Understanding the Measles Outbreak

sick baby thermometer feverAs you’ve probably heard by now, an outbreak of the measles virus has spread to more than 120 people. Last year, measles cases hit 644 in 23 separate outbreaks across the country. What’s so shocking about these numbers is that they add up to more cases than all of those seen in the five years before. So what’s going on? What is measles and why are we hearing about it? Here are some of my thoughts on the most recent outbreak.

What is the measles?

Over the last week, I’ve had a lot of people ask me about measles, so I want to get the facts straight. Measles is an extremely contagious virus spread through the air from those who are infected. Symptoms include fever, dry cough, runny nose, sore throat, inflamed eyes and a blotchy red skin rash. It used to be a common disease that killed thousands of people, mostly children, but vaccination largely eliminated it from the U.S. population. There are still a few cases every year, but nowhere near the hundreds of thousands that we used to see. It’s because measles is so easily prevented with a vaccine, called the Measles, Mumps, Rubella (MMR) vaccine for the three viruses it protects against, that the news has quickly turned to a conversation about vaccination.

While most people infected with measles get over it without any trouble, there can serious consequences. Because measles infects the lungs, it can cause a broader lung infection called bronchitis that can lead to hospitalization and death in some cases. The virus can also infect the brain and about one of every thousand cases causes brain swelling that is fatal in about one of every 10 who get it. Measles is no joke.

So what’s all the fuss about?

While a few cases happen every year, they don’t usually spread because most people are vaccinated. The virus might find one victim, but there’s nowhere for it to spread and it disappears. As long as enough people are vaccinated, that’s all that happens. Fortunately, not everyone needs to be vaccinated as long as there’s enough general protection in the population. I say fortunately because some people can’t be vaccinated or are more likely to become seriously ill if they get an otherwise mild infection. Small babies, for example, aren’t safe because they can’t get the vaccine until they’re at least a year old. That means they could be infected if they’re exposed to someone who has measles. Because their immune system doesn’t work as well as an adults’, they can die from it more easily than you or me.

A big outbreak like this indicates that we’re starting to approach the line where just enough people are vaccinated to protect everyone. As more and more people choose not to vaccinate, the virus has more and more victims to jump to when it does show up. And since measles is so infectious, it finds those who aren’t vaccinated pretty easily if there are enough people around.

What’s the deal with the MMR?

I’ve watched the argument over vaccines increase in size over the course of my life as a parent. To be honest with you, I was terrified at times. As a parent, the only thing I could focus on was figuring out what was best for my child. As a doctor, I wanted to give my kids their best shot at growing up healthy. So when I heard people talking about the harms that vaccines might lead to when given to children, I was afraid I’d made a terrible mistake in vaccinating my children. So I did some research.

It turns out the vast majority of research published to date has found vaccines to be both effective and safe. When we started vaccinating against diseases like measles, we saw infant and childhood mortality drop as more and more children lived free of diseases that would have otherwise killed them. Not only that, vaccines were incredibly safe compared with most medications we had people take. Side effects were mild with the more serious effects being rare. That in comparison to most drugs we give as doctors, including antibiotics, which have been found to have a wide variety of harmful side effects.

Most importantly, research has now shown many times over that there is no link between the MMR vaccine and autism. The paper that made that link was discredited and retracted because it was poorly designed, full of errors, and made false conclusions from the data it had.

But aren’t there risks to vaccines as well?

Very rarely, the side effects from a vaccine can be devastating. About one person per million will have a severe allergic reaction to the MMR vaccine. Brain damage has occurred from a severe response to the MMR vaccine, but the cases are so rare that there aren’t even statistics on how often they occur. Mostly, though, it’s just a sore arm. As with all things, the risks have to be weighed against the benefits.

How is this vaccine different from the flu shot?

The principle behind the MMR and the flu shot is exactly the same. So why do you get the flu shot every year and the MMR only a handful of times over your lifetime? The reason has to do with the virus itself. The flu virus isn’t very good at copying its own DNA. When it replicates, it makes a lot of mistakes that cause the virus to change rapidly over time. That means that the virus from 2014 is different enough from the one in 2013 that the body doesn’t recognize it. As a result, you need a new vaccine to cover this new, mutated form. This change in the virus is what causes the regular outbreaks of the flu.

Measles is a lot better at copying itself. Rather than reinfecting the same people, the way the flu does, it relies on a batch of new, unexposed children that show up every year. But that means that if you’re immune, you won’t be easily reinfected because the virus doesn’t change very much over time. As a result, you only need an early MMR to be protected and a booster later on in life to keep that protection strong. In this case, outbreaks only occur when the virus infects groups of unvaccinated people.

How do I protect my family?

Unfortunately, there’s no real way to treat measles except to support someone as his or her body fights off the virus. The only true protection against measles is to get vaccinated. I know some people are against vaccinating their kids. But as a doctor and an informed expert in the medical field, I can tell you that a vaccine is the only method we have to truly prevent this disease and it is the best method we have to save the lives of the thousands of children who would otherwise die of infection. Vaccines are safe, effective, and the only responsible medical answer we have to this deadly disease. If you have children, they should be vaccinated.

If you’re an adult and you haven’t received an MMR vaccine, you fall into two categories.

  • If you were born before 1957, you were probably exposed and you’re considered immune. As a result, you don’t need a vaccine.
  • If you were born after 1957, you should have received at least one dose of the MMR. Check your records. If you can’t find a record of getting the MMR, you may need to get vaccinated to protect yourself.
  • If you were born after 1957 and got only one dose of the vaccine instead of two, there’s a possibility you may need another one if you meet certain requirements. Talk to your doctor about whether you need another shot.

If you’re not sure about the guidelines and you’re concerned, just make an appointment to see your primary care physician and have a conversation about it. He or she can bring you up to speed on how well you’re protected and whether there might be other vaccines you could benefit from.

We can’t do much about the current outbreak except try to minimize the damage. But we all have the power to save our children and the most vulnerable in our population from the ravages of some of history’s most terrible diseases by vaccinating our children.

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