Measles: What You Need to Know About the Panic And Prevention
As measles continues to spread, so does the level of concern. And with the latest news of the outbreak at a Chicago daycare, parents are among the most worried. But rest assured: if your child is vaccinated, you’ve done all you can in terms of prevention. And to quell your fears (and our own!) we talked to a pediatrician who’s been there, done that (yep, she had measles).
Cheryl Wu, M.D, based in New York City, explains that this outbreak is not yet an epidemic. “If you look at the numbers, it’s not a huge amount,” she says. Between January 1 and February 6, 121 cases across 17 states have been reported, according to the Centers for Disease Control and Prevention. “But it’s concerning because measles are supposed to be totally gone from our country.”
The virus was declared eradicated in the U.S. in 2000 after widespread vaccinations. Yet the CDC reports that the majority of the currently-infected patients were not vaccinated. So how the heck did it get over here? Typically, it’s brought in from foreign travelers. And it only takes one infected person to spread the highly-contagious virus. The Disneyland incident isn’t the first example of the virus resurfacing. Wu cites a 2013 case in Brooklyn, when a teenager came home from London while infectious, ultimately spreading measles to 58 members of his Orthodox Jewish community. None of the infected were vaccinated, and 12 were babies too young to be immunized.
That brings up another concern: if your child is under 12 months old, what are you to do? Based on standard vaccine schedules, babies don’t get their MMR (measles, mumps rubella) shot until 12-15 months. If everyone around them is vaccinated, they’re considered in the clear. And the littlest babies have an added level of protection you might not realize — your own antibodies offer some virus-fighting protection for the first six months. At this age, babies begin to develop their own antibodies, making it safe to administer the vaccine. “I routinely immunize babies older than six months but under a year old who are doing international travel with MMR,” says Wu.
Still, for most babies, holding off until 12 months is best, unless you live in a community where there is an outbreak. “MMR is a live vaccine,” says Wu. That means it works like the flu shot or chicken pox vaccine — you receive a strain of the actual virus, and you make antibodies. “Measles, mumps, rubella — those guys are living in the vial. Under 12 months, some babies can still have maternal antibodies, which means they won’t get to make their own.”
So you probably won’t be able to convince your pediatrician to vaccinate your eight-month-old, even if she is in daycare with potentially-unvaccinated older children. If you are concerned she’s at risk, Wu says you have to be vocal. “Daycare centers don’t have to tell you if there are unvaccinated children. But I would ask the director the policy on accepting unvaccinated kids, and express your concern.”
Worst comes to worst and your child does contract measles, what should you do? What does it look like? First of all, don’t panic; this is not a death sentence. People born before 1957 are exempt from receiving the vaccine because they lived through so many epidemics and likely contracted the virus themselves. It used to be fairly common; it’s like a really bad case of the flu, but much more uncomfortable. “It starts with a cough, runny nose and fever,” says Wu. “The difference is that you’ll also see red eyes and Koplik spots [white spots in the mouth].” Three to five days after symptoms begin, the notorious red and white rash spreads over the body. In terms of treatment, it’s really just a waiting game and supportive care. There’s no medication for measles.
So if you can recover from measles, why the hysteria? And why the insistence on vaccination? “We vaccinate because we are scared of complications,” says Wu. “One out of every 20 children with measles will contract pneumonia. And one out of every thousand can develop encephalitis.” (Encephalitis is the swelling of the brain that can lead to convulsions, deafness and mental retardation.) A more advanced form of encephalitis, SSPE, can affect 4-11 out of every 100,000 with measles. And there’s no cure for SSPE. “If there’s no cure, what’s the second best thing? Prevention,” says Wu, advocating vaccines.
“Vaccines are good for public health and the prevention of spreading viruses, but on an individual level, they’re good for preventing more serious complications from illnesses,” says Wu. She expects that this year’s outbreak will serve as a lesson of the importance of vaccinations for future generations.