Wednesday May 22, 2019

Measles Could be Completely Wiped Off, Instead it’s Making a Comeback

In the first three months of this year, the World Health Organization reports that the number of measles cases has tripled over what it was last year

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Measles Could Be Eradicated. Instead, It's Making A Comeback. VOA

Measles is a disease that is only found in humans so it could be completely wiped off the face of the earth. But despite a highly effective and safe vaccine, it is making a comeback.

In the first three months of this year, the World Health Organization reports that the number of cases has tripled over what it was last year.

In Africa, the situation is worse. Africa saw a 700-percent increase compared to last year. Dr. Anthony Fauci heads the research on infectious diseases at the National Institutes of Health. He says in Madagascar, the case is dire.

“Madagascar has almost 1,000 deaths and has tens of thousands of infections,” Fauci said. The National Institutes of Health warns that a decline in vaccination which is causing a preventable global resurgence of this often deadly disease, including in the U.S.

“One in ten children who get infected with measles will get an ear infection that could cause deafness. One-and-twenty would get pneumonia. One in a thousand would get brain swelling, what we call encephalitis, and one to three per thousand would die. To say that it is a trivial disease is completely incorrect,” Fauci said.

Dr. Walter Orenstein at the Emory University Vaccine Center has spent his life working to end measles. He says the complications are worse in poor countries.

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Materials are seen left at demonstration by people opposed to childhood vaccination after officials in Rockland County, a New York City suburb, banned children not vaccinated against measles from public spaces. VOA

“You start off with children who are already at greater risk. They may be malnourished. They may have compromised immune systems. They may be underweight and may have no access to health care so measles is a big killer,” Orenstein said.

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You have a 90 percent chance of getting measles if you haven’t been vaccinated and you come in contact with someone who has it. Dr. Rebecca Martin, heads the CDC’s center for global health. She is working to rid Africa of measles.  “It is very infectious. It will find everybody who is not protected against measles,” Martin said.

The solution is to get two doses of the vaccine. That may mean educating parents about both the disease and the vaccine. Equally important is making vaccination a priority of health systems worldwide. (VOA)

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U.S. Measles Outbreak Raises Concerns About Immunity in Adults

This has occurred even in adults with two documented doses of the vaccine, said Dr. Michael Phillips, chief epidemiologist at NYU Langone Health, which serves parts of New York City, a hot spot in the U.S. outbreak.

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People vaccinated in the United States since 1989 would most likely have received two doses of the combined measles, mumps and rubella (MMR) shot under federal guidelines, and that is still considered the standard for protection. Pixabay

Adults in the United States who were vaccinated against measles decades ago may need a new dose depending on when they received the shot and their exposure risk, according to public health experts battling the nation’s largest outbreak since the virus was deemed eliminated in 2000.

Up to 10 percent of the 695 confirmed measles cases in the current outbreak occurred in people who received one or two doses of the vaccine, according to the U.S. Centers for Disease Control and Prevention.

The figure illustrates what can happen when a large number of individuals, even those who have been vaccinated, are exposed to the measles. CDC recommends that people who are living in or traveling to outbreak areas should check their vaccination status and consider getting a new dose.

Dr. Allison Bartlett, an infectious disease expert at the University of Chicago Medicine, said the “continued vulnerability to infection” is why high-risk adults such as healthcare workers are routinely advised to get a second dose of the measles vaccine if they have not had one.

But knowing your vaccination status can be tricky, experts said.

“It’s complicated and often futile because it’s very difficult to resurrect those old records,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center.

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Los Angeles County Department of Public Health experts, Muntu Davis, Health Officer, left, and Director Dr. Barbara Ferrer answer questions regarding the measles response and the quarantine orders during a news conference in Los Angeles Friday, April 26, 2019. VOA

People vaccinated in the United States since 1989 would most likely have received two doses of the combined measles, mumps and rubella (MMR) shot under federal guidelines, and that is still considered the standard for protection.

Anyone vaccinated between 1963 and 1989 would likely have received only one dose, with many people immunized in the earlier years receiving an inactivated version of the virus. Americans born before 1957 are considered immune as they would have been exposed to the virus directly in an outbreak.

Merck & Co Inc is the sole U.S. provider of the MMR vaccine. The company said in a statement that it has “taken steps to increase U.S. supply” of the vaccine due to the current outbreak.

HIGHLY CONTAGIOUS

The measles virus is highly contagious and can cause blindness, deafness, brain damage or death. It is currently spreading in outbreaks in many parts of the world.

According to the World Health Organization, 95 percent of a population needs to be vaccinated to provide “herd immunity,” a form of indirect protection that prevents infection in people too young or sick to be vaccinated. U.S. public health officials have blamed the current outbreak in part on rising rates of vaccine skepticism that have reduced measles immunity in certain communities.

For travelers to outbreak areas abroad, the CDC recommends adults consider getting another dose of MMR unless they have proof of receiving two prior doses, take a blood test showing immunity, or were born before 1957.

In general, the CDC says two doses of the measles vaccine should provide 97 percent protection; one dose should offer 93 percent protection. However, immunity can wane over time.

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Rapid blood tests are available that can detect whether a person is immune based on the level of measles antibodies, but the tests are not 100 percent reliable. Pixabay

This has occurred even in adults with two documented doses of the vaccine, said Dr. Michael Phillips, chief epidemiologist at NYU Langone Health, which serves parts of New York City, a hot spot in the U.S. outbreak.

He said in kids, “the vaccine is really effective,” but in some adults, memory T-cells, which recognize and attack germs, do not fight the virus as effectively as they once did.

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Rapid blood tests are available that can detect whether a person is immune based on the level of measles antibodies, but the tests are not 100 percent reliable.

Adults who have any doubt about their immunity should get another dose, Schaffner said: “It’s safe. There’s no downside risk. Just roll up your sleeve.” (VOA)