about 93% effective; two doses are about 97% effective. While the vaccination rates in the US are high (close to 90% by age three and about 95% by kindergarten), there are certain population groups that oppose vaccination. These populations become highly susceptible to vaccine preventable diseases such as measles or mumps and often serve as a source of an outbreak.
In the last 25 years, measles is uncommon in Lake County as only two cases have been reported and our 2015 suspect case tested negative on February 6th, 2015. LCHD/CHC partners with other health departments in the northeastern Illinois region, the Illinois Department of Public Health, local health care providers, schools, day care centers and others on preventing measles and improving vaccination compliance.
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