The return of measles
It’s cold and flu season, but those aren’t the only illnesses to be wary of this winter and early spring.
Measles, which was considered eliminated nearly two decades ago, has returned and with it, an intense fear of contracting the contagious disease.
Last winter, New York saw a dramatic increase in the once obsolete disease. There were 182 measles cases reported, mostly in the ultra-Orthodox Jewish community, according to the New York Times. New York and New Jersey had the highest numbers of reported cases in 2018.
Measles is a problem once again for the American public, so it’s a question of what can be done to prevent it from leading to an outbreak. Maintaining vaccination rates for the disease would seem to be the solution, despite the rise of anti-vaccination movements.
“Measles vaccination coverage is high nationwide,” Kristen Nordlund of the Centers for Disease Control’s Public Affairs office said. Nordlund stated the vaccination intake is 95%.
“This data varies by state and among communities within each state,” Nordlund said. “The measles outbreaks this year remind us that despite the fact that vaccination rates are holding steady, we still see disparities when we look at local and school level data.”
It’s not just who is or isn’t vaccinated from measles in the United States, there’s also the rest of the global population to consider.
“Although measles was declared eliminated in the United States as a result of measles, mumps, rubella (MMR) vaccination, it is still very common in countries with lower MMR coverage,” Brad Dalton, the press secretary for the Florida Department of Health’s Office of Communications, said.
“Infected international travelers could bring measles into the country at any time,” Dalton said. “If we maintain high MMR vaccine coverage, our communities will be protected. Recent outbreaks have happened when measles was brought into communities with low vaccination coverage. Since measles is very easily spread to persons without immunity, these outbreaks can quickly become large.”
Dalton said that people who’ve had two doses of the MMR vaccine have a 97% chance of warding off the disease. For those who can’t receive the vaccine and end up contracting measles, Dalton advises people to isolate themselves until the rash forms.
“Additionally, before seeking medical care, they should call the office to ensure steps are taken to protect other patients and staff,” Dalton said.
Before a child is enrolled at a grade school, the state of Florida requires certain vaccinations, including MMR. Most colleges and universities ask for evidence of particular vaccines too. But Florida also allows exemptions from vaccinations for school required vaccines.
For example, there’s a Temporary Medical Exemption (TME), for those already completing other vaccinations.
“The TME requires an expiration date after which the exemption is no longer valid, and immunizations must be completed before or at that time,” Dalton said.
Then there’s the Permanent Medical Exemption (PME), which is for a child who can’t be fully immunized for other medical reasons.
“In this case, the child's physician must state in writing the reasons for exemption based on valid clinical reasoning or evidence,” Dalton said.
There’s also the Religious Exemption if immunizations are at odds with a parent or guardian’s religious beliefs and practices.
Dr. Alex Berezow is a microbiologist and vice president of scientific communication for the American Council on Science and Health (ACSH). The ACSH is a nonprofit organization that supports advancing evidence-based policies and debunking pseudoscience to the public.
“In the event of a widespread measles outbreak, [the ACSH] would communicate to the public the danger that measles poses and urge the unvaccinated to get the MMR vaccine and for others to consider getting a booster shot,” Berezow said.
A Harvard study detailed a strain of measles that can cause “immunity amnesia” in its subjects. This results in an 11 to 73% loss of protective antibodies.
“It's not a new strain of measles,” Berezow said. “The measles virus hasn't changed much. It was noted more than 100 years ago that measles has the ability to cause the immune system to ‘forget’."
Berezow expressed that he and the ACSH were proud of their work, but they avoid complacency.
“We believe that our efforts, in combination with those of other scientists and public health agencies, have made the media stop giving voice to anti-vaxxers,” Berezow said. “But anti-vaccine propaganda is still widespread because of the internet and social media. So, our battle continues.”
The Florida Department of Health has not reported any cases of measles in Palm Beach County in 2019.
By Benjamin Wainer