By Steven Reinberg
THURSDAY, April 25, 2019 (HealthDay News) -- Measles cases in the United States have now reached 695 -- the highest since the disease was declared eliminated in 2000, the U.S. Centers for Disease Control and Prevention announced late Wednesday.
Outbreaks are occurring across the country, often linked to the "anti-vaccination" movement. One of the largest outbreaks is in New York City, where 61 new cases were reported this week.
As new case numbers surge, experts are reminding Americans that measles is highly contagious and not always a transient illness -- it can have serious complications and even prove fatal.
Measles was thought to have been a relic of the past, so most young parents haven't witnessed the disease. But it definitely isn't benign, one expert said.
"People don't remember how sick it can make you, and people don't remember that it can kill you," said Dr. Paul Offit, chair of vaccinology at the University of Pennsylvania's School of Medicine. "That's what we're up against."
It's not that measles has been eliminated in the United States, it's that the memory of measles has been eliminated, he explained.
When you get the measles, you can have a high fever, cough, runny nose, rash, and spots on your face that can spread to the rest of your body.
And common, but much more serious, complications can occur. These include pneumonia as well as encephalitis, which causes the brain to swell.
Measles put her in a coma
A case in point is the 43-year-old Israeli flight attendant for El Al who remains in a coma after catching the measles and developing encephalitis, Offit said.
"She's been in a deep coma for 10 days, and we're now just hoping for the best," Dr. Itamar Grotto, associate director general of Israel's Ministry of Health, told CNN.
She first developed a fever on March 31 and was admitted to the hospital that day. Grotto said she might have contracted measles in New York, in Israel or on a flight between the two. She is not believed to have spread the virus to anyone on the flights, CNN reported. Like many in her generation, she received only one dose of the measles vaccine as a child; two are now recommended.
Despite the severity of her case, the youngest patients are typically the most vulnerable. When children under age 2 get the measles, an inflammation of the brain called subacute sclerosing panencephalitis (SSPE) can develop five to 10 years later, said Dr. Manisha Patel, a medical officer in CDC's Division of Viral Diseases.
SSPE can cause seizures, blindness, paralysis and eventually, a persistent vegetative state and death.
Even the typical symptoms of measles can be excruciating for the parents of young children. Just ask Fainy Sukenik, who lives in Israel.
Her 8-month-old daughter, Shira, was too young to be vaccinated and got sick in December with a runny nose and a 104-degree fever, CNN reported. When red spots appeared a few days later, her parents knew it was measles.
"It wasn't just dots on one part of her body. They were everywhere: inside her mouth, between her fingers, in between her toes," her mother told CNN. "I'm an experienced mother, and never ever have I seen something like this. I was really scared."
By this time, Shira couldn't eat and could barely drink, her breathing was shallow, and she was so weak she couldn't even hold her head up. Sukenik and her husband took the baby to the hospital, where she was put in isolation and received intravenous fluids, according to CNN.
Without vaccination, it can spread quickly
The outbreaks in 2019 are troubling. But before the advent of the measles vaccine, the situation was far, far worse. Offit said that in those years, 3 to 4 million American kids got measles each year, about 48,000 were hospitalized, and about 500 died.
Measles kills about 1 in 1,000 who get it, he said. In places in the world where measles is still endemic, it kills more than 100,000 people each year, according to the World Health Organization.
To compound matters, measles spreads easily and rapidly. It's highly contagious, said Patel -- so much so that if one person in a room of 100 unvaccinated people has the measles, 90 others will get it.
The best protection against measles is the measles, mumps, rubella (MMR) vaccine.
But "vaccines are victims of their own success," Offit said, because now "people don't fear these diseases."
"We're very lucky in the United States to have high vaccine coverage," Patel said. That's why Americans aren't seeing widespread cases of measles. But when measles lands in a community where rates of vaccination are low, that's when it takes off, she added.
"The measles vaccine is one of the most effective vaccines we have," Patel said. "With one dose, it's 93% effective; with two doses, it's 97% effective."
The vaccine is also one of the safest ones, she said. It's been around since the 1960s. If parents have concerns about the vaccine, they should talk with their pediatrician, Patel said.
Misinformation leaves children at risk
Still, some people won't vaccinate their children because they erroneously believe the vaccine isn't safe and may cause autism.
In 2015, TV personality Jenny McCarthy, who has a child with autism, told the NPR program "Frontline," "If you ask 99.9% of parents who have children with autism if we'd rather have the measles versus autism, we'd sign up for the measles."
But research has long proven McCarthy and other "anti-vaxxers" wrong. Study after rigorous study has shown no connection between MMR vaccination and later onset of autism.
And given how serious the consequences of measles can be, the decision not to vaccinate a child is never wise, Offit said.
"When enough people make a choice not to vaccinate their children, measles comes back, and that's what we're seeing," he said.
So far this year, cases of measles have been reported from 22 states, and the CDC expects that number to grow.
Most of those cases were caused by unvaccinated people bringing the disease back from abroad into an unvaccinated group, Patel said.
The CDC recommends all children get two doses of MMR vaccine, starting with the first dose at ages 12 through 15 months and the second dose at ages 4 through 6.
There are just no good reasons not to get vaccinated, Offit said.
"Your job as a parent is to put your child in the safest position possible," Offit said. "Vaccines provide that safety."
Visit the U.S. Centers for Disease Control and Prevention for more on the measles.
SOURCES: Manisha Patel, M.D., medical officer, Division of Viral Diseases, U.S. Centers for Disease Control and Prevention; Paul Offit, M.D., chair, vaccinology, University of Pennsylvania School of Medicine, Philadelphia; April 24, 2019, news release, CDC; CNN
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