Measles largely impacts young children, can have serious complications

The Centers for Disease Control and Preventionrecently issued a health advisory due to an increase in measles cases across the United States – including in Missouri.

According to the Missouri Department of Health & Senior Services, in the 2022 - 2023 school year, the rate of Missouri kindergarteners who had received their two MMR vaccines was 91.3%. This is compared to 95.4% in the 2016 -2017 school year.

KBIA’s Rebecca Smith sat down with Dr. Amruta Padhye, a pediatric infectious diseases physician at University of Missouri Health Care, to learn more about the disease and what symptoms folks should be on the lookout for.

Rebecca Smith: So, measles was eliminated, or deemed “eliminated” back in 2000 in the United States, so I think it’s fair to say people might not know that much about the disease. Can you help us fill in some of those gaps?

Dr. Amruta Padhye: Before 1963, before the vaccine itself became available, it was a really common cause of hospitalization – 40,000 hospitalizations per year due to the measles virus infection and nearly 500 deaths per year in the United States.

And from there on, we have come a long way – there has been significantly greater than, like 99% decrease in the incidence.

This commonly affects the young children, so we think about young infants, young school going, you know, preschoolers toddlers, if they have been unvaccinated.

Since the elimination… about one in five cases of measles can result in hospitalization.

Common complications include ear infections, diarrhea, croup, pneumonia can happen in one in 20 kids, and then there's a very rare brain inflammation called acute encephalitis that can happen after measles.

And one important thing, that I think should be known, is that after measles infection, a person kind of, their immune system kind of gets what we call “immune amnesia,” meaning the body forgets to respond to future other infections.

Rebecca Smith: And what does this presentation of the disease look like – what should folks be looking out for?

Dr. Amruta Padhye: Some of the initial symptoms include fever, cough, runny nose, pinkeye, but then kind of few days go by and about four days into this … they may start having a rash and that should be a big clue to have their child evaluated, to reach out to their doctor.

So, the rash - it's kind of a pink color, blanching kind of rash that spreads from head to toe, center of the body to outwards, and that's kind of the infectiousness, you know, people are infectious from four days before the start of the rash to four days after the rash.

Rebecca Smith: So, how do people, you know – kids, unvaccinated kids, adults – catch measles? Like what are those risk factors?

Dr. Amruta Padhye: Yeah, so how do we get the infection? The infection, you can get that from respiratory droplets – from coughing, sneezing, and also, the virus kind of spreads airborne meaning it can linger around in the air and go longer distances.

But most of the time, we're thinking about close contacts, of persons who are around people with measles.

Rebecca Smith: Missouri does have a low rate, compared to a lot of other places, of MMR [measles-mumps-rubella] vaccination for kindergarteners, and so, what would be your recommendation to parents, to folks who maybe have been putting off that vaccination? Or have questions about it?

Dr. Amruta Padhye: I would recommend to parents who have not vaccinated their kids for MMR to kind of think it through again, kind of look at the data.

We know that, at least, you need a herd immunity of at least 95% people vaccinated to prevent ongoing transmission, and as you mentioned that numbers have come down in the recent years – making more people susceptible to the infection.

Nine in 10 people can get the infection if they're susceptible and they're exposed to somebody.

So, these are really tangible risks and one cannot rely on herd immunity when the herd immunity itself is kind of going down.