From December 28, 2014 to February, 121 cases of measles were reported in the United States, according to the Centers for Disease Control. Sound Medicine spoke with a pediatrician and a public health expert to get the facts on the disease: its effects, how it’s spread, who is at risk, and the laws surrounding vaccinations at schools. David Kimberlin, MD, is Co-Director of the Division of Pediatric Infectious Diseases at University of Alabama at Birmingham and current president of the Pediatric Infectious Diseases Society (PIDS). Ross Silverman, JD, MPH, is professor of Health Policy and Management at the Fairbanks School of Public Health at Indiana University. Here are the biggest points we took away from both interviews. We've posted the full audio from both interviews below.
1. Measles is a potentially debilitating, destructive virus. In the pre-vaccine era 500 children annually died from measles, many more were left permanently brain damaged from it, and many contracted pneumonia. “It is an incredibly severe infection,” says Kimberlin. However, about 60 percent of children recover in two to three weeks without complications.
2. Measles is one of the world’s most infectious diseases in humans. It’s extremely easy to catch measles, because the virus can live suspended in the air for up to two hours, explains Kimberlin. “If someone has measles in a room, coughs, leaves the measles behind, leaves the room, then someone - who has not been vaccinated - over the next hour or two going into the room can acquire the virus very, very easily,” he says.
3. There is no medication to treat measles. There are no anti-viral drugs specifically used to treat measles, Dr. Kimberlin says. There is some data showing that children who have a vitamin A deficiency have more severe cases of measles, and the CDC recommends giving vitamin A to infected children. But the vitamin does not target the measles virus – it just supports the immune system’s ability to fight it.
4. Some people cannot safely receive the vaccine for health reasons. Infants under one year old and, children with cancer and other individuals with compromised immune systems cannot be safely vaccinated, and are the most at-risk during an outbreak. “They are at the mercy of other parents doing the right thing by other children, so measles does not get a foothold in the community and ultimately get spread to the weakest and most vulnerable among us,” says Kimberlin.
5. If you’re not sure whether you were vaccinated or had measles as a child, you can get vaccinated as an adult. Virtually everyone born before 1957 had measles, according to Kimberlin. The CDC will view someone born before 1957 as being measles-immune. If you were born after 1957 and you're not sure about your status, there's no harm in getting a vaccine, even if you have indeed been vaccinated previously or had measles.
6. School vaccination requirements vary from state to state. In some states, the law requires all schools to require their students to be vaccinated. In others, the rule applies only to public schools. According to an article co-authored by Ross D. Silverman in the Journal of the American Medical Association, states also vary in the leniency surrounding exemptions to the school vaccination rule. Every state allows for medical exemptions for children with compromised immune systems, adverse reactions following a prior vaccination, allergies to vaccine components, and certain illnesses. Forty-eight states allow exemptions on religious grounds. Twenty states allow parents to opt children out for philosophical or moral reasons.
7. States with more liberal school exemption rules have more unvaccinated children. States that allow a philosophical exemption tend to have higher rates of people taking the exemption, and higher rates of vaccine-preventable illnesses, like measles, according to Silverman.