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What You Need to Know

Measles is back. The virus dramatically declined in the U.S. when the measles vaccine was invented in 1963 and then virtually disappeared once the combination measles, mumps and rubella (MMR) vaccine was made widely available in 1971. However, according to the Centers for Disease Control and Prevention (CDC), slightly more than 200 cases were reported nationwide in the first two months of 2019, five of them in Illinois.

“It’s not necessarily an epidemic, but it’s an outbreak, for sure,” says Anita Chandra-Puri, MD, a pediatrician with Northwestern Medical Group. “The No. 1 message is that measles is highly contagious, but the vaccine is very effective. And the No. 1 way to protect all patients is to maintain a healthy vaccination rate.”

Reasons to Vaccinate

Although the CDC sets national recommendations, each state sets its own requirements. All children in Illinois must be vaccinated to attend school. The MMR schedule requires two shots, the first after age 1 and the second after age 4.

“The first dose is 93 percent effective, and the second dose is 97 percent effective against measles,” Dr. Chandra-Puri says. Parents may decide not to immunize their children (or themselves) for religious reasons or because they cannot be immunized due to such medical conditions as cancer, prolonged steroid use or being otherwise immuno-compromised. Illinois does not otherwise recognize “philosophical reasons” for rejecting vaccines, although other states do.

“It’s that much more important for those who are immuno-competent to get vaccinated in order to protect those who can’t get vaccinated,” Dr. Chandra-Puri says. “You rely on herd immunity. The concept is so important. That’s why measles is no longer endemic to the U.S.” Instead, the virus is now imported from countries with lower vaccination rates. That is believed to be the cause of the current outbreak.

“When inappropriate fears arose in 1998 about the perceived (though false) connection between the MMR and autism, it created enough doubt in developed countries that many people stopped immunizing their children,” Dr. Chandra-Puri explains. “Now, travellers who have been exposed (to measles) outside the U.S. may land in a pocket of poorly vaccinated people, and that’s how it spreads.”

Measles typically begins with a high fever, cough, head cold and/or conjunctivitis. A rash develops three to four days later and lasts for about a week. Those who have been exposed to the virus are contagious from five days before the rash develops until about four days afterward.

“We did such a good job of immunizing people in the past that they don’t see the disease, and they’ve become complacent,” Dr. Chandra-Puri says. “It’s important for everyone to be immunized against all vaccine-preventable illnesses. Have a good discussion about vaccine safety with your doctor. Disease outbreaks, perhaps unfortunately, remind people of the value of vaccines.”

Anita Chandra-Puri, MD
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