Jaime Lewis (Host): Measles cases are resurging across the country, raising concerns among healthcare professionals. But here to discuss this highly contagious virus is Dr. Howard Gill, Chairman of the Department of Pediatrics at Holy Cross Health in Fort Lauderdale,

This is Thrive with Holy Cross Health, a production of Holy Cross Health. I'm Jamie Lewis. Dr. Gill, thank you for being here.

Howard Gill, MD: Thank you for having me. Welcome to Fort Lauderdale.

Host: Well, thank you so much. Let's start with something perhaps that people do know, but for those who don't, what exactly is measles? And how is the virus transmitted from person to person?

Howard Gill, MD: Well, measles is a highly transmissible viral illness that occurs worldwide. Prior to the development of the vaccine, over 2 million children died worldwide annually. It's one of the most highly contagious infectious disease known to man, similar to smallpox, which has been eradicated since 1976, and the infection tends to peak in late winter and spring, which is right around now.

The only natural host of measles is humans. So, you can't contract measles from your pet or from another animal in your realm. It is transmitted by direct contact, either through respiratory droplets, which is saliva or nasal drops, or by airborne spread, which is sneezing or coughing. Now, once exposed, over 90% of individuals will develop measles.

Host: Would you please walk us through a timeline of from, let's say, exposure to the manifestation of symptoms. What kind of signs should parents specifically watch for in their children?

Howard Gill, MD: Once exposed, the incubation period to become ill is about eight to twelve days. Now, a patient who's been exposed to measles who might be incubating the illness but has not expressed any signs yet can be contagious up to four days before they develop the signs of the illness.

Host: that sounds very dangerous for not being aware that it's transmissible at that point, and being a carrier, essentially. What are some of the serious complications that can arise from a meas infection, particularly for I'm thinking vulnerable populations.

Howard Gill, MD: Well, within two to four days of being exposed, you will develop high fevers, usually up to a hundred, three to 104, which is about 40, 41 degrees Celsius. typical stuffy nose conjunctivitis, which is pink eyes, and definitely a cough. Now, once the fever develops, a red rash will develop and usually starts on the face and will trickle all the way down to your neck, to your trunk, to your abdomen, and eventually onto your legs.

Other common symptoms could be a sore throat, enlarged lymph nodes, which are glands in your neck, or actually anywhere on your body. The fever and the rash will last about seven days, but the cough can remain for at least two weeks afterwards. Other infections, some more serious complications could be vomiting and diarrhea. Hepatitis, which is when the virus invades the liver. Pneumonia is a common one and is the common cause of death in children. Encephalitis, which is when the virus spreads into the brain, is an extremely serious complication and really doesn't have a good outcome.

Host: Well, a lot of us know about something called the MMR vaccine. I had it as a kid. My children have had it. So, it's been around for a long time, for decades. Could you explain how that vaccine works to protect against the virus and maybe talk about its effectiveness in preventing outbreaks?

Howard Gill, MD: The vaccine is what's called an attenuated virus vaccine. So, they take the virus and they weaken its strength. It's also given in combination with the mumps and rubella virus. That's why it's called the MMR. Rubella is known as German measles, and mumps is a virus that causes enlarged parotid glands on the sides.

When the attenuated virus enters the body, it triggers the immune system to recognize and attack it. Similar to how it would happen with natural infection, which is what I had when I was younger. The immune response leads to production of antibodies, which are proteins that specifically target and neutralize and kill the measles virus. Now, these antibodies remain in the body providing long-lasting immunity, unless something develops where that might weaken your immunity such as an illness or other types of immune deficiencies.

Host: Well, I know that there are a lot of misconceptions about the measles vaccine. Can you talk a little bit about the concerns parents raise with you and how you like to address them?

Howard Gill, MD: There's many misconceptions. I'll just tell you the top three. One is my child has an egg allergy. You may still receive the vaccine because there is no egg component. Second one is the vaccine has harmful ingredients. The inert ingredients are usually sugars or an antibiotic to prevent the fluid from getting infected. And of course, the big one is that causes autism. Now, multiple large-scale investigations and studies have found no link between the measles, mumps, rubella vaccine, and autism. The false claim that links the vaccine to autism originated with a discredited study in England, which was redacted due to fraudulent data.

Host: Yeah, I've heard about that. Well, how does measles vaccination contribute to, let's say, herd immunity? You know, the broader or public health. And why is that particularly important for immunocompromised people?

Howard Gill, MD: Herd immunity, when it is achieved, at least 95% of the community is immune from measles, either by vaccination or through wild-type disease. So, the whole community is protected. So, even those who cannot receive the vaccine such as small infants; immunocompromised, patients who might have cancer or a congenital immunodeficiency where they have weakened immune systems, people with some autoimmune diseases who cannot receive the vaccine, these people in our communities, community members are now protected because 95% of the community is protected either mostly through the vaccine or some older individuals who might have had the wild-type virus when they were younger.

Host: Well, I know that the different ages and stages of life require different treatment or different preventative care. So, what are the current guidelines for measles vaccination, including recommendations for those different ages and stages?

Howard Gill, MD: The first dose is given at between 12 and 15 months of age. Second dose would given between ages four and six years. Now, there might be instances where you could be traveling to an area where there's might be a high volume of measles infections and therefore you can get the vaccine before that 12-month period. In those cases, you will receive the 12 to 15-month and the four to six year vaccine. And that individual would've had three vaccines in their lifetime instead of two.

Host: So if somebody has not been vaccinated prior to that, how would they go about getting care?

Howard Gill, MD: Well, anyone could receive the vaccine at any age. So even if you did not receive the vaccine when you were younger, if you lived in a different country or where the vaccine wasn't available or you just did not have access to the vaccine, you could receive the vaccine at any age.

Host: Okay. I think that's important. So, is there anything else that you wanna leave listeners with regarding measles and the recent resurgence?

Howard Gill, MD: Well, one dose of measles vaccine is 93% effective at preventing measles. Two doses gives you 97-100% immunity, and it's long-lasting often through your whole life. And since the vaccine was introduced in 1963 globally, over 75% of the world is immune to measles; therefore, preventing, as I mentioned before, the 2 million deaths that occurred annually worldwide, less in the United States, but worldwide, 2 million children died; hence, the development of the vaccine in the first place.

Host: All right. Well, thank you so much for all your expertise and enlightening us on this very important subject.

Howard Gill, MD: Thanks for having us. Everybody, get vaccinated please.

Host: That was Dr. Howard Gill, Chairman of the Department of Pediatrics at Holy Cross Health in Fort Lauderdale. To learn more or to schedule an appointment, visit holycross.com/drgill. And thank you for listening to Thrive with Holy Cross Health.