As of Wednesday, April 24, 695 cases of measles have been reported in 22 states, including Tennessee, according to the Centers for Disease Control and Prevention (CDC).
This is the greatest number of cases reported in the United States since measles was eliminated from the country in 2000, according to the CDC.
Measles is an infectious virus that causes fever and a red rash on the skin and can be fatal. According to the CDC, measles is so contagious that 90 percent of the people close to an individual with the disease will also become infected if they are not immune.
The virus, which affects humans, is airborne, and spread through coughing and sneezing. The measles virus can live for up to two hours in the airspace where an infected individual coughed or sneezed. Other people breathing that contaminated air, or who touch an infected surface then then touch their eyes, noses or mouth can then contract the disease, the CDC’s website states.
Case in Tennessee
As of Wednesday, one case had been reported in Tennessee, according to the Tennessee Department of Health (TDH).
TDH continues to investigate that case and to notify people who may have been exposed to the illness through contact with the patient, a resident of East Tennessee.
This investigation has identified two locations the patient visited in Tennessee where members of the public may have been exposed to measles.
Individuals who were at either of these locations during the dates and times specified below may have been exposed to measles: the Mapco at 200 Browns Ferry Road in Chattanooga from 7:30 to 10 p.m. on April 11, and the Speedway at 2148 North Charles G. Seivers Blvd. in Clinton from 5:30 to 8 p.m. on April 12.
The high number of cases in 2019 is primarily the result of a few large outbreaks – one in Washington state and two large outbreaks in New York that started in late 2018, according to CDC.
“It’s always concerning when we have a disease that was once eradicated from the country to be making a [comeback] again,” said Dr. Meagan Aiken, a pediatrician at Tennova Pediatrics in Tullahoma. “We went for several years with no cases of measles until 2000. Then, measles started popping back up and we’ve seen some cases. The last major outbreak was in 2014. There have been some cases on and off since then.”
While Tennessee has seen only one case so far this year, there has been a widespread outbreak in other states and many states have been affected, said Aiken.
The states with reported cases of measles are Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New York, Oregon, Texas, Tennessee and Washington, according to CDC.
The recent outbreaks started through importation, according to CDC. Measles is imported when an unvaccinated traveler visits a country where there is widespread measles transmission, gets infected with measles, returns to the U.S. and exposes people who are not vaccinated.
When measles is imported into a community with a highly vaccinated population, outbreaks either don’t happen or are small. However, once measles is in an under-vaccinated community, it becomes difficult to control the spread of the disease, according to CDC.
“In almost all of the cases of measles that have been reported and documented, the people have not been vaccinated or have been improperly vaccinated,” Aiken said. “Usually, the first person to bring it back has travelled to a country where there is a widespread measles outbreak – Israel, Ukraine and the Philippines are the three big ones. So somebody that goes and is not fully immunized gets exposed.”
Individuals need two doses of the measles-mumps-rubella (MMR) vaccine for proper protection against measles.
Those that have gotten only one dose of MMR may be at risk, said Aiken, adding that prior to 1989, only one dose of MMR vaccine was required.
She urged individuals who are not certain if they have proper immunization to contact their health care providers.
“The only way to prevent measles is getting vaccinated,” Aiken said. “If you have one MMR vaccine, you have 93% rate of not getting it, meaning the vaccine works 93% of the time. If you have had two doses, the vaccine works about 97%. So the majority of people are covered and will not get measles if they get vaccinated.”
The measles vaccine is completely safe, she added.
“I encourage you to get vaccinated – you are not only protecting yourself, but you are also protecting people around you,” Aiken said. “Not vaccinating puts people that can’t get these vaccines at risk to catch these diseases. There are certain populations of people that are unable to get those vaccines – they may want to but they can’t because of a medical reason.”
In the ninth century, a Persian doctor published one of the first written accounts of measles disease, according to CDC.
The symptoms of measles generally appear about seven to 14 days after a person is infected.
Symptoms include high fever, cough, runny nose and red, watery eyes. Two or three days after symptoms begin, tiny white spots may appear inside the mouth. Three to five days after symptoms begin, a rash breaks out. It usually begins as flat red spots that appear on the face at the hairline and spreads downward to the neck, arms, legs and feet, according to CDC.
In 1912, measles became a nationally notifiable disease in the country, requiring U.S. health care providers and laboratories to report all diagnosed cases. In the first decade of reporting, an average of 6,000 measles-related deaths were reported each year.
In the 1950s and 1960s, medical professionals focused efforts on creating and improving measles vaccine.
Thanks to a highly effective vaccination program, in 2000, measles was declared eliminated from the U.S, meaning there was no continuous disease transmission for more than 12 months.
Elena Cawley may be reached at firstname.lastname@example.org.