April 12, 2024 – When a mother in Atlanta, GA, realized Measles After symptoms in her son returned from an international trip earlier this year, she knew that taking him directly to a local emergency room could put others at risk.
She put him in a car outside the ER, alerting the staff inside.
“We were able to bring the child in immediately and immediately put him in an isolation room and mask and avoid potential exposure, but it could have been very different,” pediatric infectious disease specialist Matt Lynam said. , MD, said his colleagues in Children’s Health Care. Atlanta treated the patient.
The boy, who was older than 5 years and had not been vaccinated, recovered from measles after being hospitalized.
Federal health officials are urging medical and public health organizations to look for potential measles cases because outbreaks of the disease are on the rise this year.
“A lot of the symptoms of measles — fever, cough, red eyes, a rash, even if it hasn’t developed yet — there are a lot of other things that can present like that,” Lynam said. “If you’re not able to recognize it very quickly and isolate that child and their family very quickly, you can get exposure to health care.”
The maternal scene in Atlanta is unusual for health care workers. Several communities have received alerts in recent weeks that people have unknowingly contracted measles in everyday places like Walmart. Suburban Chicago or in a medical center California.
Measles is so contagious that 9 out of 10 unprotected people who come into contact with it can get sick, and as cases increase and vaccination rates drop, the risks are increasing in some communities.
CDC released warning Last week, the measles vaccination rate among US kindergarteners dropped from a herd immunity rate of about 95 percent. Meanwhile, the number of cases is increasing. Within the first 3 months of 2024, the nation exceeded the total number of cases recorded in all of 2023.
The most recent CDC group Nationwide measles cases stand at 113 in 2024, nearly doubling in less than 2 weeks. The pace is so fast that CDC data scientists published a projection of whether measles is on track for a record-breaking year.
What is the complication of measles in 2024?
The CDC’s new estimate predicts there will be 300 measles cases in the U.S. this year, down from the chart-topping year of 2019, when there were 1,274 cases. But the 300 cases still make 2024 the fourth-most cases in the past 25 years.
In 2000, measles was declared “eradicated” in the United States, meaning it was no longer persistently present in the country. A vaccine for measles became available in 1971, and it took the nation three decades to achieve herd immunity, which usually occurs once about 95 percent of the population is vaccinated. Since 2000, measles outbreaks have resulted from unvaccinated international travelers bringing measles back to the United States after being infected abroad, then spreading the disease to other unvaccinated people.
But vaccination rates have dropped so low that now, there is a strong possibility that the disease will lose its “eliminated” status and once again begin to circulate and spread regularly in the United States, according to a new CDC report. Report Published Thursday.
“It’s really probably the only infection that’s this contagious, so you really have to vaccinate to prevent transmission,” explained Kathryn Paulus, MD, an adult communicator at Penn State Health Milton S. Hershey Medical Center in Hershey, PA. Doctor of diseases.
Paul, published a paper with Anthony Fauci, MD, and others New England Journal of Medicine Titled “Measles in 2019 – Going Backwards”, it examines the record-setting year and recalls that measles had a global impact in the millions before the development of a vaccine. The disease was so common that there is considerable data on its toll on the human body, including a risk of 1 in 1,000 cases resulting in potentially fatal neurological complications.
Lessons learned from measles in 2019
Today, health officials diagnose measles on an epidemic basis, which depends almost entirely on whether people in a community have been vaccinated.
“It’s really different from other infections that are less transmissible,” Paul said. “We were able to stop the spread of COVID by doing things like social distancing and masking. But measles is so contagious that you really have to rely on the vaccine to control the outbreak.
The case was one of the largest modern riots in the United States, spanning 2018 and 2019 and occurring in and around Rockland County, NY. An Orthodox Jewish community was at the center of the outbreak, which was sparked by international travel. The county ultimately had more than 300 measles cases linked to the outbreak. In 2019 alone, New York State had 1,274 of the nation’s 911 measles cases.
Unvaccinated children Stay home from school For 21 days if they have measles. Public health officials worked to find cases and question people who were in isolation. It was there that a health department official called an “all-out” campaign to get people vaccinated against measles, visiting local doctors’ offices, private and public workplaces, and providing information in the neighborhood. Also the door hangers should be split.
Debra Blagg, MD, MPH, medical director of the New York State Department of Health’s vaccine division, said, “There was a huge increase in the number of vaccines available, and I think that’s ultimately what stopped the outbreak.” Working as a pediatrician and public health officer in New York as well as time at the CDC.
He noted that following the 2018 to 2019 measles outbreak, New York state ended its school immunity religious exemption.
Children usually receive the first dose of measles vaccine at age 1, and a second dose is recommended between ages 4 and 6, according to American Academy of Pediatrics. But children can get a second dose as soon as 28 days after the first dose, which increases protection from 93 percent to 97 percent.
Last week, the CDC said the measles vaccination rate among US kindergarteners has slipped from 95% to 93%, and is even lower in some communities. During the 2020 to 2021 school year, there were a quarter of a million kindergarteners attending school who had not been vaccinated against measles.
CDC data scientists estimate that the current vaccination rate of 93% means a single child with measles attending a school of 100 children is about 10 more likely to become ill. As school vaccination rates decline, the number of people who become ill increases, reaching nearly a third of the school population who become ill if vaccination rates drop below 70%.
About half of children who get measles are usually hospitalized. There is no cure, only supportive care.
Herd immunity protects not only vulnerable children, such as infants who are too young to be vaccinated, but also people with weakened immune systems.
“I see bone marrow transplant patients primarily and help treat infections in that population,” Paul said. “We can’t give them some of these vaccines, including the measles vaccine because it’s a live vaccine.
Close friends and family members of people who have had a transplant are asked to make sure they are up to date on vaccines.
“We run into situations all the time where people are not up-to-date on vaccinations for a variety of reasons, and we find that people want to protect their loved ones,” said Paul, who suggests that someone Have concerns about vaccinations. A trusted medical professional with whom they can discuss these concerns.
Talking about vaccines
In New York state in 2018 and 2019, the prevalence was exacerbated by low vaccination rates, although lack of vaccination is not always the result of vaccine hesitancy or misinformation, the blog noted.
“People were kind of complacent and thinking, ‘Oh, everybody’s been vaccinated and we’re not at risk,'” he said. “It doesn’t take much to reduce vaccination rates and the disease has become an epidemic. People don’t believe you when they don’t see it in their community.
“We are such a mobile society and disease outbreaks are just a plane ride away,” the blog continued. “We still have to be vigilant about getting the vaccine and dealing with vaccine hesitancy.” Community trust and participation are important.
For anyone who has a friend or family member or colleague who is vaccine hesitant and wants to help that person, the first step is to organize your mindset when entering the conversation, and the second step is to be a patient listener. To be, advised Lynam, based on his communication with the parents of his patients.
“A lot of times, there’s a tendency to demonize these parents and say, ‘You’re hurting your child and you don’t care about them.’ I think this could not be further from the truth. The most important thing in working with family, friends, colleagues, or patients is to remember first and foremost that these parents are no different than you or me, and they want what is best for their children. And want to keep them safe.
Remember that they are feeling really uncomfortable after hearing or reading something about vaccines.
“What I try to do when I’m in these situations is, first, I check in with myself and remind myself that they want what’s best for their child.” Then I tell them. I try to understand their specific concerns because often that helps how you respond,” Lynam said, suggesting that the American Academy of Pediatrics website could be a resource for them to learn more about their questions. for the.
“It’s not usually a one-and-done conversation,” he said. “You have to be patient.”
