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The Measles

Posted on May 11, 2016

 

By: Carla Blieden, Pharmacist
Expert Compounding Pharmacy 800-247-9767

What it is, how you get it and what to do about it

Hello. I am Carla Blieden and I am the vaccination specialist at Travelwise Vaccination Services, in partnership with Expert Compounding Pharmacy. I essentially grew up in the pharmacy. If you’ve been a valued patient of the pharmacy, you won’t recognize me, but you will recognize my mom, Elaine who has been with the pharmacy for over 31 years. It is such a pleasure to work alongside her and pharmacist Dana Madievsky. Since I graduated from the University of Southern California’s School of Pharmacy in 2009, I have been working as a public health pharmacist – I am a travel vaccination specialist as well as a clinical pharmacist in HIV/AIDS and diabetes clinics in downtown Los Angeles.

With vaccinations being such a buzz topic right now, I thought it would be appropriate for me to finally introduce myself on the Expert Compounding Pharmacy blog. I’d also like to address some important information about the measles vaccination.

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Carla Blieden, Pharmacist

As of January 20, 2015, there have been a reported 102 cases of measles in the United States. More than 90% of these cases have been linked to a single outbreak, originating from the Disneyland theme park in Southern California. 14 states have reported cases of the measles this year alone. You might be asking yourself, why is it such a big deal if only 100 people have the measles? It might help to know that in 2000, measles was declared eliminated from the US, due solely to the development and widespread use of effective vaccination. However, in 2008, 2011, 2013, 2014 and now, measles outbreaks are occurring in the US. This is because while it was eliminated in the US, it still exists in many countries around the world. Additionally, many people stopped vaccinating their children. Since many people travel, it’s not surprising that at some point, someone who was not vaccinated would contract measles while traveling or a foreign traveler, would bring the disease into the US. If this person then came into contact with a group of people who were not vaccinated, a small outbreak would occur – which happened last year in a community in Ohio.

Measles Facts:

  • The majority of cases are people who were not previously vaccinated against measles

  • Measles is highly contagious – actually, one of the most contagious viruses. 9/10 susceptible people who come into contact with measles will contract the virus

  • 1/1,000 measles cases can result in permanent brain damage from acute encephalitis

  • 1 to 2/1,000 children who are infected with measles will die from breathing or brain complications

How does someone get sick from measles?
When someone has measles, it lives in their throat and nose. So, it makes sense that measles is spread through respiratory droplets (ie. it is airborne). If someone who has measles coughs or sneezes, the measles virus can be passed on. The virus can survive on a surface and in the air for up to 2 hours – this means that you might not even come into close contact with the person who is sick and you can still get measles.

What are the symptoms of measles?
First symptoms: Fever, cough, runny nose, red eyes.
After a few days, a rash appears, usually on the face and then spreads to the rest of the body.
It is important to know that someone can be infectious before they develop signs and symptoms!


What do I do if I have come into contact with someone who has measles?

Watch for signs and symptoms, avoid contact with others and contact your primary care physician.

How can I prevent measles?
Get vaccinated!
If you can’t get vaccinated, please make sure that you practice good hygiene (wash your hands often, don’t touch your eyes, nose or mouth), don’t spend time with anyone who is sick, and definitely don’t share utensils or cups with anyone who is sick!

What does the vaccine entail?
Measles vaccination is only available as a combination vaccination with mumps and rubella (MMR), or with mumps, rubella and varicella (chicken pox) (MMRV). Two doses of MMR vaccine will protect more than 99% of those vaccinated from being able to contract the virus. Two doses have been recommended since 1989.

What if I can’t remember if I was vaccinated?
Your doctor can order a special lab that will test for immunity to measles, or, you can discuss with a healthcare professional if you should get the vaccination without this lab test.

Who should not get the measles vaccine?
You should not get the vaccine if:

  • You have had a life-threatening allergic reaction to the antibiotic neomycin or any component of the MMR vaccine

  • You are pregnant (and women who plan on getting pregnant should wait until 4 weeks after vaccination)

  • If you have certain conditions or are taking medications that affect the immune system – please discuss getting the vaccination with your doctor or pharmacist. (Some examples: HIV, certain cancers, taking steroids)

  • Also, discuss with your doctor or pharmacist if you have received other vaccinations in the last 4 weeks, or had a recent blood transfusion.

Who should be vaccinated against measles?
In my professional opinion, anyone who does not have proof of immunity (see below) and has no contraindications to the vaccine should be vaccinated against measles.

What is considered evidence of immunity?
Per the CDC, at least one of the following:

  • Written documentation of adequate vaccination:

    • One or more doses of a measles-containing vaccine administered on or after the first birthday for preschool-age children and adults not at high risk

    • Two doses of measles-containing vaccine for school-age children and adults at high risk, including college students, healthcare personnel, and international travelers

  • Laboratory evidence of immunity

  • Laboratory confirmation of measles

  • Birth in the United States before 1957

If I am traveling, what advice do you have?
Before international travel, it is always a good idea to speak with a travel specialist who will know where current outbreaks are occurring, and will be able to recommend the appropriate course of action. Large measles outbreaks have occurred in other countries and travelers have brought measles back into the US, so the importance of a visit with a travel pharmacist or doctor cannot be overemphasized.

References:
http://www.cdc.gov/measles/index.html
http://www.immunize.org/askexperts/experts_mmr.asp
http://www.immunize.org/vis/mmr.pdf

Please feel free to contact us for additional information, referrals or if you have any questions.
tel.: 818 988-7979, email: info@expertpharmacy.org

Tags: compounds, measles, Pharmacy, vacca