THE GORGE — As of March 27, there were 483 confirmed measles cases in 20 states, including Washington, nationwide. That’s nearly 200 more cases than in all of last year. Oregon still has not had a case.
The U.S. declared measles eliminated 25 years ago, but that status only holds if an outbreak lasts less than 12 months. Officials worry this outbreak of the highly contagious airborne virus could cost that status.
On a recent webinar for reporters, three doctors highlighted key points.
Dr. David Higgins, a pediatrician from the University of Colorado Anchutz Medical Campus, stressed that while much attention is given to people who are anti-vaccine, most parents are vaccinating their children.
“Every single case, every hospitalization, every single death from measles is preventable with vaccination,” said Higgins. “Measles vaccines are safe, which is why an overwhelming majority of parents say, ‘Yes, I am going to vaccinate my child.’”
Of the 483 current cases, 97% are unvaccinated, or their vaccination status is unknown.
Nationally, in 2023, 92.7% of American children in kindergarten had gotten both recommended doses of the MMR (Measles, Mumps and Rubella) vaccine, according to the World Health Organization.
In Wasco and Sherman counties, 96% of school age children have gotten both doses of the vaccine, compared to 94% in Hood River County, 94.3% in Klickitat County, and 95% in Skamania County.
Measles is most risky for children under 5 — particularly those under 1 — and people who are unvaccinated, pregnant people, those with underlying conditions, and people who are severely malnourished, said Dr. Tina Tan, of Northwestern University Feinberg School of Medicine.
Measles symptoms start with fever, cough, runny nose, pink eye, and white spots in the mouth, followed by a red blotchy rash that begins on the face and spreads to the body, beginning three to five days later.
Generally, measles causes one to three deaths per 1,000 cases. There has been one confirmed death from this measles outbreak — the first in 10 years — and one death under investigation.
“We’re concerned with more than just dying from measles. We’re concerned about the complications,” said Higgins.
Long term complications include permanent hearing loss, blindness, and permanent neurological deficits, Tan said.
Typically, 20% of people who get measles need to be hospitalized. “These are not people hospitalized for quarantine,” Higgins said. “They’re hospitalized because they are sick and have a complication. They can’t breathe, or they have severe diarrhea and need IV fluids, or they can’t breathe and need oxygen.”
Early in the outbreak, which began in late January, U.S. Health and Human Services Secretary Robert F. Kennedy Jr. erroneously claimed that some children with measles were hospitalized so they could be under quarantine.
The vast majority of people with measles recover, but it can cause brain swelling, seizures, blindness, deafness, and erase other immunities from the body. The panel continued on to bust a few more widespread myths.
Malnourishment is a risk factor for a more severe case of measles, but from a global perspective, American children are not considered malnourished, said Tan.
Many children in developing countries are severely malnourished, and Vitamin A can help them decrease the severity of a measles infection, she said. She stressed, however, that Vitamin A is not a treatment or a cure as Kennedy has suggested, but just supportive therapy. The American Academy of Pediatrics (AAP) also recommends Vitamin A to reduce disease severity.
The AAP recommends two age-specific doses of Vitamin A taken a day apart for those infected. It cautions against taking more than recommended, since toxicity can result, producing liver damage and other issues.
Higgins said states can have high vaccination rates but have pockets of low vaccination rates. The current measles outbreak started in a Mennonite community in Texas that has low vaccination rates.
In the U.S., vaccination rates are lower for a variety of reasons, including misinformation. Globally, other countries have lack of vaccine access due to ongoing supply chain disruption from COVID-19, Higgins said.
Worldwide, measles cases increased 20% from 2022 to 2023, according to Dr. Amy Winters with the University of Georgia’s College of Public Health, but global figures are massively underreported.
Higgins said the vaccine is “incredibly safe” with decades of research supporting its efficacy, but noted the vaccine can cause mild, temporary effects such as rash, fever, and soreness at the injection site.
The idea that the measles (MMR) vaccine causes autism has been, according to Higgins, “thoroughly disproven by dozens of studies including millions of children.”
There can be serious side effects from the vaccine, but they are “extremely rare,” Higgins said. Likewise, Winter emphasized the outbreak could’ve been prevented if more children had been vaccinated.
Measles is the most contagious disease known, said Tan.
An infected person can infect up to 18 other people, and are contagious well before symptoms appear. By comparison, a person with the flu will only infect two others, said Winter.
For unvaccinated Americans traveling abroad where measles is more prevalent and vaccination rates are lower, “measles is only a plane flight away,” Higgins said.
In 2019, a year with high measles rates in the U.S., 63% of cases were due to importations from another country brought to the U.S. by Americans who had traveled abroad, Winter said.
The first dose of measles vaccine is recommended for kids ages 12-15 months, and the second dose at 4-6 years old.
People born before 1957 are presumed to have had measles and acquired lifetime immunity that way. But people born after 1957 and vaccinated before 1968 got a less effective version of the vaccine, and officials recommend they get a booster.
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