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Posts for category: Infectious Disease

By contactus@priority-pediatrics.com
July 01, 2019
Category: Infectious Disease
Tags: immunizations   travel   measles  

CDC Travelers' Health Update

Measles is in many countries and outbreaks of measles are occurring

around the world. People traveling internationally should be fully vaccinated

at least two weeks before traveling. Anyone who is not immune to measles

is at risk of getting infected when they travel. More information.

Which travelers are at risk? You are at risk of measles infection if you travel

internationally and you have not been fully vaccinated against measles or have

not had measles in the past. The best protection against measles is vaccination. 

Measles is extremely contagious. If you are sick, do not travel and avoid contact

with others. Call your doctor and tell them where you traveled. 

What countries are having measles outbreaks? Measles is in many countries

and outbreaks of disease are occurring around the world, including Europe, the

Middle East, Asia, the Pacific, and Africa. Each year, an estimated 10 million

people get measles, and about 110,000 of them die from the disease or complications. 

Currently, many countries are experiencing measles outbreaks; this includes many

popular travel destinations like Israel, Thailand, Vietnam, Japan, Ukraine, England,

Brazil, the Philippines, and more. CDC has issued a Global Travel Notice: Watch

(Level 1) for these outbreaks. Before your next trip, check your destination.

How can I be fully protected before my trip? Make sure you and your family are

fully vaccinated or that you have other evidence of measles immunity. Evidence of

immunity means that you: (1) were born before 1957 or (2) have a lab test showing

that you have had measles in the past, (3) have a lab test showing you were immunized

against measles, or (4) you have written documentation of receiving measles vaccine. 

If you do not have evidence of measles immunity, call your doctor and make an

appointment to get the MMR vaccine. MMR is nearly 100% effective at preventing

measles. If you are unsure if you have had two doses of the vaccine, or do not have

documentation of your prior doses, it is safe to get additional doses. 

Information for you: Check to make sure you are fully vaccinated or otherwise

protected against measles before you travel.
• Infants 6–11 months of age traveling internationally should have one dose of

measles vaccine.

.  Infants vaccinated before 12 months of age should be revaccinated on or after

their first birthday with two doses, separated by at least 28 days.

• Children 12 months of age or older should have two doses, separated by at least

28 days.
• Adolescents and adults who have not had measles or have not been vaccinated

should get two doses, separated by at least 28 days.
• Two doses of MMR vaccine are nearly 100% effective at preventing measles.
• See Vaccine Information Statements (VIS) for more information.

By contactus@priority-pediatrics.com
June 26, 2019
Category: Infectious Disease
Tags: immunizations   travel   cdc   measles   Travelers  

Most measles cases in the U.S. result from international travel. Make sure you and your loved ones are protected against measles before international travel.

https://www.cdc.gov/measles/plan-for-travel.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fmeasles%2Ftravelers.html

By contactus@priority-pediatrics.com
May 26, 2019
Category: Infectious Disease
Tags: immunizations   measles   update   2019   Vaccinations   Public Health  

Measles – 2019 Outbreaks

 

Total Number Of Measles Cases In US Climbs To 25-Year High Of 971, CDC Reports

The Washington Post (5/30) reports there have been 971 cases of measles in the US so far this year, “the greatest number since 1994, when 963 cases were reported for the entire year,” according to the Centers for Disease Control and Prevention (CDC). The agency announced the new total on Thursday, rather than waiting for Monday when it typically updates the count, “because it had reached this new milestone.”

       

The New York Times (5/30) reports CDC Director Robert Redfield said, “Measles is preventable and the way to end this outbreak is to ensure that all children and adults who can get vaccinated, do get vaccinated.” Redfield added, “Again, I want to reassure parents that vaccines are safe, they do not cause autism. The greater danger is the disease that vaccination prevents.” The Times adds that the “measles was eliminated as an endemic disease in the United States in 2000,” but if the current outbreak continues then the US could lose that status, “meaning the disease would be considered endemic in the country for the first time in a generation.”

 

Updated 5/22/2019 

Pediatricians are monitoring multiple outbreaks of measles across several U.S. states.

Situation

  • Current outbreak locations:
  • Number of infections: 880 cases in 24 states (from 1/1/19 through 5/17/19)
  • Pediatric population affected: All pediatric populations at risk. Patients 19 years or younger have accounted for 77% of the cases so far; 48% have been younger than 5 years old.
  • The main outbreaks have been associated with travelers who brought measles back from Israel, Ukraine, and the Philippines.
  • Cases have been reported in Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New York, Pennsylvania, Oklahoma, Oregon, Texas, Tennessee, and Washington.

Background

  • Infants and children aged less than 5 years, adults aged more than 20 years, pregnant women, and people with compromised immune systems, such as from cancer, chemotherapy, or HIV infection, are at high risk for severe illness and complications from measles.
  • Measles can cause serious illness requiring hospitalization, even in previously healthy children.
  • Consider measles in patients with fever and rash and ask about recent international travel, exposure to international travelers, or exposure to people with measles
  • During an outbreak, MMR vaccine should be offered to all people exposed or in the outbreak setting who lack evidence of measles immunity. During a community-wide outbreak that affects infants, MMR vaccine has been shown to be effective in preventing symptoms after exposure and may be recommended for infants 6 through 11 months of age.
  • Involvement of state and local health departments is often advisable for any diagnosis of measles, as there may be specific ways these departments wish to receive specimens and manage patients.

Actions as recommended by the American Academy of Pediatrics and the U.S. Public Health Service

Resources

10 Things You Should Know about Measles:

By contactus@priority-pediatrics.com
March 28, 2019
Category: Infectious Disease
Tags: immunizations   measles   epidemics   MMR   Outbreaks  

There are now 314 confirmed cases of measles in 15 states, with six states reporting measles outbreaks, according to the latest data for 2019 from the Centers for Disease Control and Prevention (CDC).

The situation is severe enough in New York's Rockland County, a suburb of New York City, that an emergency was declared effective today with 155 confirmed cases, according to the local health department.

Rockland County executive Ed Day declared the countywide state of emergency to include anyone less than 18 years of age who is unvaccinated against the measles. They are barred from public places until this declaration expires in 30 days or until they receive the measles-mumps-rubella vaccination.

Most of these cases (82%) are people who have not been vaccinated against measles and most are individuals aged 4 to 18 years (46%) and younger children aged 1 to 3 years (24%), many of them concentrated in an ultra-Orthodox Jewish community, where vaccination rates are far below the average.

In neighboring New York City, as of March 27, there have been 214 confirmed cases of measles in Brooklyn and Queens since October. Most of these cases have also involved members of an Orthodox Jewish community. The initial child with measles was not vaccinated and acquired measles on a visit to Israel, where a large outbreak was occurring.

Other Outbreaks:

States that have reported measles cases to the CDC besides New York are Arizona, California, Colorado, Connecticut, Georgia, Illinois, Kentucky, Michigan, Missouri, New Hampshire, New Jersey, Oregon, Texas, and Washington.

The six outbreaks (defined as three or more cases) reported so far this year in the United States include — along with Rockland County and New York City — the four states of California, Illinois, Texas, and Washington.

As of March 22, Washington State reports 74 cases of measles; 73 in Clark County (most in children aged 1 to 10 years; 63 not vaccinated) and one in King County (a man in his 50s who traveled to Clark County).

Texas has 14 confirmed cases of measles as of March 21 and Illinois has six cases. In California, there are seven confirmed measles cases as of March 22, including one outbreak of three cases linked to a patient with international travel.

The CDC advises anyone traveling internationally to be vaccinated against measles before leaving.

The 314 measles cases and six outbreaks reported to the CDC through March 21, 2019, compare with 372 cases and 17 outbreaks reported in all of 2018. In 2000, the CDC declared that the disease had been eliminated in the United States.

 

Atlanta is primed to experience a similar Measles outbreak as reported above due to an increasing number of families who are chosing NOT to immunize their children against Measles and other childhood diseases. Our International Airport makes importation of Measles from outside the USA a real possibility, not to mentione travel within the country to and from outbreak areas.  It is never to late to immunize yourselves and your families.

Dr. T

By contactus@priority-pediatrics.com
February 10, 2019
Category: Infectious Disease
Tags: Autism   vaccine   measles   Contagious   Complications  

4 things everyone needs to know about measles

Claire McCarthy, MD

Faculty Editor, Harvard Health Publishing

We are in the midst of a measles outbreak here in the US, with cases being reported in New York City, New York state, and Washington state. In 2018, preliminary numbers indicate that there were 372 cases of measles — more than triple the 120 cases in all of 2017 — and already 79 cases in the first month of 2019 alone. Here are four things that everyone needs to know about measles.

Measles is highly contagious

This is a point that can’t be stressed enough. A full 90% of unvaccinated people exposed to the virus will catch it. And if you think that just staying away from sick people will do the trick, think again. Not only are people with measles infectious for four days before they break out with the rash, the virus can live in the air for up to two hours after an infectious person coughs or sneezes. Just imagine: if an infectious person sneezes in an elevator, everyone riding that elevator for the next two hours could be exposed.

It’s hard to know that a person has measles when they first get sick

The first symptoms of measles are a high fever, cough, runny nose, and red, watery eyes (conjunctivitis), which could be confused with any number of other viruses, especially during cold and flu season. After two or three days people develop spots in the mouth called Koplik spots, but we don’t always go looking in our family members’ mouths. The characteristic rash develops three to five days after the symptoms begin, as flat red spots that start on the face at the hairline and spread downward all over the body. At that point you might realize that it isn’t a garden-variety virus — and at that point, the person would have been spreading germs for four days.

Measles can be dangerous

Most of the time, as with other childhood viruses, people weather it fine, but there can be complications. Children less than 5 years old and adults older than 20 are at highest risk of complications. Common and milder complications include diarrhea and ear infections (although the ear infections can lead to hearing loss), and one out of four will need to be hospitalized, but there also can be serious complications:

  • Five percent of people with measles get pneumonia. This is the most common cause of death from the illness.
  • One out of 1,000 get encephalitis, an inflammation of the brain, that can lead to seizures, deafness, or even brain damage.
  • One to two out of 1,000 will die.
  • There is another possible complication that can occur seven to 10 years after infection, more commonly when people get the infection as infants. It’s called subacute sclerosing panencephalitis or SSPE. While it is rare (four to 11 out of 100,000 infections), it is fatal.

Vaccination prevents measles

The measles vaccine, usually given as part of the MMR (measles-mumps-rubella) vaccine, can make all the difference. One dose is 93% effective in preventing illness, and two doses gets that number up to 97%. In general the first dose is usually given at 12 to 15 months and the second dose at 4 to 6 years, but it can be given as early as 6 months if there is a risk of exposure (as an extra dose — it doesn’t count as the first of two doses and has to be given after 12 months), and the second dose can be given as soon as 28 days after the first.

The MMR is overall a very safe vaccine. Most side effects are mild, and it does not cause autism. Most children in the US are vaccinated, with 91% of 19-to-35 month-olds having at least one dose and about 94% of those entering kindergarten having two doses. To create “herd immunity” that helps protect those who can’t get the vaccine (such as young infants or those with weak immune systems), you need about 95% vaccination, so the 94% isn’t perfect — and in some states and communities, that number is even lower. Most of the outbreaks we have seen over the years have started in areas where there are high numbers of unvaccinated children.

If you have questions about measles or the measles vaccine, talk to your doctor. The most important thing is that we keep every child, every family, and every community safe.