Confirmed measles cases in Texas expected to rise

5:33 AM, Feb 18, 2019

Measles supposedly was eradicated in the United States years ago, but it’s still around.

Having 1 case in 2015, 1 in 2016 and 1 in 2017 in Texas and then having 9 cases last year is a significant jump, and that’s something that has medical officials concerned.

The measles kills 450 people every day, and more than 100,000 people a year worldwide.

Health officials are reporting more than 100 confirmed cases of the measles nationwide. In Washington State, more than 50 cases have been reported. Here in Texas, officials say around 7 have been confirmed. And that number is expected to rise.

“It was actually kind of predicted; there were some hot spots that were identified by the CDC that had high unvaccination rates. So it is not a surprise that we are seeing measles again,” said Corpus Christi Medical Center ER Dr. Kim Onufrak.

Measles are highly contagious and can be spread through coughing and sneezing. Measles can also linger for up to 2 hours.

“One of the signs is very high fever about 104.5 or even 105 or even higher. So fever, cough, coryza, which is a runny nose, and conjunctivitis where you have the red eyes and crusty eyes. The rash is a very telltale sign. You start to have a flat rash that starts on the forehead, and it starts to slowly spread down the face, down towards the neck, to your trunk and down to your lower legs. You will even find the rash on the palms of your hands and the soles of your feet,” said Onufrak.

Measles was eliminated in the United States back in the year 2000 so we should have zero cases of measles in Texas, but instead we’re seeing these numbers grow every year.

“Infants and children under 5 and adults over 20 are most at risk, especially if you are unvaccinated. 1 out of 1,000 people can start to come down with bacterial infection of the lungs called pneumonia. You can start to also have swelling in the brain, and there is a rare complication we don’t see very much in the United States but approximately 7-10 years after contracting the measles, you can feel fine but all of a sudden start to have thissclerosing panencephalitis,” said Onufrak.

In recent years, states reported more measles cases compared with previous post-elimination years, due to out of country travel and spreading among unvaccinated people.

The states that have reported cases to CDC are California, Colorado, Connecticut, Georgia, Illinois, New Jersey, New York, Oregon, Texas, and Washington.

The CDC believes that measles comes in from countries where Americans frequently travel, such as England, France, Germany, India, the Philippines and Vietnam.

Worldwide, about 20 million people get measles each year, according to the agency. Measles is one of the leading causes of death for children, according to the World Health Organization, which estimates that 450 die each day worldwide due to the illness.

Spread of Measles:

Measles is a highly contagious virus that lives in the nose and throat mucus of an infected person. It can spread to others through coughing and sneezing. Also, measles virus can live for up to two hours in an airspace where the infected person coughed or sneezed.

If other people breathe the contaminated air or touch the infected surface, then touch their eyes, noses, or mouths, they can become infected. Measles is so contagious that if one person has it, 90% of the people close to that person who are not immune will also become infected.

  • The majority of people who got measles were unvaccinated.
  • Measles is still common in many parts of the world including some countries in Europe, Asia, the Pacific, and Africa.
  • Travelers with measles continue to bring the disease into the U.S.
  • Measles can spread when it reaches a community in the U.S. where groups of people are unvaccinated.

The symptoms of measles generally appear about seven to 14 days after a person is infected.

Measles typically begins with:

  • high fever,
  • cough,
  • runny nose (coryza), and

It usually begins as flat red spots that appear on the face at the hairline and spread downward to the neck, trunk, arms, legs, and feet. Small raised bumps may also appear on top of the flat red spots. The spots may become joined together as they spread from the head to the rest of the body. When the rash appears, a person’s fever may spike to more than 104° Fahrenheit.

After a few days, the fever subsides and the rash fades.

Complications:

Measles can be a serious in all age groups. However, children younger than 5 years of age and adults older than 20 years of age are more likely to suffer from measles complications.

Common Complications:

Common measles complications include ear infections and diarrhea.

  • Ear infections occur in about one out of every 10 children with measles and can result in permanent hearing loss.
  • Diarrhea is reported in less than one out of 10 people with measles.

Severe Complications:

Some people may suffer from severe complications, such as pneumonia (infection of the lungs) and encephalitis (swelling of the brain). They may need to be hospitalized and could die.

  • As many as one out of every 20 children with measles gets pneumonia, the most common cause of death from measles in young children.
  • About one child out of every 1,000 who get measles will develop encephalitis (swelling of the brain) that can lead to convulsions and can leave the child deaf or with intellectual disability.
  • For every 1,000 children who get measles, one or two will die from it.

Measles may cause pregnant woman to give birth prematurely, or have a low-birth-weight baby.

Long-term Complications

Subacute sclerosing panencephalitis (SSPE) is a very rare, but fatal disease of the central nervous system that results from a measles virus infection acquired earlier in life.

SSPE generally develops 7 to 10 years after a person has measles, even though the person seems to have fully recovered from the illness. Since measles was eliminated in 2000, SSPE is rarely reported in the United States.

If you have been exposed, what should you do?

Immediately call your doctor and let him or her know that you have been exposed to someone who has measles. Your doctor can

  • determine if you are immune to measles based on your vaccination record, age, or laboratory evidence, and
  • make special arrangements to evaluate you, if needed, without putting other patients and medical office staff at risk.

If you are not immune to measles, MMR vaccine or a medicine called immune globulin may help reduce your risk developing measles. Your doctor can help to advise you, and monitor you for signs and symptoms of measles.

If you do not get MMR or immune globulin, you should stay away from settings where there are susceptible people (such as school, hospital, or childcare) until your doctor says it’s okay to return. This will help ensure that you do not spread it to others.

Am I protected against measles?

CDC considers you protected from measles if you have written documentation (records) showing at least one of the following: you received two doses of measles-containing vaccine, and you are a(n)—

  • school-aged child (grades K-12)
  • adult who will be in a setting that poses a high risk for measles transmission, including students at post-high school education institutions, healthcare personnel, and international travelers
  • You received one dose of measles-containing vaccine, and you are a(n)—
  • preschool-aged child
  • adult who will not be in a high-risk setting for measles transmission.
  • A laboratory confirmed that you had measles at some point in your life.
  • A laboratory confirmed that you are immune to measles.
  • You were born before 1957.

Do I ever need a booster vaccine?

  • No. CDC considers people who received two doses of measles vaccine as children according to the U.S. vaccination schedule protected for life, and they do not ever need a booster dose.

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