The Measles Scare at O’Hare Explained by Dr. Most
The Measles might seem like an old infection, but a case was reported at O’Hare last week. Steve had a special conversation with Dr. Kevin Most about how the highly contagious infection could be considered spread if the patient is within 30 or 40 feet within other people in public…
“Many of you have heard about a possible case of Measles traveling thru O’Hare last week. Many of you may be thinking, what is the big deal, don’t we all get a Measles vaccine as a child, you may have heard of the MMR vaccine. This is a vaccination we get at age 12 -15 months and a second one sometime between ages 4-6 years old. It is even recommended for High School students to get a set of boosters, yet this is rarely done as the number of cases is so low. Adults who do not have known immunity should consider getting vaccinated, but again it is a risk reward story. For example between 2005 and 2015 there were only 3 cases in Chicago, in 2017 we had a 15 state outbreak with 120 cases. In 2014 we had close to 700 cases in the US
The great thing is that the vaccine is very effective, especially after 2 doses. This vaccination program began in 1963, before that vaccine 3-4 million children a year got Measles in the US, each year 500 died. 50,000 were placed in hospital and over 1,000 got life threatening brain infections. The problem is that there are many countries that do not vaccinate for measles and thus travelers coming into the country can bring in active cases and spread them.
This virus is highly contagious and just being in the same room with a patient with measles would be considered exposure, even 2 hours after the individual left that room. So the health department is recommending that anyone who was in the airport on January 10th between 6:30 am and 1 pm in terminals 1 and 5 consider being checked for immunity from their doctor which is a simple blood test. They are saying that they are not sure if this individual was in other terminals at this time.
The concern many of you may be thinking is what about the child under the age of 12 months, fortunately the mother shares her immunity to measles with the newborn and that is why we wait until the child is 1 to give the actual vaccine. Without the mothers immunity the child would have no immunity to a virus that could kill them or leave them deaf. The small caveat about this is the child who has to travel from age 6 months to a year. If that child was going to an area where there is no vaccinations we would vaccinate early. The other bad thing is the patient can be contagious before they had the rash. The concern for anyone at O’Hare in those areas or on the flights should be aware and know what to look for.
The common signs are high fever, cough. Runny nose red watery eyes, 3-5 days later a rash will break out that will often start in the face and spread downward all the way to the feet within a few days. Often the patient will have a high spiking fever just prior to the rash up to 104. The concern is the complications that come along with measles, this includes pneumonia, , ear infections that may lead to hearing loss and infection in the brain causing seizures and intellectual deficits. Unfortunately it can also cause death.
The other big story across the country is obviously the number of cases of influenza that are being seen. This is covering 49 of the 50 states with Hawaii not at high levels yet ( not fair ! great weather and no flu) It is also hitting all ages from pediatric patients to Seniors. The hospitals are full and we are not seeing a slowdown of new cases. Emergency rooms are full. There are a few messages here, one is the flu vaccine this year is not an ideal match, some are quoting only 10% effective, in fact the CDC is stating it is closer to 40% effective. Also this is a strain that we see early in the year and it is often followed by a totally different strain, so please get a flu shot if you have not. If you were in Vegas and you had 2 games to choose from, one had a 40% chance of you winning (getting the flu shot) the other had 0% chance of you winning ( declining the flu shot) which would you do. Many still think of influenza as just a bad cold, I can tell you every hospital in Chicago has many patients in the hospital and the intensive care because of influenza.
A couple of things in closing, try talking to your primary care doctor instead of going off to the ED, most cases can be treated as an outpatient. Take Tylenol or Advil when you have a fever, we as docs don’t want to see what you look like when you are at 102, we want to know what you like when you do not have a fever. So unless you want to hang out in ER or docs office take some Tylenol before going in.
In closing, if you are sick, do not visit any patients in the hospital. These patients are already fighting some illness and we do not want to give them influenza on top of it. It is one of the reasons, I never left my office yesterday and went home early.”