What public health, medical professionals want you to know about measles

  • In this Jan. 30, 2019 photo, signs posted at The Vancouver Clinic in Vancouver, Wash., warn patients and visitors of a measles outbreak.   AP PHOTO/GILLIAN FLACCUS  

Staff Writer
Published: 5/9/2019 5:54:27 PM

NORTHAMPTON — Nearly 20 years ago, measles was declared eliminated from the United States. But an outbreak of measles is now surging throughout the country. At least 764 cases across 23 states have been confirmed so far this year — the largest number of reported cases since 1994, according to the Centers for Disease Control and Prevention (CDC). 

There haven’t been any cases of the highly contagious disease in western Massachusetts in 2019, but one person in the Boston area was diagnosed with measles in March.

Medical professionals say that the Pioneer Valley is at risk of an outbreak and have urged people to make sure they are fully immunized.

“It’s not a matter of if measles is going to affect western Massachusetts again — it’s when,” said City of Northampton Public Health Director Merridith O’Leary. She said that there was a case of measles in the city in 2014. That year, a Smith College faculty member contracted measles, eight cases were reported in Massachusetts, and a total of 600 vaccines were administered between Hampshire and Hampden counties.

“Given we know we have suboptimal immunization here, we are certainly a community at risk of having a measles outbreak,” said Dr. Joanne Levin, medical director of infection prevention at Cooley Dickinson Health Care. 

And with many college graduations around the corner, that risk is heightened, said Kerry-Beth Garvey, associate director of medical services at Smith College. “We are worried that people are going to be coming in and going out from all kinds of places with varying levels of immunity and protection,” she said.

Extremely contagious

According to the CDC, up to 90 percent of people who are not immune to measles will become infected simply by being close to one person with the virus.

The virus is spread through respiration. “When people breathe, talk, sneeze, these droplets that have the virus in them can stay in the air for hours,” O’Leary said. “People really need to know that measles is one of the most contagious of infectious diseases out there.”

“That’s why it’s so scary to nurses,” Garvey added. “We know that if a person is on a bus, or in a dining hall that’s impacted, that entire space for a four-hour period is considered infectious.”

Anyone born before 1957 is presumed to be protected against measles, mumps and rubella (MMR), as they were likely exposed naturally, according to the CDC.

But between 1963 and 1967, some people got an ineffective version of the vaccine, though Levin said those cases are rare. O’Leary added that people vaccinated prior to the late 1980s may have had only one dose of the MMR vaccine, rather than the current recommended two doses, as the standard changed. One dose of the vaccine is 93 percent effective, according to the CDC, while two doses are 97 percent effective in preventing measles.

For people who fall into one of these categories, there’s no medical reason why they shouldn’t get another shot, Levin said: “It’s reasonable to be vaccinated. We want to err on the side of vaccination.”

“The safest thing to do is just take another vaccine,” she said, adding that a blood test can be done to check for immunity.

Over the past few months, Dr. Timothy Parsons, a family practitioner at Northampton Family Medicine, has fielded a number of questions about measles vaccines.

“There’s been significant interest and phone calls to our clinic about the status of immunization from adults,” he said.

He has done about 20 blood tests for immunity and found that about a third of patients needed a shot. Parsons got another shot himself after doing the blood test.

At Smith College, Garvey said many alumni from around the country have contacted the school asking about their vaccination records. “We’ve had a lot of activity. We’ve had a lot of calls,” she said. Some students at the college who previously had not been vaccinated recently chose to get vaccinated — about a fifth of those who’d had waivers at the time, Garvey said.

‘Community conversations’

Compared to the rest of the state, western Massachusetts has higher-than-average vaccine exemption rates. In Hampshire County, 3.7 percent of kindergartners were exempt from at least one vaccine, compared to the state average of 1.3 percent, according to the state Department of Public Health’s most recent data, from 2017-2018. Those exemptions — from vaccines protecting against polio, varicella, and measles, mumps and rubella, among others — vary from school to school.

“I think public health issues are always a dance between protecting the public’s health and individual liberties,” Levin said. “On this particular issue of measles vaccines, I think there are many people who don’t realize how many people they put at risk when they don’t vaccinate themselves or their children.”

Some people — the very young and those who are immunocompromised, for example — cannot be vaccinated but are protected if enough other people around them are vaccinated.

“We tend to think the vaccine is scarier than the disease because we haven’t seen the disease in a long time,” said Jenny Meyer, public health nurse at the City of Northampton Health Department.

Vaccines are safe, Meyer said, and as Levin put it, “getting the vaccine is safer than getting the measles.”

The best way to do outreach to vaccine-hesitant parents is through parents talking to each other, Meyer added: “What we’re doing is starting to encourage community conversations.”

Meyer also encouraged people with questions to reach out to her at jmeyer@northamptonma.gov, or to contact their pediatrician. 

Fever, a dry cough, runny nose, conjunctivitis, small white spots inside the mouth, and a flat, blotchy skin rash are typical symptoms of measles.

Common complications from measles include diarrhea and ear infections. Severe complications include pneumonia and encephalitis, which can lead to hospitalization and death.

If people exhibit symptoms of the illness, Levin stressed the importance of calling a doctor or health care provider before making an in-person visit. “Measles is so contagious,” she said, “we want to try to bring them into a health care setting without exposing other patients.”

More information is available at www.mass.gov/service-details/measles and at www.cdc.gov/measles/index.html

Greta Jochem can be reached at gjochem@gazettenet.com.


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