The Occurrence of Measles

by Michael_Koger

Despite remarkable advances in measles control, this condition continues to be a global public health problem.

Measles (rubeola) is an ancient infirmity which has taken the lives of millions worldwide. It is highly contagious. Around the year 2000, however, the United States attained elimination of it through vaccination and other preventive measures [1, 2, 3].

The use of measles, mumps, and rubella vaccine (MMR) has been in progress for more than 60 years [1, 2, 3].

Elimination has to do with certain geographic areas which no longer has a specific illness. It is not synonymous with eradication in which the condition is not present anywhere on the globe. In other words, eradication alludes to a worldwide prevalence of zero for that infection [1, 2, 3].

Measles Protection

     Most people in the United States have protection against this infirmity because vaccination is available.  This generates herd immunity and protects others in the community.  However, there have been resurgences of the infection in the United States because many parents and others do not want children to take it [1, 2, 3]. 

     The live-attenuated MMR is safe and effective for most individuals.  In some other regions of the world, vaccination may be inadequate or not in use at all because of social and political unrest.  In the United States, vaccine hesitancy leads to the same problem [1, 2, 3].

     In fact, the World Health Organization believes that vaccine hesitancy is “..one of the top 10 threats to global health” (Paules, Marston, and Fauci, p 2186;  2019).  Those who take the live-attenuated MMR have 97 percent protection against those illnesses.  Moreover, since 2000, vaccination against this virus has prevented approximately 21 million deaths worldwide.  One must remember that prior to aggressive use of this vaccination, there were 2 to 3 million deaths annually across the globe [2].

     Since there are many countries which do not administer MMR adequately, there is a problem with residents of those geographic areas who come to the United States or other parts of the world. They infect people because there are many who do not have protection [1, 2, 3].

Immunosuppression and Measles

     The presence of immune system disease poses a serious matter for patients and clinicians.  For example, these clients may have unusual clinical presentations which are a challenge to diagnose and treat.  The same is true for those who have human immunodeficiency virus (HIV) infection as they may encounter an exposure to measles.  Death can be the outcome for some of them due to medical complications.  However, children who have HIV infection require routine measles vaccination [1, 2, 3].

     Another serious matter with immunosuppression has to do with cancer, solid organ transplant, high-dose glucocorticoid therapy, and immunomodulatory therapy for rheumatologic disease.  Specifically, many of these scenarios pose a contraindication for the use of live-attenuated measles vaccine.  In fact, an inactivated measles vaccine became available in the United States from 1963 to 1967 [3].   

Conclusion

     The dilemma of measles control continues to be a public health matter.  Vaccination and other measures are highly effective in resolving it, but there must be cooperation between the public and the medical system.

 

References

  1. Centers for Disease Control.  (2019).  Measles.  Retrieved June 22, 2019.
  2. Paules, C., Marston, H., and Fauci, A.  (2019).  Measles in 2019—Going Backward.  The New England Journal of Medicine, 380, 2185-2187.
  3. Porter, A. and Goldfarb, J.  (2019).  Measles: A dangerous vaccine-preventable disease returns.  Cleveland Clinic Journal of Medicine, 86, 393-398.
  4. The photo shows a stethoscope and is reprinted with permission of the Centers for Disease Control.
  5. Copyright 2019 Michael Koger, Sr., M.D.  All rights reserved.

Disclaimer

     The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact their physician for advice.

Updated: 06/26/2019, Michael_Koger
 
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