Can we stop the resurgence of measles?

Here are seven things to be aware of regarding the latest outbreaks of measles.

Have you been taken aback by recent reports of measles outbreaks in the US? We thought we were done with measles, didn’t we?
More than 20 years ago, widespread immunisation in the US stopped the continuous spread of measles, which was a significant public health accomplishment. Nearly every child in the United States contracted measles prior to the development of an effective vaccine in the 1960s. Every year, 400 to 500 people perished from complications like hearing loss or pneumonia brought on by measles.

As I write this, 34 states have reported 1,197 confirmed cases, the majority of which have involved minors. The worst outbreak is in west Texas, where two unvaccinated school-age children recently passed away and 96 people were hospitalized — the first measles deaths in the United States since 2015. A measles-related death has also been reported by New Mexico officials.

Can these tragedies be avoided?

Outbreaks of measles are very preventable. According to estimates, a community is protected against measles when 95% of its members are vaccinated, protecting both those individuals and others in the group.
However, school-age children’s measles vaccination rates nationwide decreased from 95% in 2019 to 92% in 2023. In over half of all Texas counties, kindergarten immunisation rates have fallen below 95%. The reported prevalence is 82% in the community at the epicentre of the outbreak in west Texas. Many people are at risk of contracting measles because declining vaccination rates are prevalent in other US regions as well.

In the US, only 3% of recent occurrences included individuals who were known to be completely vaccinated. The other individuals had only received one of the two doses of the vaccine (2%), were unvaccinated, or had an unclear immunisation status (95%).

Information regarding measles

As more communities experience measles epidemics, it’s critical to comprehend the causes and preventative measures. Here are seven measles-related facts.The measles virus spreads easily.

In recent years, outbreaks have occurred in a number of areas. Through the air we breathe, the measles virus can easily transmit from one person to another. Hours after a cough or sneeze, it may still be present in the air. Nine out of ten nonimmune individuals exposed to measles are expected to get the illness. Compared to the flu, COVID-19, or even Ebola, measles is significantly more contagious.

Early diagnosis is difficult.

After an infection, symptoms often appear seven to fourteen days later. Fever, coughing, and runny nose are common early symptoms that might be mistaken for other viral diseases such the flu or colds. Koplik spots are tiny, painless white spots that develop in the mouth a few days during the sickness. However, they are frequently lacking and easy to overlook. After a day or two, a characteristic skin rash appears.
Regretfully, a person who has measles is extremely contagious for days prior to developing a skin rash or Koplik spots. By the time measles is identified and preventative measures are implemented, others have frequently already been exposed.

Measles can be lethal or extremely dangerous.

Measles isn’t your average cold. Numerous difficulties may arise, such as

  • Encephalitis, or inflammation of the brain, can cause seizures, hearing loss, or intellectual incapacity.
  • Pneumonia
  • Inflammation of the eyes (and sometimes loss of eyesight)
  • Adverse pregnancy consequences, like miscarriage
  • Years after the first measles infection, a rare and deadly brain condition known as subacute sclerosing panencephalitis (SSPE) may manifest.

Children under five, adults over twenty, pregnant women, and those with compromised immune systems are most likely to experience complications. Up to three out of every 1,000 cases of measles result in death.
144 cases, or around one in eight, have necessitated hospitalisation during the most recent epidemics.

Measles can weaken your immune system.

Antibodies produced by your immune system will subsequently identify and aid in establishing a defence against these invaders when you become ill due to a bacterial or viral infection. According to a 2019 Harvard Medical School (HMS) study, the measles virus can eliminate up to three-quarters of a child’s prior immunity to certain viruses or bacteria, such as herpesvirus, flu strains, pneumonia-causing bacteria, and skin infections.

“You wouldn’t necessarily link pneumonia and measles if your child contracts both two years apart. The study’s first author, Dr. Michael Mina, who was a postdoctoral researcher in geneticist Stephen Elledge’s lab at HMS and Brigham and Women’s Hospital at the time of the study, suggested that the symptoms of measles itself might just be the beginning.

Vaccination works quite well.

The current vaccination offers 97% protection after two doses, which is significantly greater than most previous vaccines. Measles seldom strikes someone who has received all recommended vaccinations. The illness is usually less severe and less prone to spread when that occurs.

The immunisation against measles is safe.

The measles vaccine has a very good safety record. As with most immunisations, common side effects include muscle stiffness, low-grade fever, and transient arm ache. The idea that immunisations, including measles, cause autism has been disproved. Nonetheless, a considerable amount of vaccine hesitancy and declining vaccination rates have been caused by this often spread false information.

Strategies to prevent contracting measles

  • Vaccination. Children typically receive the first dose of the Measles-Mumps-Rubella (MMR) vaccination around age one, and the second dose between ages four and six. A kid or adult who has not had vaccinations may receive these doses at a later time.
  • If you were vaccinated against measles before 1968 but were born after 1957, you should think about getting vaccinated again or having your measles antibodies checked (see below). Compared to later versions, the vaccination administered prior to 1968 was less effective. Additionally, most people developed immunity after contracting measles prior to 1957, albeit this immunity might decrease.
  • separation. Everyone who has been diagnosed with measles and anyone who may be sick should stay away from close contact with other people for four days after the rash goes away in order to prevent the disease from spreading.
  • Wearing a mask can help stop the measles from spreading to other individuals. To prevent contracting it, family members or other close contacts should also wear masks.
  • Regular hand washing aids in preventing the virus’s spread.
  • Testing. Consider getting a blood test to determine your immunity to measles if you are unsure of your history of measles vaccinations or if you might be at risk of contracting the disease. Immunity might decrease and memories of previous immunisations can be misleading, particularly if decades have passed.
  • Planning ahead of time. Make sure you have had the most recent vaccines if you are travelling to an area where measles is prevalent.

The bottom line

Although recent measles news may have come as a shock, it is concerning. The number of cases (and maybe fatalities) is expected to rise, experts warn. Furthermore, outbreaks will inevitably continue to occur as vaccination rates decline. According to one study, nine to fifteen million youngsters in the United States may be at risk of contracting measles.
However, there is also good news: we know that measles can be eradicated and epidemics can be controlled. Learn how to keep your family and yourself safe. Respectfully interact with those who are concerned about getting vaccinated by sharing what you know about the illness from reputable sources, particularly the proven safety of immunisation.