Measles may present a threat in Western Massachusetts areaDate: 6/4/2019 SPRINGFIELD – The nationwide measles outbreak shows no signs of mitigating, with the CDC recently releasing a report indicating there have been 971 confirmed cases so far this year, with fears the numbers may continue to climb through the summer and fall. Massachusetts is now part of the 26 states included in this outbreak, with a second case confirmed last week in the Eastern part of the state.
Though Western Massachusetts has so far not seen any confirmed cases of measles, Dr. Michael Klatte, a pediatric infectious disease specialist at Baystate Medical Center, told Reminder Publishing that may not continue to be the case.
“Massachusetts as a whole has a extremely high rate of immunization of young children, but I think what people don’t realize is that there are pockets across the state – including a number of them here in Western Mass – where there are large numbers of under immunized and in some cases, unimmunized children, and that puts everyone at risk,” Klatte said. He noted that the four counties in Western Massachusetts – Franklin, Berkshire, Hampshire, and “to some extent, Hampden” have the highest vaccine exemption rate in the state outside of Cape Cod and the Islands. Most of these vaccine exemptions are recorded as being for religious reasons, Klatte added.
“Given how widespread the [measles] outbreak has been over the past year and a half, I wouldn’t be surprised at all if we were to see active cases here in Western Mass.,” Klatte shared.
The state mandate
According to the Massachusetts Department of Public Health (MassDPH) website, Massachusetts requires that all healthcare workers, all school-aged children – kindergarten through grade 12, and all students attending college in the Baystate be vaccinated against the measles with two doses of the MMR vaccine – the first dose is usually administered to children at 12-14 months and the second dose at 2 to 4 years of age. Vaccination is also recommended for all health science students and all international travelers.
Vaccine exemptions are granted to individuals with allergies to gelatin, neomycin or a previous dose of the vaccine, women who are pregnant or plan to become pregnant and those with suppressed immune systems. Klatte said to receive a religious exemption – the most common exemption in our area – a parent or guardian must fill out a form that indicates administering the vaccine would be in conflict with a parent’s sincerely held religious beliefs.
A serious illness
Considered eradicated in the U. S. in 2000, the Mass DPH website describes measles as a viral disease that spreads easily from person to person. Symptoms present like those of a cold or flu at first, with a cough, runny nose, watery eyes and a high fever, followed by the telltale red, blotchy rash. Individuals are contagious for four days before symptoms begin, and for four days after onset. The virus can survive in the air for up to two hours after a person coughs. Symptoms appear 10 to 14 days after the person is exposed. The most vulnerable members of the population are babies under 12 months of age, adults who were vaccinated before 1968 because some early vaccines did not give lasting protection, and those who have never been vaccinated or had the measles. Measles is confirmed through the results of a nose or throat swab, or a blood test.
Klatte said severe complications from the measles can include meningitis, encephalitis, severe pneumonia that can lead to respiratory failure and in rare cases, a degenerative brain disease called SSPE that appears seven to 11 years after an individual is infected with the measles. SSPE, he added, usually occurs in children who contracted measles before two years of age.
“I see these children who come in with terrible [measles] infections and complications and require hospitalization and know these terrible conditions could have been prevented by vaccinations, it’s frustrating,” Klatte said.
Current recommendations
With the summer travel season right around the corner, Klatte said he and his colleagues have been getting questions from parents concerned about travelling to areas where measles outbreaks are ongoing. “In those situations the CDC recommends parents check with the local health department of a jurisdiction, city, county or state they will be visiting to see if vaccination prior to travel for children 6 months to 11 months, 30 days is recommended,” Klatte said. One dose of the MMR can be given to that age group before travel, he said, but it will not count toward the two-dose immunization required by the state for admittance to school.
If an unimmunized infant in that age range is exposed to measles, the child can receive one dose of the MMR within three day of the exposure, he added.
Klatte said colleagues had also forwarded him the CDC’s recent recommendation regarding adult revaccination. He said the CDC recommends those individuals who were vaccinated between 1963 and 1967 who received the inactivated or killed vaccine be revaccinated. He also said until 1989, only one dose of the MMR was required. The CDC now is recommending individuals vaccinated between 1967 and 1989 be given a second dose of the MMR.
“One dose in an otherwise healthy person offers about 93 percent protection,” he said. “The reason the CDC began [recommending] a second dose was to try and capture some of the individuals in the remaining seven percent that did not get proper [immunity] from the first dose; the second dose offers 97 percent protection.”
He said there is also one option available to offer some protection to children less than six months of age – and those children and adults who cannot get the MMR – who are exposed to measles.
“There is a product called intramuscular immune globulin – basically it is a shot that should be given within six days of exposure,” Klatte said. “The product is pooled antibodies from thousands of donors,” which provides a passive immunity, which is a kind of protection from the disease.”
|
