Here is a brief history of the measles, with information courtesy of the Centers for Disease Control. Video by Jordan Fenster / lohud.
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Fear, rumors and anger appear to be spreading through Rockland County quicker than the measles outbreak underway.
Fueled by social media, the misinformation wildfire has ignited suspicion and animosity among neighbors and strangers alike. All the confusion comes as the measles tally topped 50 cases in an urgent public awareness campaign.
The Journal News asks public health questions and government officials about efforts to keep communities safe.
One talk took place with Dr. Robert Amler, dean of New York Medical College's School of Health Sciences and Practice. He also coordinated the Centers for Disease Control and Prevention's measles surveillance, investigation and control program in the 1980s.
Another was with Matthew Zahn, chair of the Infectious Diseases Society of America's Public Health Committee. He is also a medical director of the Epidemiology Program for Orange County Public Health, and oversaw the response to the so-called Disneyland Molecules outbreak that sickened hundreds in 2015.
ROCKLAND: Measles outbreak spreading
What follows are some of their answers and key details from the ongoing analysis of CDC and public health information.
How bad is the rockland outbreak?
It is one of the largest in modern history. An outbreak in an Orthodox Jewish community in Brooklyn ended with 58 cases in 2013, the worst since 1992.
Nationwide this year, 142 measles cases were reported by early last month, which exceeded the 2017 total of 120.
"For the first time we're going to see, in the same document, what's happening with measles and what's also happening with blood lead levels in adults." – Dr. Robert Amler, dean of the School of Health Sciences and Practice at New York Medical College. (Photo: File photo by Tania Savayan / The Journal News)
Rockland had 52 confirmed cases and seven suspected cases during a recent outbreak update.
As a result, authorities are pushing vaccination clinics and safety protocols, such as banning unvaccinated students from attending classes in three Rockland communities if their school has a vaccination rate of 70 percent or less.
Why is measles so contagious?
The measles virus is transmitted via the misty droplets that come when an infected person coughs, sneezes and even breathes. The virus can live up to two hours in the air and on surfaces in a room where an infected person has been.
Someone infected can transmit the disease from four days after a four days after a flat, itchy, red rash shows up. Measles symptoms may not appear for a week to three weeks after exposure.
How dangerous is measles?
Complications from measles include pneumonia, brain damage, deafness, and death.
It can be especially dangerous for babies, who have not had the virus. People with immune system problems are also at heightened risk.
What is the death toll?
The last measles-related death in the USA was a woman in Washington state in 2015. She was probably exposed to measles at a medical facility during a measles outbreak, health officials said.
The Washington woman died of pneumonia, which is the most common cause of death related to the mammals virus. She also had other health conditions and was taking medications that suppressed her immune system. It was the first measles death since 2003.
Still, measles remains a significant threat in other countries with lower vaccination rates. Worldwide, 19 cases of measles per 1 million persons are reported every year, killing about 89,780.
What's the timeline for clearing a measles outbreak?
Typically it takes up to two months after a case of measles is introduced.
The disease incubation period is about 10 to 14 days … and the outbreak usually does not last more than a couple of generations of infectious spreading.
So, there will be a case and then two weeks pass before another crop of cases.
As new cases pop up, however, officials have to track down potential exposures and push back the timeline.
This, of course, presumes you have a well-vaccinated population. Authorities stay vigilant of the fled-ups even longer in communities with lots of unvaccinated who are more likely to get sick.
How effective is the measles vaccine?
Very effective. One dose of the measles vaccine is about 93 percent effective at preventing the maladies if exposed to the virus. Two doses are about 97 percent effective.
When is someone protected against measles?
According to the CDC, the following are the following:
They received two doses of measles-containing vaccine, and are a (n):
- school-aged child (grades K-12)
- adult who will be in a setting that poses a high risk for measles transmission, including students at post-high school education institutions, healthcare personnel, and international travelers.
They received one dose of measles-containing vaccine, and are a (n):
- preschool-aged child
- adult who will not be in a high-risk setting for measles transmission.
A labatory confirmed that they had measles at some point in your life.
A laboratory confirmed that they are immune to the measles.
They were born before 1957.
Could anyone completely vaccinated still get measles?
Very few people, about three out of 100, who get two doses of the vaccine will still get to the nose if the virus is exposed.
Experts are not sure why. It could be that their immune systems did not respond as well as they should have to vaccine.
Still, fully vaccinated people who get measles are more likely to have a milder illness.
Fully vaccinated people are also less likely to spread the disease to other people, including people who can not get vaccinated because they are too young or have weakened immune systems.
What are people who are unsure of their measles immunity?
First try to find vaccination records or documentation of measles immunity. Without written documentation, people should get vaccinated with measles-mumps-rubella (MMR) vaccine.
Another option is to have a blood test to determine the immunizations, but this option is likely to cost more and will take two doctor's visits, CDC officials said.
There is no harm in getting another dose of MMR vaccine for people who may already be immune to measles (or mumps or rubella).
Q: Do people ever need a booster vaccine?
No. CDC views people who received two doses of measles vaccine as children according to U.S. The vaccination schedule is protected for life, and they do not need a booster dose.
Adults need at least one dose of measles vaccine, unless they have evidence of immunity.
Adults who are going to be in a setting that can have two doses separated by at least 28 days. These adults include students at post-high school education institutions, healthcare personnel, and international travelers.
If you're not sure whether you were vaccinated, talk with your doctor. For more information, visit the CDC posting about who needs measles vaccine.
How do the sick offices during outbreaks?
They are looking for symptoms.
Until doctors and nurses are aware, a patient may visit multiple clinics or emergency rooms seeking care, and that leads to a large number of people in the potentially being exposed.
Authorities encourage people with their health care provider, a local clinic, or a local emergency department before going for care. Making the prior contact is to be exposed to the illness.
Medical officials also try to identify those who are susceptible to measles, such as babies and immune-compromised, and limit exposure in waiting rooms and other office spaces.
What does a measles outbreak cost taxpayers?
The long-term toll is unclear, but the public-health cost was $ 5.3 million in 2011 for attempts to contain measles during 16 outbreaks with 107 total cases.
The so-called Disneyland Molecules spread across hundreds of people across the country, including 35 cases in Orange County where the amusement park is located.
It cost hundreds of thousands of dollars related to just the 35 local cases, health officials said.
How common was measles before the vaccine?
Before the vaccination program started in 1963, about 3 to 4 million people got measles every year in the United States. Of those people, 400 to 500 died, 48,000 were hospitalized, and 4,000 developed encephalitis (brain swelling) from the measles.
Who is bringing the measles into the US?
Travelers can bring measles into the United States from any country where the disease still occurs or where the outbreaks are occurring in Europe, Africa, Asia and the Pacific.
In recent years, many measles cases have come into the United States from common U.S. travel destinations, such as England, France, Germany, India. During 2014, many measles cases came from the Philippines and Vietnam.
Rockland's measles outbreaks and cases in New York City – and Bergen County and Lakewood, New Jersey – have been linked to Israel.
Experts recommend Americans, especially those who travel abroad, must have updated vaccination records with them.
They can keep records with their passports to avoid them and avoid unnecessary slowdown when traveling and in places with an outbreak.
Who's checking travelers from the places with measles?
There are options of screening, and that often depends on what is going on around the world.
There is the ebola outbreak and travelers coming from certain countries in Africa in 2014. At that time, people either entered or returning from particular countries were carefully screened.
International public health organizations closely monitor these outbreaks and notify governments that determine screening protocols.
What do people know about quarantines?
The goal is to protect from infection of infection, and the federal government derives its authority for isolation and quarantine from the commerce clause of the U.S. Constitution.
There were short-lived quarantines during the Ebola outbreak in 2014 at the state level in New York and New Jersey. But experts criticized the lawmakers involved, including Gov. Andrew Cuomo, for endangering the efforts to curb the outbreak in Africa.
Lawmakers across the country also called for banning travel from the hardest-hit countries. Strict airport screening was put in place instead.
Large-scale isolation and quarantine were last enforced at the federal level during the influenza ("Spanish Flu") pandemic in 1918-1919, which killed 50 million globally.
The Journal News / lohud's Nancy Cutler contributed to this report.
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