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This is serious: The results of a measles outbreak have harmful outcomes

News
Article
Contemporary PEDS JournalMarch 2024
Volume 40
Issue 02

Donna Hallas, PhD, CPNP, PPCNP-BC, PMHS, FAANP, FAAN, shares her thoughts on the latest issue of Contemporary Pediatrics.

This is Serious: The results from a Measles outbreak have harmful outcomes | Image Credit: © Prostock-studio - © Prostock-studio - stock.adobe.com.

This is Serious: The results from a Measles outbreak have harmful outcomes | Image Credit: © Prostock-studio - © Prostock-studio - stock.adobe.com.

Homer’s philosophical quote, “When it is out of sight, it is out of mind” can be applied to the current measles outbreak in the United States and worldwide. Our patients and all pediatric providers need to know and respect the history of measles and remain steadfast in strongly recommending vaccination.

In 1912, measles became a nationally notifiable disease in the United States, which revealed approximately 6,000 measles-related deaths reported each year.1 Prior to 1963, it was estimated that 3 to 4 million individuals in the United States contracted measles annually and included the majority of children under 15 years old.1 The death rate was estimated to be between 400 and 500 people with approximately 1000 individuals experiencing the adverse outcome of measles encephalitis.1

In 1963, the first measles vaccine became available which significantly reduced the incidence and prevalence of measles outbreaks in the United States and later worldwide.2 Because of this, many individuals today have vaccine induced immunity to measles, and providers rarely have patients presenting with symptoms of measles. In fact, due to the vaccination program, measles was declared eliminated from the United States in 2000.1 However, since 2020, there have been measles outbreaks in various states in the United States. The article in Contemporary Pediatrics, by senior editor Joshua Fitch, Measles cases are reported in multiple states, discusses the current spread of measles in the United States.2

Out of sight, out of mind

With the success of the MMR vaccine, most parents no longer are aware of measles as a disease nor fear that their children will contract measles. However, this lack of knowledge results in parents being unaware of the potential harmful outcomes from contracting measles, including the adverse outcomes and even the potential for death in their unvaccinated children under the age of 5 years, as well as in children and adults who are immunocompromised. In addition, pediatric nurse practitioners and all pediatric providers need to know how to diagnose measles and to be aware of the possibility of children who contract measles developing a bacterial or viral superinfection, including but not limited to obstructive laryngitis, mastoiditis, hepatitis, encephalitis, and/or pneumonia.3

The MMR Vaccine Information Statement (VIS) given to parents and any individual at the time of vaccination, provides detailed information focusing on the vaccine itself, and includes brief paragraphs about measles, mumps, and rubella (MMR) diseases at the top of the VIS.4 Perhaps the VIS and providers need to emphasize the potential for adverse outcomes from contracting the disease especially for those parents who are questioning whether to have their child vaccinated or are vaccine hesitant or vaccine refusers.

Measles disease and death rates

Prior to the availability of the measles vaccine in 1963, the World Health Organization reported that major measles epidemics occurred every 2 to 3years resulting in 2.6 million deaths in each epidemic year.2 The MMR vaccine has reduced worldwide deaths to 128,000 in 2021.2 However, in my opinion, this number of deaths related to contracting measles remains significant worldwide. As pediatric nurse practitioners, let’s make 2 statements loud and clear, “Vaccinate your babies and children against measles” and “infection deaths from measles are vaccine preventable!”

Click here for the each article from the March issue of Contemporary Pediatrics.

References:

1. Centers for Disease Control and Prevention. Measles history. November 5, 2020. Accessed March 19, 2024. Retrieved from https://www.cdc.gov/measles/about/history.html#:~:text=It%20is%20estimated%203%20to,of%20the%20brain)%20from%20measles

2. World Health Organization [WHO]. Measles. August, 9, 2023. Accessed March 20, 2024. https://www.who.int/news-room/fact-sheets/detail/measles

3. Sanderson, S., & Gaylord, N.M. Infectious Diseases. In, Maaks, D.L.G., Starr, N.B., Brady, M.A., Gaylord, N.M., Driessnack, M., & Duderstadt, KG. (2020), Burns pediatric primary care. 7th edition: Elsevier. Pages 479-481.

4. Centers for Disease Control and Prevention. Vaccine information statement, MMR vaccine (Measles, mumps, and rubella: What you need to know. 2021. Accessed March 20, 2024. https://www.cdc.gov/vaccines/hcp/vis/vis-statements/mmr.pdf

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Tina Tan, MD, FAAP, FIDSA, FPIDS, editor in chief, Contemporary Pediatrics, professor of pediatrics, Feinberg School of Medicine, Northwestern University, pediatric infectious diseases attending, Ann & Robert H. Lurie Children's Hospital of Chicago
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