Measles is a highly contagious respiratory disease that is extremely harmful to children.
About one in 10 children with measles will also get an ear infection and up to one in 20 will get pneumonia.
For every 1,000 children with measles, one or two will die.
The good news is that it is a very preventable disease, which is why it is so important for children to be properly immunized.
Measles Outbreaks:The Importance of Vaccinations
Featured Speaker:
Greater Newport Physicians
Peri Suzan Gunay, MD
After her east coast education at Harvard, Dartmouth, and Brown Universities, Dr. Gunay completed her pediatric training at Northwestern University in 1989. Her special interests include behavior and development of children, ADHD, and craniofacial conditions. Dr. Gunay has served in leadership positions with Greater Newport Physicians, an affiliate of MemorialCare Health System and is also an active member of the American Academy of Pediatrics.Greater Newport Physicians
Transcription:
Measles Outbreaks:The Importance of Vaccinations
Deborah Howell (Host): Hello and welcome to the show. You are listening to weekly dose of wellness brought to you by Memorial Care Health System, I am Deborah Howell and today’s guest is Dr. Peri Suzan Gunay, a board certified pediatrician who has served in leadership positions with Greater Newport Physicians and affiliate of Memorial Care Health System. She is also an active member of the American Academy of Pediatrics and is here today to talk to us about the importance of measles vaccination. Welcome, Dr. Gunay.
Dr. Peri Suzan Gunay (Guest): Hi Deborah, thanks for having me.
Deborah: Oh, my pleasure. Right at the top, what is measles?
Dr. Gunay: Well, measles is a highly contagious virus infection that is a respiratory illness, also has a large degree of fever and other possible complications, it is truly quite a serious infection.
Deborah: Okay, you said highly infectious, what does that mean?
Dr. Gunay: Well, in the United States, due to the fact that there is a vaccination that has been very effective at reducing the overall incidence in our country, we have not really had to experience measles very often but there are a lot of countries where the amount of measles is still quite high and so occasionally, people will bring measles here, if someone who is not immune to measles, in other words who has not received their vaccination, is exposed to measles in a closed way, there is almost 100% chance that they will actually contract it.
Deborah: Okay, now when you say in a close way, does that mean I am sitting in a closed car, sharing air, does that mean I have to kiss you to get measles or hug you or tell me what you mean by.
Dr. Gunay: Well, it is shared by the secretion, so very close contact like kissing or sharing a cup could transmit it but it is also transmitted through the air, so that if you are in a room or an area where someone is actively contagious, then it can be transmitted as well, that does not require, you know, super close contact, just being in the same room or building where someone is at risk of transmission.
Deborah: Okay, so if you are a nurse then would you need to wear a mask when you are treating a patient with me, so how is that handled.
Dr. Gunay: Well, if a person is caring for someone with measles that is not immune to the disease, then yes they would need to mask in order to prevent, in order to avoid contracting it from an exposure, if you have immunity then that precaution is not required because your immunity would allow you to, you know, not be susceptible. Overall, if someone has received their vaccinations, the protection is quite high, it is still possible to catch it but it is much-much lower than in people that have not been immunized.
Deborah: Okay, so we see all these new strains of flu, measles from what I am gathering from you is pretty much one strain or you know, because one vaccination covers immunity there, maybe you could speak to that.
Dr. Gunay: Yeah, it does not transform into multiple different varieties, the way that influenza does, although in some respect, it does have some similarities in that it tends to show up with the first symptom of being a pretty high fever that can last for quite a few days like perhaps four to seven days and then shortly after the fever, a lot of runny nose, cough, congestion will occur. Measles as opposed to influenza though has a lot of watery red eyes associated with it and often a fairly heavy amount of diarrhea and then additionally several days into the illness, a rash will appear that is quite pronounced and will start on the face and upper chest and then move down the body.
Deborah: It just sounds dreadful and you are dealing with all of that while you have a high fever, oh my goodness.
Dr. Gunay: I guess, you know one in a thousand individuals who contract measles will actually die of it, there are, you know, mild complications such as ear infections, dehydration, pneumonia, but worldwide about 120,000 people will die of measles every year. Often the people who are more susceptible to dying if they contract measles may have immune deficiency or nutritional deficiency like vitamin A, however it really can affect anyone in a serious way and can sometimes even cause blindness or encephalitis as well which is the swelling of the brain.
Deborah: Wow, is it often misdiagnosed as flu?
Dr. Gunay: We simply don’t tend to see it very often in the United States, it certainly could be misdiagnosed as flu. In the late 80s when we had an epidemic in the United States, I was finishing my training in Chicago and one of my internist who was just delivering a baby came down with measles after having been exposed to a patient in the hospital and at that time, part of the reason she contracted it was that we were not recognizing that the epidemic had started and people were not thinking about measles. We are experiencing an outbreak currently in California, there has been a number of, 50 or 60 cases statewide and Orange County happens to, has the unfortunate privilege of having the most cases in the state in somewhere in the mid 20s just for 2014 which is a 10 times increase from prior years, so we are concerned that it may spread throughout the county if we don’t get under-immunized or unimmunized individuals to their doctors to get their vaccination.
Deborah: So, you certainly attribute that bounce in numbers to people who have been little bit afraid to get their immunizations.
Dr. Gunay: Yeah, I think that there was a lot of fear about the possible relationship of vaccinations to autism in the last 10 or 15 years which caused a lot of people to be fearful and avoid vaccinations and in particular, the MMR came under a lot of scrutiny, however after looking very closely at that in the last 10 or 15 years, that really has been found to be not the case, so I think we have seen people being a little more willing to accept their immunizations and not have that concern.
Deborah: Okay, how is measles treated?
Dr. Gunay: Mostly, measles have to be treated with supportive care. Because of the virus and not a bacteria, antibiotics are not going to change the course of the measles virus. We cannot treat complications such as secondary bacterial infections like ear infections and pneumonias with antibiotics and we can support dehydration with either oral by mouth liquids hydration or if necessary IV hydration either in emergency rooms or in the hospitals. We don’t want patients with measles who are not needing that sort of support however to be going into emergency rooms and even clinics and offices, they have not needed because they may actually expose other people and increase the spread. The Public Health Department has some special clinics that they set up but if there are suspected cases that don’t require emergency care, the best option is for the patients to let their doctor know they think they may have symptoms of measles and they can be directed to that sort of clinic.
Deborah: Okay, so in your opinion, is measles almost totally preventable?
Dr. Gunay: Yes, it is definitely a vaccine preventable disease. In the United States, we are considered a measles free country in the sense that the virus is no longer endemic or no longer being transmitted on a routine basis and that is due to the success of our relatively high immunization rates in the United States but there are quite a few countries worldwide where it still is quite rampant and that is often the source of the cases that come in and do cause these outbreaks similar to what we are experiencing right now in California.
Deborah: Okay and doctor, my final question to you is who should be vaccinated for measles?
Dr. Gunay: Well, children receive their initial dose when they are at least one year of age generally, although under a year, six months to year can receive a dose if they are known to have a direct exposure and that may help protect them. They then also receive a second dose before entry to kindergarten but the second dose can be received as early as one month after the birth, again if there is a situation where there is a high risk of exposure such as what we are experiencing presently. Patients can ask that their preschool children receive their second dose earlier than kindergarten entry and then anyone over age 5 or 6 who has not been immunized or under review with their doctors found to not be immune could potentially receive the vaccination.
Deborah: So get your vaccinations, get your kids vaccinated, don’t be afraid, this is the good thing to do for your health of yourself and your children, correct.
Dr. Gunay: Exactly, I cannot agree with you more.
Deborah: Well, thank you so much Dr. Gunay. It has been a real pleasure to have you on our program today. To listen to this podcast and for more information, please visit memorialcare.org. I am Deborah Howell, join us again next time as we explore another weekly dose of wellness, brought to you by Memorial Care Health System, have a fantastic day.
Measles Outbreaks:The Importance of Vaccinations
Deborah Howell (Host): Hello and welcome to the show. You are listening to weekly dose of wellness brought to you by Memorial Care Health System, I am Deborah Howell and today’s guest is Dr. Peri Suzan Gunay, a board certified pediatrician who has served in leadership positions with Greater Newport Physicians and affiliate of Memorial Care Health System. She is also an active member of the American Academy of Pediatrics and is here today to talk to us about the importance of measles vaccination. Welcome, Dr. Gunay.
Dr. Peri Suzan Gunay (Guest): Hi Deborah, thanks for having me.
Deborah: Oh, my pleasure. Right at the top, what is measles?
Dr. Gunay: Well, measles is a highly contagious virus infection that is a respiratory illness, also has a large degree of fever and other possible complications, it is truly quite a serious infection.
Deborah: Okay, you said highly infectious, what does that mean?
Dr. Gunay: Well, in the United States, due to the fact that there is a vaccination that has been very effective at reducing the overall incidence in our country, we have not really had to experience measles very often but there are a lot of countries where the amount of measles is still quite high and so occasionally, people will bring measles here, if someone who is not immune to measles, in other words who has not received their vaccination, is exposed to measles in a closed way, there is almost 100% chance that they will actually contract it.
Deborah: Okay, now when you say in a close way, does that mean I am sitting in a closed car, sharing air, does that mean I have to kiss you to get measles or hug you or tell me what you mean by.
Dr. Gunay: Well, it is shared by the secretion, so very close contact like kissing or sharing a cup could transmit it but it is also transmitted through the air, so that if you are in a room or an area where someone is actively contagious, then it can be transmitted as well, that does not require, you know, super close contact, just being in the same room or building where someone is at risk of transmission.
Deborah: Okay, so if you are a nurse then would you need to wear a mask when you are treating a patient with me, so how is that handled.
Dr. Gunay: Well, if a person is caring for someone with measles that is not immune to the disease, then yes they would need to mask in order to prevent, in order to avoid contracting it from an exposure, if you have immunity then that precaution is not required because your immunity would allow you to, you know, not be susceptible. Overall, if someone has received their vaccinations, the protection is quite high, it is still possible to catch it but it is much-much lower than in people that have not been immunized.
Deborah: Okay, so we see all these new strains of flu, measles from what I am gathering from you is pretty much one strain or you know, because one vaccination covers immunity there, maybe you could speak to that.
Dr. Gunay: Yeah, it does not transform into multiple different varieties, the way that influenza does, although in some respect, it does have some similarities in that it tends to show up with the first symptom of being a pretty high fever that can last for quite a few days like perhaps four to seven days and then shortly after the fever, a lot of runny nose, cough, congestion will occur. Measles as opposed to influenza though has a lot of watery red eyes associated with it and often a fairly heavy amount of diarrhea and then additionally several days into the illness, a rash will appear that is quite pronounced and will start on the face and upper chest and then move down the body.
Deborah: It just sounds dreadful and you are dealing with all of that while you have a high fever, oh my goodness.
Dr. Gunay: I guess, you know one in a thousand individuals who contract measles will actually die of it, there are, you know, mild complications such as ear infections, dehydration, pneumonia, but worldwide about 120,000 people will die of measles every year. Often the people who are more susceptible to dying if they contract measles may have immune deficiency or nutritional deficiency like vitamin A, however it really can affect anyone in a serious way and can sometimes even cause blindness or encephalitis as well which is the swelling of the brain.
Deborah: Wow, is it often misdiagnosed as flu?
Dr. Gunay: We simply don’t tend to see it very often in the United States, it certainly could be misdiagnosed as flu. In the late 80s when we had an epidemic in the United States, I was finishing my training in Chicago and one of my internist who was just delivering a baby came down with measles after having been exposed to a patient in the hospital and at that time, part of the reason she contracted it was that we were not recognizing that the epidemic had started and people were not thinking about measles. We are experiencing an outbreak currently in California, there has been a number of, 50 or 60 cases statewide and Orange County happens to, has the unfortunate privilege of having the most cases in the state in somewhere in the mid 20s just for 2014 which is a 10 times increase from prior years, so we are concerned that it may spread throughout the county if we don’t get under-immunized or unimmunized individuals to their doctors to get their vaccination.
Deborah: So, you certainly attribute that bounce in numbers to people who have been little bit afraid to get their immunizations.
Dr. Gunay: Yeah, I think that there was a lot of fear about the possible relationship of vaccinations to autism in the last 10 or 15 years which caused a lot of people to be fearful and avoid vaccinations and in particular, the MMR came under a lot of scrutiny, however after looking very closely at that in the last 10 or 15 years, that really has been found to be not the case, so I think we have seen people being a little more willing to accept their immunizations and not have that concern.
Deborah: Okay, how is measles treated?
Dr. Gunay: Mostly, measles have to be treated with supportive care. Because of the virus and not a bacteria, antibiotics are not going to change the course of the measles virus. We cannot treat complications such as secondary bacterial infections like ear infections and pneumonias with antibiotics and we can support dehydration with either oral by mouth liquids hydration or if necessary IV hydration either in emergency rooms or in the hospitals. We don’t want patients with measles who are not needing that sort of support however to be going into emergency rooms and even clinics and offices, they have not needed because they may actually expose other people and increase the spread. The Public Health Department has some special clinics that they set up but if there are suspected cases that don’t require emergency care, the best option is for the patients to let their doctor know they think they may have symptoms of measles and they can be directed to that sort of clinic.
Deborah: Okay, so in your opinion, is measles almost totally preventable?
Dr. Gunay: Yes, it is definitely a vaccine preventable disease. In the United States, we are considered a measles free country in the sense that the virus is no longer endemic or no longer being transmitted on a routine basis and that is due to the success of our relatively high immunization rates in the United States but there are quite a few countries worldwide where it still is quite rampant and that is often the source of the cases that come in and do cause these outbreaks similar to what we are experiencing right now in California.
Deborah: Okay and doctor, my final question to you is who should be vaccinated for measles?
Dr. Gunay: Well, children receive their initial dose when they are at least one year of age generally, although under a year, six months to year can receive a dose if they are known to have a direct exposure and that may help protect them. They then also receive a second dose before entry to kindergarten but the second dose can be received as early as one month after the birth, again if there is a situation where there is a high risk of exposure such as what we are experiencing presently. Patients can ask that their preschool children receive their second dose earlier than kindergarten entry and then anyone over age 5 or 6 who has not been immunized or under review with their doctors found to not be immune could potentially receive the vaccination.
Deborah: So get your vaccinations, get your kids vaccinated, don’t be afraid, this is the good thing to do for your health of yourself and your children, correct.
Dr. Gunay: Exactly, I cannot agree with you more.
Deborah: Well, thank you so much Dr. Gunay. It has been a real pleasure to have you on our program today. To listen to this podcast and for more information, please visit memorialcare.org. I am Deborah Howell, join us again next time as we explore another weekly dose of wellness, brought to you by Memorial Care Health System, have a fantastic day.