Clinicians at Children's Medical Center Dallas are on the lookout for
possible cases of measles, and parents in North Texas are urged to take
steps that will help avoid an outbreak of this highly infectious and
for Disease Control (CDC) recently reported that the number of U.S.
measles cases in the first four months of 2014 is at an 18-year high.
According to Dr. Jeffrey S. Kahn, director of infectious disease at
Children's and professor at the University of Texas Southwestern Medical
Center, the incidence of measles in North and South America is still low
compared with the rest of the world, but the U.S. uptick is an early
warning signal for local parents to check their children's vaccination
schedules and make sure they are current.
"Measles is one of the most easily transmitted diseases in the world,
and even with relatively small numbers in the United States it's a cause
for concern, as measles can lead to serious complications, including
pneumonia, bronchitis and encephalitis," said Kahn.
Measles is a viral respiratory disease that predominantly affects
children but also strikes adults. Although it was officially declared
eliminated in 2000-meaning it no longer regularly passes through the
U.S. population-in recent years it has re-emerged, including an outbreak
last year in Tarrant and Denton counties that put local physicians and
health officials on alert. Although North Texas has not experienced a
community outbreak in 2014, individual cases have been identified in
Collin and Dallas counties this year.
According to the CDC,
the U.S. tally now stands at 168 confirmed cases in 15 states, with the
largest outbreaks in California and New York. Canada
also has experienced a spike in measles this year, with 320 cases in
Vancouver and smaller outbreaks in other cities. Many cases in North
America have been linked to international travel, particularly from the
Philippines, which has been hit hard by the disease. Globally, measles
is still endemi and a leading cause of childhood mortality in the
Measles has been on the rise in Europe, too, where vaccines are widely
available. The World
Health Organization reports that within the WHO/Europe region,
measles rose from 7,073 cases in 2007 to 31,685 cases in 2013-an
increase of 348 percent.
According to Kahn, babies less than a year old-prior to their first
measles, mumps and rubella (MMR) vaccination-are particularly
vulnerable, along with unvaccinated children and adults, whether by
choice or because they have an underlying condition such as
immunodeficiency that contraindicates vaccination. Young children who
have not had a second inoculation also are more susceptible to the
disease. And, fully vaccinated older children and adults may not be
entirely protected due to waning efficacy of earlier vaccines. Measles
also is dangerous for unvaccinated pregnant women due to high risks for
spontaneous abortion, premature labor and low birth weight babies.
"Even with heightened awareness in the medical community, measles can be
difficult to track and diagnose as there is a long incubation period,
and many physicians and nurses in the United States have never even seen
a patient with measles. However, when we notice an uptick in cases, we
have to be vigilant and fully prepared for the possibility that we will
see measles in the emergency room," said Kahn.
Measles is so contagious that tiny virus particles can remain live and
airborne in a room for up to two hours after a person with measles walks
through it. A tight enclosure such as an airplane virtually ensures that
every person will be exposed to the virus if one passenger is
contagious-and possibly the next planeload of passengers, too.
According to Kahn, if a child at Children's is diagnosed with measles,
the area must be evacuated, cleaned and quarantined for several hours.
He said measles can spread like wildfire in non-immunized populations
and create a nightmare for public health officials who must track each
sick person's movements and alert those who may have been exposed.
There is no specific medical treatment for measles other than supportive
care at home, although many children who develop complications require
hospitalization. Symptoms include fever, fatigue, cough, conjunctivitis,
runny nose and red rash, which usually appears four to five days after
the fever begins. Children with symptoms-particularly if they have
recently traveled internationally-should be evaluated for measles.
Parents should contact their primary care physicians if they suspect
Academy of Pediatrics and CDC recommend a first dose of the MMR
combined vaccine at 12 to 15 months and a second dose at 4 to 6 years of
age. If families are planning to travel internationally, the CDC
recommends that infants 6 to 11 months old get the vaccine. Texas
requires evidence of two-dose MMR vaccination prior to attending a
child-care facility or public or private school in Texas, although
parents may opt out by filing an affidavit for exemption. Forty-eight
states allow exemptions from vaccination requirements.
After decades of widespread vaccination and virtual elimination of
measles, U.S. health officials worry that the number of unvaccinated
children is becoming a problem, not only for the spread of measles but
also pertussis and other preventable diseases. Prior to the first
licensed measles vaccine in 1963, hundreds of children in the U.S. died
every year from the disease and thousands were hospitalized, some with
permanent impairment. Even with the best care available today, one or
two children in 1,000 with measles will die from the disease. Today's
vaccines are safe and effective, with common side effects typically mild
and serious reactions rare. The risk of severe complications from
measles outweighs the remote risk of severe complications from the
vaccine. Parents are urged to discuss any concerns with their primary
care physicians and utilize reliable sources of information to make
About Children's Medical Center
Founded in 1913, the not-for-profit Children's Medical Center is the
seventh-largest pediatric health care provider in the country, receiving
more than 760,000 patient visits annually at its two full-service
campuses in Dallas and Plano, multiple specialty clinics and 16 primary
care MyChildren's locations. Children's was the state's first pediatric
hospital to achieve Level I Trauma status and is the primary pediatric
facility affiliated with UT Southwestern Medical Center. For more than
100 years, Children's has been dedicated to making life better for
children. For more information, please visit childrens.com.
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