Well, here I go again…. another highly contagious health scare hits the headlines and I find myself doing research. Yup, talking about measles this time.
No, I am not paranoid, but as a nurse, I feel its my obligation to stay abreast of current health care concerns – I find it even more important as a nursing instructor. So, I am sharing what I know with all of you!
Now, what’s the big deal about measles? Well, considering it was virtually eradicated in the US due to vigilant vaccination programs, most are not familiar with this highly contagious disease. In fact, in 2000 the CDC declared measles eradicated from the US. Unlike the flu, pneumonia or heart disease, we are just not familiar and need to re-educate ourselves on a disease we don’t deal with on a daily basis. (On a more personal note, I do not titer for measles, so that just makes my concern level a little higher…and personal!)
So what happened? Well, much like the Ebola spread – travel happened! It spread from a highly populated area (an amusement park in California that has a mouse as a mascot) to other various areas of the country. Basically, some infected people shared their measles with a bunch of visitors and they all traveled back to their homes… some in other states. As with previous outbreaks, it has spread more significantly among unvaccinated populations – which seems obvious. Here all the reported outbreaks since 2000 as reported to the CDC. As you can see, 2014 showed an increase in reported cases in relation to previous years.
From January 1 to February 6, 2015, 121 people from 17 states were reported to have measles according to the CDC. They feel these are still related to the California outbreak and have issued health warning to local health departments to be on the alert.
I am not even going to entertain the vaccination conversation, however, I will say simply this, I am not surprised this is happening. It was just a matter of time. The principle of eradication is based on herd immunity, if the herd doesn’t have immunity (not vaccinated), then it will begin to spread in the herd. Just to be clear, we are the herd.
What is measles?
- Measles is HIGHLY contagious respiratory virus
- 90% of those with no immunity who come in contact with an infected person will become infected
- It lives in the nose and throat mucus and is transmitted through coughing and sneezing.
- The virus CAN survive on surfaces for up to TWO hours where an infected person coughed or sneezed.
- Infected people can spread the disease from 4 days before to four days after the rash appears.
- Symptoms usually appear 7-14 days after infected
Signs & Symptoms
Beginning symptoms usually 7-14 days after infected
- High fever
- Runny nose (coryza)
- Red, water eyes (conjunctivitis)
2-3 days after symptoms begin – white spots (Koplik) spots may appear inside the mouth
3-5 days after symptoms begin – rash begins.
- Usually begins as flat read spots on the head, hair line
- Spreads downward to the neck, trunk, arms, legs & feet
- Typically accompanied with very high fevers (104F)
- Usually in the same direction
- Rash can be on the palms of the hands & soles of the feet
Currently the CDC is encouraging health care providers to “Think Measles. Consider measles in patients with a febrile rash, cough, coryza or conjunctivitis.”
- Typically more severe in under 5 years and over 20 years of age
- Common complications
- ear infections – can result in permanent hearing loss
- Severe complications – requiring hospitalization
- Encephalitis (swelling of the brain) – can lead to convulsions, deafness or mentally retarded
- Death – 1-2 per 1000 affected
- There is no specific treatment – only supportive care to help manage symptoms and complications
- Immediately isolate the person for up to 4 days after the rash subsides to prevent further spread
- The MMR vacine can be administered within 72 hours post exposure may provide some protection from the disease or modify the severity.
- If can not show immunity, patients can receive immunoglobulin, however, must be administered within 6 days of exposure and may provide some protection or modify the clinical course.
- Recommended, detailed guidelines can be found on the CDC website.
Hopefully this gives you a good, general overview of measles. If you are a health care provider, especially if a first responder, ER worker or in a doctors/pediatricians office – please spend some time educating yourself on this not-so-common disease. You can find some great info on the CDC website tailored specifically to healthcare providers – I would especially take a look at the photos.
Although, certainly, I am aware, more people will die from the flu, diabetes and heart disease this year -those are common diseases that most are familiar with. I am not old enough to remember people suffering from measles and clearly, most of the public has not either. So, as a nurse, I owe it to the patients I serve to be educated so I can better take care of them and myself.
Thanks for visiting and please share!