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The United States is
experiencing a multistate outbreak of measles. The Centers for
Disease Control and Prevention (CDC)
reports that from Jan 1 to Feb 13, 2015 the number of measles cases was 141 and
the disease had spread to 17 states and the District of Columbia. The CDC reported that as of Feb 24 the number of
US measles cases had increased to 154 and the cases were linked to “three
separate outbreaks” – Disneyland, and unrelated outbreaks in Illinois and
Nevada.
The multistate outbreak is believed
to have started when a traveler who was infected with measles overseas visited
Disneyland, though the specific source isn’t known, according to the CDC. An
analysis of the virus causing this outbreak shows it is identical to a virus type
that caused a large outbreak in the Philippines last year. But the virus type
appears to be common: it has also been identified in 14 other countries and at
least six U.S. states with cases that aren’t linked to the Disneyland outbreak.
Also, seven countries in Europe and Central
Asia (Kyrgyzstan, Bosnia, Russia, Georgia, Italy, Germany, Kazakhstan) have
reported 22 567 cases of measles in 2014 and thus far in 2015. According
to the World Health Organization (WHO), the outbreaks are due to a
growing number of parents who either refuse to vaccinate their children or are
facing barriers in getting the immunizations they need.
Before the era of widespread
vaccination measles was a disease that affected the overwhelming majority of
children. The symptoms of
measles generally appear about 7 to 14 days after a person is infected and
typically begin with
•
high fever
•
cough
•
runny nose and
•
red, watery eyes
Two or three days after symptoms begin, tiny white
spots may appear inside the mouth and a skin rash breaks out. 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 join 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.
The Persian physician and philosopher Rhazes (860-932) in
the 10th century A.D. wrote and described measles as a disease that is “more
dreaded than smallpox”. In 1757,
Francis Home a Scottish physician, found that measles is an infectious disease.
In the decade before 1963 when a vaccine became
available, nearly all children got measles (Rubeola) by the time they were 15
years of age. It is estimated 3 to 4 million patients in the United States were
infected each year and approximately 400 to 500 patients died and 4,000
suffered encephalitis from measles.
In 1954, John F. Enders and Dr. Thomas C. Peebles
collected blood samples from several ill students during a measles outbreak in
Boston, Massachusetts in an effort to isolate the virus and make measles’
vaccine. They succeeded in isolating the virus in the blood of a 13-year-old
boy. In 1963, John Enders and colleagues
transformed their Edmonston-B strain of measles virus into a vaccine. Measles
vaccine today is usually combined with mumps, rubella and varicella and given
in one or two doses.
According to CDC most of those infected this year
were not vaccinated. Dr. Anne Schuchat, director of the National Center for
Immunization and Respiratory Diseases, said, “it is not a problem with the
measles vaccine not working. ...It is a problem of the measles vaccine not
being used”.
As measles is a viral
disease no specific medication is available for its treatment. However some measures such as acetaminophen
for high fever, a humidifier for relief of cough and vitamin A do provide
symptomatic relief.
In non-immunized patients, measles vaccination within 72 hours
of exposure to the virus may provide protection against the disease.
Pregnant women, infants and patients with weakened immune
systems who are exposed to the virus may receive an injection of antibodies
called immune serum globulin. When given within six days of exposure, these
antibodies can prevent measles or make symptoms less severe.
Vaccination
still remains the best way to prevent measles.
One dose of the Measles, Mumps and Rubela vaccine (MMR) is 93% effective while two doses are
97% effective in preventing the disease.
On Feb 21 two California senators introduced legislation that
“would permit only medical exemptions as legitimate reasons to sidestep
vaccinations,” The WHO has issued a warning and demands
that counties control the outbreaks with "no exception" as the
epidemic threatens the goal of eliminating measles in the region by the end of
2015.
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