By Mr. Douglas Demaio (Army Medicine)May 14, 2012
Medical professionals here want to raise awareness about measles outbreaks in Europe and the U.S.
Health officials observed a spike in measles cases in the U.S. and Europe in 2011 and are concerned about similar outbreaks in 2012.
"The only way to ensure the disease remains low is by ensuring that people get immunized," said Victorio Vaz, an epidemiologist for Bavaria Medical Department Activity.
Europe had more than 30,000 cases, according to cdc.gov. In 2011, the U.S. had the highest number of measles cases in 15 years with 222 cases. Many of the cases were linked to foreign travel in Europe.
Sporadic importations of measles have occurred in the U.S. since the Center for Disease Control and Prevention declared it eliminated from the U.S. in 2000.
"The CDC declared the disease eliminated, not eradicated," Vaz said. "Eradication is when there is no transmission occurring anymore; elimination means when it gets to a certain level and there is no endemic transmission, but it can occur.
Measles is a serious disease, Vaz said. Nine out of 10 people who come in to contact with the virus and are not immune from it will get the disease.
According to the World Health Organization, in 2010, there were 139,300 measles deaths worldwide, which equated to about 15 deaths every hour due to measles.
"In 2011, the CDC became very concerned over the fact that there were 222 cases in the U.S.," Vaz said, who was previously in charge of the Office of Infectious Diseases Services in Arizona before moving to Bavaria. "Ninety percent of those were associated with international travel. A majority of those were not immunized or they did not know their status."
Of those 222 who were infected, 50 people ages 16 months through 19 years did not to get the vaccine because of religious, philosophical or personal objections, Vaz said.
Measles is spread by contact with an infected person or through coughing and sneezing, he said. The virus can remain active and contagious for up to two hours in the air and on surfaces.
Persons who have the virus can be infectious and transmit the disease four days before showing any symptoms. Vaz said. People with measles usually have a rash, high fever, cough, and runny nose, or red, watery eyes.
"Very few parents have observed or seen… measles," Vaz said. "Therefore, they are less concerned about the need to vaccinate. It is only natural that people become complacent about the disease."
The concern about the disease is more focused on the complications that can develop from the disease, Vaz said. People can get an ear infections, encephalitis, diarrhea, or pneumonia... Measles can be severe in infants, young children less than 5 years old and even persons older than 20 years due to malnutrition.
A European monthly measles report from the European Centre for Disease Prevention and Control stated that between Jan. 1 and Feb. 28 there were 1,447 cases reported throughout Europe. Germany had 20 reported cases and Romania had the most reported cases through February with 816. France had 227 reported cases.
There is no need for alarm, Vaz said, but people should be aware that there is a risk that persons who travel in Europe may be exposed to the virus.
"Anytime you are going into a large group of people, whether it is a sports event or a show, there is obviously a possibility that you may come into contact… with the virus," he said.
The U.S. has done a good job at lowering the endemicity of measles through vaccinations, but that is because most of the people in the U.S. have been vaccinated against the virus, Vaz said. Children receive two vaccines; between 12 and 15 months of age, infants will receive the Measles, Mumps, Rubella vaccine and receive a second dose between 4 to 6 year olds.
"When it comes to international travel, then the recommendations change," Vaz said. "It is not just a childhood disease like many people think."
People should talk with their doctor about being up-to-date with their vaccines or getting the vaccine and should consider having children between the ages of 6 and 12 months get their first vaccine when considering travel overseas, he said. While the dose may not count toward two-dose requirements for school entry, it is recommended to protect the most susceptible segment of the population.