Bali Measles Update — The New South Wales Health department has recently advised travellers to be alert for signs and symptoms of measles infection after the fifth diagnosis of measles in NSW since the beginning of March 2018.
Cases include an adult and three infants who acquired their infection while travelling in Asia including Bali. NSW Health encourages all travellers, planning travel to Asia, to discuss travel plans with their GP.
Parents of children under the age of 12 months, planning travel to Asia and Bali, should discuss travel plans with their GP, as the first dose of measles vaccine can be given earlier than the first birthday under certain circumstances.
Facts About Measles
- Measles is highly contagious. The measles virus lives in the nose and throat mucus of an infected person, and can be spread through sneezing and coughing. The virus can remain active and contagious on a surface where the infected person sneezed or coughed for up to two hours. Transmission can begin four days before symptoms appear, and measles is so contagious that 90 percent of exposed people who are not immune will become infected, according to the CDC.
- Early measles symptoms look like flu symptoms. Seven to 14 days after the person is infected, her symptoms will begin to develop: high fever, cough, runny nose, and red, watery eyes. Two to three days after these symptoms appear, tiny white spots called Koplik might appear inside the mouth, according to the CDC. Three to five days after the initial symptoms, the red-spotted rash characteristic of measles breaks out, and the fever spikes. The rash and fever usually subside within a few days.
- Measles can lead to severe complications. For every 1,000 people with measles, 1 to 3 will suffer from severe complications, some of which include pneumonia and swelling of the brain (encephalitis). These complications can lead to death.
- There is no treatment for measles. Because measles is caused by a virus, there is no specific treatment. However, taking Vitamin A might make the illness milder, says Stephen Pelton, MD, chief of Pediatric Infectious Diseases at Boston Medical Center.
- The measles vaccine is highly effective. The current measles vaccine has led to a 99 percent reduction in measles cases compared to the pre-vaccine era. Before the vaccine was licensed in 1963, the CDC estimated 3 to 4 million measles cases occurred each year in the United States, with 500 deaths. By the 21st century, the number shrunk to 86 cases with no deaths. The measles vaccine is included in MMR, a combination vaccine that protects against measles, mumps, and rubella (German measles).
- You probably won’t get infected if you’ve been vaccinated, and the risk is even lower if you’ve received both recommended doses. The first dose of the measles vaccine is usually given to infants aged 12 to 15 months, but it’s never too late to get vaccinated, even as an adult.
The second dose can be given four weeks after the first, but is usually administered between the ages of 4 and 6 years, which is before a child typically starts kindergarten. The vaccine is considered to be 99 percent effective for people who have received both doses, compared to 95 percent for one dose.
- Because of a thoroughly discredited report, many parents are wary of vaccinating their children. In 1998, British medical researcher Andrew Wakefield published a study in The Lancet claiming that the MMR vaccination caused children to show signs of “regressive autism.” The Lancet retracted the study in 2010, but the stigma against the MMR shot remains. Only about half of Americans feel childhood vaccines are safe and effective, according to a poll by the Associated Press and GfK Public Affairs.
“For the children who can’t get this vaccine to be protected, everyone else has to get vaccinated,” Dr. Goldfarb says. “It’s selfish of parents not to vaccinate their children based on bogus information.”
- The Disneyland measles outbreak in December 2014 that lasted for several months was related to the “anti-vaccination” movement. Individual cases are not a result of the anti-vaccine movement. However, large outbreaks are always due to having a population of under-vaccinated children who are then exposed. Of the 110 measles patients in California after the Disney theme park outbreak, 45 percent were unvaccinated, the CDC reported.
Children, many of whom are unvaccinated immigrants, as well as people who travel to infected areas and become exposed, often bring the disease back to their country such as the recent cases in NSW. Secondary cases occur in people who have not been vaccinated or are among the estimated five percent of people who don’t respond to a single dose of MMR.
- Measles isn’t the only disease that’s spreading due to decreased vaccination rates. The vaccine for mumps is less effective than for measles and rubella.
- Measles could be eliminated completely. Health officials worldwide believe measles can be completely eradicated. All six-member states of the World Health Organization (WHO) are committed to eliminating measles worldwide by the year 2020.
