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measles

Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children's Hospital. File photo from Stony Brook Medicine

With COVID-19 pandemic restrictions in the rearview mirror, residents have been returning to the open road and the open skies, visiting places and people.

In addition to packing sunscreen, bathing suits and cameras, local doctors urge people to check the vaccination status for themselves and their children, which may have lapsed.

“During COVID, many people did not keep up with their vaccines,” said Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. “That has led to a decrease in the amount of children who are vaccinated.”

Last week, the Centers for Disease Control and Prevention issued a health advisory to remind doctors and public health officials for international travelers to be on the lookout for cases of measles, with cases rising in the country and world.

As of June 8, the CDC has learned of 16 confirmed cases of measles across 11 jurisdictions, with 14 cases arising from international travel.

Measles, which is highly contagious and can range from relatively mild symptoms to deadly infections, can arise in developed and developing nations.

Measles can be aerosolized about 60 feet away, which means that “you could be at a train station and someone two tracks over who is coughing and sneezing” can infect people if they are not protected.

The combination of increasing travel, decreasing vaccinations and climbing levels of measles in the background creates the “perfect mixture” for a potential spread of the disease, Nachman said.

Typical first symptoms include cough, runny nose and conjunctivitis.

Conjunctivitis, which includes red, watery eyes, can be a symptom of numerous other infections.

“Many other illnesses give you red eyes,” Nachman said, adding, “Only when you start seeing a rash” do doctors typically confirm that it’s measles.

People are contagious for measles when they start to show these symptoms. Doctors, meanwhile, typically treat measles with Vitamin A, which can help ease the symptoms but is not an effective antiviral treatment.

As with illnesses like COVID, people with underlying medical conditions are at higher risk of developing more severe symptoms. Those with diabetes, hypertension, have organ transplants or have received anticancer drugs or therapies can have more problematic symptoms from measles.

In about one in 1,000 cases, measles can cause subacute sclerosing panencephalitis, or SSPE. About six to 10 years after contracting the virus, people can develop SSPE, which can lead to coma and death. 

In addition to children who need two doses of the measles vaccine, which typically is part of the measles, mumps and rubella vaccine, or MMR, doctors urge people born between 1957 and 1985 to check on their vaccination status. People born during those years typically received one dose of the vaccine. Two doses provide greater protection.

Two doses of the MMR vaccine provide 97% protection from measles. One dose offers 93% immunity, explained Dr. David Galinkin, infectious disease specialist at Port Jefferson-based St. Charles Hospital.

People born before 1957 likely had some exposure to measles, which can provide lifelong immunological protection.

Nachman also urged people to speak with their doctor about their vaccination status for measles and other potential illnesses before traveling. People are protected against measles about two weeks after they receive their vaccine.

Doctors suggested that the MMR vaccine typically causes only mild reactions, if any.

Tetanus, Lyme

In addition to MMR vaccines, doctors urged residents to check on their tetanus vaccination, which protects for 10 years.

“The last thing you want to do is look for a tetanus vaccination in an international emergency room,” Nachman added.

During the summer months, doctors also urged people to check themselves and their children, especially if they are playing outside in the grass or near bushes, for ticks.

Intermediate hosts for Lyme disease, a tick typically takes between 36 to 48 hours from the time it attaches to a human host to transmit Lyme disease.

Nachman suggested parents use a phone flashlight to search for these unwelcome parasites.



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After Rockland County declared a countywide state of emergency last week banning any person under 18 who is unvaccinated for measles from public spaces, Suffolk County issued a recommendation.

In a press release, Suffolk County Executive Steve Bellone (D) and Suffolk County Health Commissioner Dr. James Tomarken urged county residents to make sure they are immunized against measles. Despite the recent ban in Rockland County due to a reported 157 cases of measles since October 2018, there is no immediate public concern in Suffolk.

“In light of recent reports, residents should make sure to receive their measles shots to protect themselves,” Bellone said in the press release. “While there is no immediate public health concern in Suffolk County, this should serve as a reminder to do what is necessary out of an abundance of caution.”

Stony Brook Children’s Hospital’s Dr. Sharon Nachman, division chief of Pediatric Infectious Diseases and professor of pediatrics, said early symptoms of measles, which is a virus, can be mistaken for the common cold with a patient suffering from a runny nose, fever and red, watery eyes. She said even doctors can miss the signs of measles, that is until the typical rash of flat red spots appears.

The best protection against measles is the measles, mumps, rubella vaccine, the doctor said, and two doses of the MMR vaccine is needed. Measles is highly contagious, and a person could infect others even 60 feet away. She said an unvaccinated person can potentially catch the measles even if they were in the same supermarket or airport as an infected person.

“The reason for the isolation is to keep the kids who are at risk from the kids who are incubating the illness, or they don’t know they have measles,” she said, adding there are those who are unable to be vaccinated due to medical reasons.

The doctor said anyone born before 1957 more than likely had measles. After 1957, three different vaccines for measles, mumps and rubella were given, and now all are combined into one immunization called MMR. She said one should find their immunization records to see if they received two rounds of each when it was split, or two doses of the MMR vaccine. Once a person gets the measles or the proper doses of the MMR vaccine, they are immune to measles.

Nachman said it’s important to get the full doses, and if a person isn’t sure if they got two rounds of MMR, an extra dose will not hurt them.

When she talks with parents who are hesitant about the immunizations, Nachman said she tells them not to be fooled by what’s written on the internet, and to make sure any website they visit has a review process by professionals as anyone can write anything on a blog without checking facts.

The doctor also said it’s important to remember diseases such as measles are still in the environment, and just because we don’t have an outbreak right now, it doesn’t mean it’s not possible. She calls immunization “community protection” instead of using the common term “herd immunity,” which describes when the majority of the population is vaccinated, there is less likelihood of an unvaccinated person being infected.

“You have to do the same thing for your entire community that you expect your community to do for you,” she said. “That’s what community protection is all about. You don’t want your kid getting into a car unless the driver is wearing a seatbelt and your kid is wearing a seatbelt. That’s what a community does. It protects everyone in the community.”

According to the Centers for Disease Control and Prevention website, cases of measles have been confirmed in 15 states and is still common in many parts of the world. Measles has been brought into the United States by unvaccinated American travelers and foreign visitors, according to the website. Worldwide, an estimated 20 million people get measles. Out of those infected, 146,000, mostly children, die from the illness each year.