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Melanie Cole (Host): Welcome. Today we are talking about measles and the recent outbreak that we have seen in many parts of the country. My guest is Dr. Robert Healy. He’s an adult medicine physician with The Carle Foundation Hospital. Dr. Healy, what’s the current state of measles today? What have you been seeing?

Robert Healy, MD (Guest): It’s gotten a little quieter. We have been dealing measles outbreak here in our local area of Champaign Urbana for approximately six weeks and we haven’t had a new case now for over two weeks.

Host: Tell us about measles. I mean was it gone and is it back now or was it never really completely gone? What’s gone on with it in the last 20 years or so?

Dr. Healy: So, in 2000, the CDC said that measles was eradicated from the United States of America. And what that meant was there was no more new cases developing from people in the US. What has happened though is we do get cases from people who travel outside of the US. It’s still a pretty severe disease and pretty significant in different areas of the world. Within the last few months, there has been an outbreak in Israel. There’s been outbreaks in other parts of the world so people who travel, who are unimmunized can get the disease and it can take up to 14-21 days for them to show symptoms of the disease, meanwhile they are traveling back to the United States to go back to their community and they just start showing symptoms and become infective.

Host: How does it spread?

Dr. Healy: It’s one of the most contagious infectious diseases that we see. It’s spread through the air. So, remarkably, if someone is in a room that has measles, and that can be four days before their rash appears, so they could like they a regular cold; if they cough or sneeze or they are just breathing; there is measles virus in the air and if there is someone in that room who has not been vaccinated, there is a 90% chance they will catch measles. So, a really high rate of infection. Also, if the person with measles leaves that room; for up to two hours later, a person without immunity can still become infected.

Host: Wow. That’s amazing. And it is so contagious. Is it more harmful if an adult, you know we hear if adults get chicken pox that it could be a lot worse. Is that the same with measles?

Dr. Healy: Measles can affect – can have serious consequences for anybody but like with most diseases; the really young and the really old can really be hit hard. There are deaths from measles. There has been hundreds of deaths around the world just in the last month from measles. Luckily, we didn’t see any deaths here or any serious complications. But there can be complications such as brain problems, there could be deafness, there could be what’s called encephalopathy which is when your brain becomes inflamed essentially and it can affect your memory, it can affect certain of your functions. There could be really bad pneumonia that could develop. And then years after getting measles, it can cause a neurologic condition that can cause problems for people who have had it before.

Host: It’s a terrible disease. Dr. Healy, why do you think and in your opinion, that now all of the sudden as you said it’s been spotted in Israel and then people come over and I think even at Midway Airport in Chicago, there was an infection and people were walking around with masks on like SARS. Why do you think this is happening and what do you want other providers to know about discussing this with their patients, the MMR vaccine and some of the questions people have about this?

Dr. Healy: I think the most important thing is for everyone to be vaccinated or as many people as possible to be vaccinated. Now there are certain people that can’t get the vaccine, if you are currently pregnant you can’t get the vaccine if you haven’t had it before. If you have certain types of chronic illnesses, you can’t get the vaccine. Certain types of allergy to the vaccine itself can cause problems and you won’t be able to get the vaccine. But far and away, the majority of people can get the vaccine and should be getting the vaccine.

Now there’s been a lot of negative press over the years about the vaccine not being safe or we are giving too many vaccines to our children. The bottom line though, is that the evidence shows that the vaccines are safe. They help prevent and contain illnesses like measles. And again, my opinion, but I think everyone should be vaccinated who is not medically unable to. There are states and there are areas where people could have for reasons of philosophy or religion, they could say they don’t want to vaccinate their children and we allow that. The problem is that in order for a community to be safe from a measles outbreak; they really have to have a high degree of the number of people who are vaccinated, way above 90%.

In Champaign County we were lucky because 98% of the people are vaccinated here. This current measles outbreak in Champaign Urbana affected the U of I and that large student population there. But luckily, when they looked at their records, they only had about 200 students who did not get a vaccine. So, out of the 40,000 plus students they only had 200 that didn’t get the vaccine. Unfortunately, two of those students got the disease this time around.

So, but comparing it to places like in Washington State, I think it’s Clark County, they had an outbreak, I think the latest I saw last week was over 40 cases of measles. They have a rate of vaccine of about 73%. So, when the rate of vaccine in a population goes down, you don’t get what’s called herd immunity which is that most people are vaccinated even if someone who isn’t becomes infected and spreads the virus; there is really no one to spread it to because if you had the vaccine you are protected. Whereas if a quarter of the people walking around have not gotten the vaccine; that’s a lot of people that can get the infection.

Host: That’s so interesting but then what do we want to know or what do we want to tell people about that herd immunity because that’s the reason that some people choose not to get the vaccine. They figure well if I’m close enough to all of those people that got it, then I’ll be just fine and that’s one of the myths. How as a provider, do you explain to people about some of the myths that surround this vaccine.

Dr. Healy: Yeah, I think the biggest myth is that there can be a causation from the vaccine and autism. And that has been thoroughly debunked and should not really be something that people think right now. Unfortunately, stories like that and some of the studies that were done improperly really, I think tap into a fear people have of pharmacy corporations and big medicine organizations and they think that it’s proof that there could be some kind of conspiracy. But the evidence is out there that there’s not a link to autism. So, that’s one thing that’s very important to realize.

The other thing is about herd immunity. You really need to have like I said over 90% of the group that you live in immune and really what that’s most important for is that there’s people out there that can’t get the vaccine as I spoke about earlier. There are also people that have – they are going through chemotherapy, that have had bone marrow transplants for things such as leukemia and different kinds of cancers and they can’t be immunized. So, if there’s enough measles going around in a community, those people and their parents feel like they really can’t take them out in the community and they really feel isolated. And they can suffer a great deal if they were to get infected.

Host: If you are of a certain age Dr. Healy and you’re an adult medicine physician, did we all get the measles vaccine when we were younger and if we did not; I mean I remember my brother getting measles I think, but that was back in the 60s or early 70s. Who can get vaccinated now?

Dr. Healy: So, the vaccine came out in about 1963. The data shows that if you were born before 1957; you almost certainly got measles and you are immune because once you get it, you are immune to it in the future. So, if you’re old enough to be born before 1957; that’s proof of immunity. They started giving out the vaccine in 63. The recommendation is to get two shots, one at age about one years old and one when you are going into kindergarten. And for most people, that’s enough to give them immunity. The statistics show that the first shot gives you about 90-93% immunity and the second shot raises that to about 97% immunity. Or 97% of the people who get it will be immune to measles. So, the two shots is enough.

An interesting thing that happened a number of years ago in this community because we’re home to such a large university, there was a mumps outbreak and a mumps epidemic among the students. And it was recommended because the MMR, one of the things that’s included in that three vaccine set is mumps, the other being the measles. Because mumps immunity kind of went away over a number of years; the recommendation was to get a third MMR booster a number of years ago and that really helped protect us in this case because the third MMR also included a third measles booster and if people hadn’t gotten vaccinated some of them chose to be vaccinated back then when the mumps was going around.

Host: Wow. Now what would you like other providers to know about debunking the myths that you cleared up here today very clearly Dr. Healy and how you really – we shouldn’t be seeing measles again, not like this and not in the numbers that we’ve seen recently. How can other providers bring home this point and reiterate it, the importance of these vaccines especially for their children?

Dr. Healy: I think the important thing is pointing how we can help others who have immune deficiencies or are going through cancer therapy or going through bone marrow transplants by getting ourselves and our kids immunized. I think also, really important for providers is to keep in mind when someone is going to be travelling internationally; their immunization record should be checked, and they should get immunized with the MMR in two vaccines that is one month apart if they are going to be travelling internationally so that they don’t get infected with measles and then bring it back to our communities.

Host: So important. Thank you so much for coming on and updating us on the recent measles outbreak that we’ve seen in many parts of the country and certainly in Champaign. Thanks again. You’re listening to Expert Insights with The Carle Foundation Hospital. For a listing of Carle providers and to view Carle sponsored educational activities please visit www.carleconnect.com, that’s www.carleconnect.com. We hope the information gained will be applicable to your work and life. This is Melanie Cole.