Cheryl Martin (Host): This podcast is for informational purposes only and is not intended to be used as personalized medical advice.

 We are hearing a lot about measles outbreaks these days and here to tell us about this disease and exactly how serious it can be for children and adults, is Dr. Mariel Castillo, a Pediatrician at Skagit Regional Health.

 This is Be Well with Skagit Regional Health. I'm Cheryl Martin, Dr. Castillo, glad to have you on to talk about measles.

Mariel Castillo, MD: Thank you for having me here.

Host: What exactly is measles and how serious can it be for children and adults?

Mariel Castillo, MD: So measles is an acute viral illness. It is highly contagious, and it has been around since the ninth century, believe it or not, and it is one of the most highly communicable of all infectious diseases. So it's very important that we talk about this today. It can cause serious illness, long-term disability and death in people of all ages.

Host: So who is at risk for complications?

Mariel Castillo, MD: The ones that are less than five years old, older than 20 years old, pregnant women, immunocompromised people due to cancer, chemotherapy, or HIV infection.

Host: So how does measles spread and why is it considered so contagious?

Mariel Castillo, MD: It spreads by direct contact with infectious droplets or by airborne spread. It is so contagious because the attack rate is 90%, which means that if you are not immune to it and you are exposed in a close contact setting, nine out of 10 people will actually get infected. It's that easy.

Host: So talk about the common symptoms of measles and when should someone seek medical attention?

Mariel Castillo, MD: It is very nonspecific when it starts. It acts like just any other respiratory virus out there, including common cold viruses. It starts off with a fever, cough, runny nose or eye redness, and the hallmark rash actually starts a few days after all that. Meanwhile, you're already contagious before the rash begins.

Host: So is there a treatment for it?

Mariel Castillo, MD: Uh, unfortunately, there is no specific antiviral agent to this day. And so that's why it's been so difficult when you are not vaccinated, it's easy to get to you. The only treatment available is really vitamin A, but it's not an actual cure. It can help decrease morbidity and mortality.

Host: There's been a rise in measles cases lately. What's contributing to that increase?

Mariel Castillo, MD: In about the year 2000, measles was actually declared eliminated from the United States, but unfortunately since then, misinformation have contributed to this rise in cases over the recent past few years.

Host: Is that because we saw a decrease in people getting the vaccine?

Mariel Castillo, MD: Yes, and because of also travel overseas, and so measles cases have been brought into the US by those travelers, both American and foreign visitors.

Host: So, Doctor, please explain how the measles vaccine works in the body to protect us.

Mariel Castillo, MD: The measles vaccine is a live attenuated virus, meaning it is a weakened version of the virus that we get from the shot. It's just enough to cause an immune response, but not enough to cause serious illness. When we get the shot, our body develops these, what we call memory cells and antibodies so that when we actually encounter the real measles virus in the future, our bodies remember it and then the antibodies that have already been induced in our system start to disarm the virus. They basically act as our soldiers for us.

Host: So today, is the measles vaccine safe?

Mariel Castillo, MD: Yes, it has always been safe from the time the scientists have studied it in thousands of children in New York City and Nigeria in the I would say 1958 to 1960. Since then, it has been proven to be very safe and very effective time and time again. Multiple studies have shown that it is highly effective. There's a 97% chance that you will not get sick from the measles virus.

Host: So for parents who have questions about the measles vaccine, where can they find trustworthy evidence-based answers?

Mariel Castillo, MD: From the Centers for Disease Control, the CDC, the American Academy of Pediatrics, AAP, and the World Health Organization, WHO. Those are the reputable sources of information.

Host: Are there common side effects of the vaccine, and if so, how serious are they?

Mariel Castillo, MD: Yes, the common side effects are pretty much like any other vaccine out there, fever, rash, pain at the site of injection or some swelling there, but those are minor side effects and very temporary.

Host: So why do some people still hesitate to get the measles vaccine? And what would you say to them?

Mariel Castillo, MD: There was a fraudulent research paper that came out in 1998 in The Lancet, which is a medical journal. It was debunked in 2010. Unfortunately, the systemic misinformation from anti-vaccination groups have persisted.

Host: So is it ever too late to get vaccinated against measles?

Mariel Castillo, MD: No, it is never too late. And actually if hopefully you get a chance to discover that you were exposed to the measles virus, if you get a vaccine, the MMR vaccine, within 72 hours of that exposure, it is still it effective. If you do develop the illness, you can still have a milder illness.

Host: So should adults get the vaccine as well?

Mariel Castillo, MD: Oh, yes. We need the entire population to be vaccinated. We're hoping for a 95% vaccination rate in the entire population so that herd immunity can be achieved, meaning measles outbreaks can be prevented and therefore deaths can also be prevented.

Host: So if adults got the measles vaccine as a child, do they still need to get it again?

Mariel Castillo, MD: No, it's lifelong. The protection is lifelong unless, you are one of the rare few whose bodies did not actually mount that immune response when you got the vaccine. And actually you need two doses of it for it to be 97% effective.

Host: You've touched on this a little bit, but how can communities work together to prevent measles outbreaks and keep everyone safe? Any other suggestions?

Mariel Castillo, MD: My appeal to the folks out there is to avoid social media posts spreading misinformation and be informed of the dangers of misinformation. Because it can really cost a life or lives that have happened before. And has been happening again recently in the US, way after we've declared elimination.

Host: Dr. Mariel Castillo, thank you for keeping us informed on this important topic, extremely insightful. Thank you.

Mariel Castillo, MD: Thank you so much.

Host: For more information, visit skagitregionalhealth.org. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library for other topics of interest to you.

Thanks for listening to Be Well with Skagit Regional Health.