Tag: measles

When is Measles Season?

For a while, especially once we eliminated the endemic spread of measles, we weren’t thinking about measles seasons anymore.

In addition to the recent rise in measles cases, this slide shows the patterns of measles seasons in different parts of the world.
In addition to the recent rise in measles cases, this slide shows the patterns of measles seasons in different parts of the world.

Unfortunately, with ongoing outbreaks and rising cases, many people are asking again – just when is measles season?

When is Measles Season?

Traditionally, the time when measles case counts are the highest occurs:

  • during the late winter and early spring (temperate climates, like the United States)
  • after the rainy season (tropical climates)
  • when kids are in school

So just like flu season, it’s always measles season somewhere…

And in areas of the world where measles is still highly endemic, you can expect cycles of larger measles epidemics every 1 to 4 years.

Can you guess why?

“As higher uniform population immunity is achieved the scale of epidemics, both their duration and absolute number of cases, progressively decreases. Epidemic frequency simultaneously decreases with increasing time intervals between epidemics. Another uniform feature as elimination is approached is the loss of epidemic seasonality.”

Durrheim et al on Measles – The epidemiology of elimination

I’ll give you a hint – there is nothing different about the measles virus during those years.

Eventually though, as the number of people susceptible to measles builds up, there is the opportunity for bigger outbreaks. Of course, that doesn’t happen if most people are vaccinated and protected.

When is Measles Season in the United States?

What about in the United States in the post-vaccine era?

Visiting a place with a lot of measles, especially if you aren't vaccinated and protected, increases the risk that you will bring measles home with you and start an outbreak.
Visiting a place with a lot of measles, especially if you aren’t vaccinated and protected, increases the risk that you will bring measles home with you and start an outbreak.

We don’t really have a measles season, as all of our cases are now imported from other parts of the world.

  1. Where and when are folks traveling?
  2. Where is measles on the rise?

That’s when we will see more measles cases here.

“Source countries included Philippines (14 cases), Ukraine (8), Israel (5), Thailand (3), Vietnam (2), Germany (2), and one importation each from Algeria, France, India, Lithuania, Russia, and the United Kingdom.”

Increase in Measles Cases — United States, January 1–April 26, 2019

In the early part of 2019, we saw a lot of cases because unvaccinated travelers were returning from Philippines, Ukraine, and Israel, countries in peak measles season.

Are Europe's measles outbreaks slowing down yet?
Are Europe’s measles outbreaks slowing down yet?

As cases in those countries hopefully slow down over the summer, unfortunately, we might see a rise in other parts of the world.

Of course, there is an easy way to end our measles seasons once and for all.

Two doses of MMR is your best protection against measles.

Get vaccinated and protected, especially before traveling out of the country.

More on Measles Season?

Is Measles Really Airborne?

As we reach record numbers of measles cases, what are anti-vaccine folks concerned about?

Anti-vaccine folks trying to do research about measles and miss dozens of articles describing how measles is indeed airborne.
Anti-vaccine folks trying to do research about measles and miss dozens of articles describing how measles is indeed airborne.

Making sure their kids get caught up on their vaccines so that they don’t catch measles, since it is so contagious? Nope. They are still trying to find reasons to justify their decision to leave their kids unvaccinated and unprotected.

Is Measles Really Airborne?

Guess what?

Measles really is airborne!

Surpised?

Are you thinking that I am relying on a single experiment from 1964 or do you think I found some more evidence when I did my research?

Is this something folks really doubt, after all, if measles isn’t airborne, how would it be so contagious? How would people get sick after simply being in the same room as someone else with measles, even if the sick person had already left?

“During the past decade, increasing attention has been giving to the theory that indoor air is a vehicle of respiratory infection and to the logical sequence of such a theory, that the transfer from person to person of such infection can be reduced by increasing ventilation.”

Wells et al on Ventilation in the flow of measles and chickenpox through a community

In fact, even before the measles virus was actually discovered in the 1950s, it was known that measles was airborne. Wells did her experiments in the 1940s.

“It is far from clear to me yet whether measles is solely an airborne infection, as I think Wells believed, or whether contact and airborne routes both play roles in different circumstances. It is clear however that airborne infection is sufficiently common and important to be a dertermining factor in the continuance of measles at the present time. It must receive due respect and weight in planning the future steps necessary for eradication.”

Langmuir on Changing concepts of airborne infection of acute contagious diseases: a reconsideration of classic epidemiologic theories.

And those experiments were revisited in the 1970s, when measles wasn’t eradicated as quickly as expected. Alex Langmuir was Chief Epidemiologist at CDC at the time.

Did you ever hear about the story of the folks who got measles International Special Olympics Games in the Minneapolis-St. Paul metropolitan area during July 1991? It’s not a story the anti-vaccine groups would tell you. It’s a published case report, An outbreak of measles at an international sporting event with airborne transmission in a domed stadium.

“…the dynamic airborne transmission of measles illustrates the potential for transmission in the absence of a recognized exposure.”

Ehresmann et al on An outbreak of measles at an international sporting event with airborne transmission in a domed stadium

Several people at the Games got measles simply because they were in the domed stadium, even though they had no direct contact with anyone who had measles.

There are also reports of kids getting measles at their pediatrician’s office, simply because another kid with measles had been seen a little earlier.

Airborne Transmission of Measles in a Physician's Office

The kids described at the Michigan pediatrician’s office didn’t have any direct contact with the child with measles. They simply showed up in the same office an hour later.

“Four children had transient contact with the source patient as he entered or exited through the waiting room; only one of the four had face-to-face contact within 1 m of the source patient. The three other children who contracted measles were never in the same room with the source patient; one of the three arrived at the office one hour after the source patient had left.”

Block et al on Measles outbreak in a pediatric practice: airborne transmission in an office setting

Researchers described a similar situation at a pediatrician’s office in DeKalb County, Georgia at around the same time.

“Airflow studies demonstrated that droplet nuclei generated in the examining room used by the source patient were dispersed throughout the entire office suite. Airborne spread of measles from a vigorously coughing child was the most likely mode of transmission.”

Block et al on Measles outbreak in a pediatric practice: airborne transmission in an office setting

And increasing, we are seeing that airborne transmission means more folks are at risk on airplanes.

There is no doubt that measles is contagious and that measles really is airborne. Just like there is no doubt that vaccines are safe, with few risks.

More on Is Measles Really Airborne?

Is Measles Dangerous If You Are Pregnant?

While folks often try and make it seem like measles is a common childhood illness, we know that it can be dangerous.

“One of the patients was a 20-year-old pregnant woman who had rash onset on January 5 following exposure to her 12-year-old brother. After delivering a healthy baby on January 6, the mother developed severe pneumonia that was followed by respiratory arrest. She was resuscitated and transferred to an intensive care unit in a larger hospital nearby in Tennessee.”

Epidemiologic Notes and Reports Transmission of Measles Across State Lines — Kentucky, New Hampshire, Tennessee, Virginia

Rarely do people who have really had measles describe it as just a fever and a rash. They remember that it was called a harmless killer for a reason.

Is Measles Dangerous If You Are Pregnant?

And there are some situations in which measles can be especially dangerous, including if you get sick when you are very young, very old, or have immune system problems.

Pregnant women should be screened for measles immunity.
Pregnant women should be screened for measles immunity.

And what if you are pregnant when you get measles?

“The Health Department announced today that the number of measles cases has grown to 390, including two pregnant women diagnosed with the infection, one diagnosed in mid-April.”

The Number of Measles Cases Grows to 390

If you are pregnant and you are exposed to someone with measles, you can get IVIG post-exposure prophylaxis to prevent you from actually getting measles, but this typically only works if given within six days of the exposure.

“To date, studies have not identified an increased risk for birth defects when pregnant women get the measles during pregnancy. However, studies suggest that measles infection is associated with an increased risk for miscarriage, stillbirth, prematurity and the baby being born with a measles infection.”

When Measles Strike, It’s Not The Happiest Place On Earth For Pregnant Women

Unlike a rubella infection during pregnancy, a measles infection is not thought to cause birth defects. Tragically, it can, like rubella, lead to an increased risk for having a miscarriage.

“Infants who develop congenital measles are at increased risk for mortality and for subacute sclerosing panencephalitis, which is more common when measles is diagnosed in infancy. In addition, subacute sclerosing panencephalitis in newborns infected with measles either congenitally or shortly after birth appears to be more severe, with a shorter latency and rapidly progressive course.”

What Obstetric Health Care Providers Need to Know About Measles and Pregnancy

And if the mother gets measles very late in her pregnancy, it can also lead to a case of congenital measles, or a baby being born with an active measles infection.

“In 52% of cases, measles was likely acquired from a relative. Complications included pneumonia in one child; two pregnant women required hospitalization, including one who miscarried.”

Notes from the Field: Measles Outbreak Among Members of a Religious Community — Brooklyn, New York, March–June 2013

Don’t take the risk that you might get measles while you are pregnant.

Make sure you are vaccinated and protected before you ever start thinking about getting pregnant, as pregnancy is a contraindication to getting the MMR vaccine. And you should wait at least 4 weeks after getting vaccinated before getting pregnant.

More on Measles in Pregnancy

Did CBS and Hulu Remove the Brady Bunch Measles Episode?

Have you heard the latest anti-vaccine conspiracy theory?

Measles is highly contagious, which is likely why all of the Brady kids got sick.
Measles is highly contagious, which is likely why all of the Brady kids got sick.

Remember the Brady Bunch measles episode?

The one where all the kids got sick and two different pediatricians had to visit the house to check on the kids?

Did CBS and Hulu Remove the Brady Bunch Measles Episode?

While anti-vaccine folks apparently use the fact that the Brady Bunch did a measles episode as a reason to skip or delay their own child’s vaccines, they have gone a little further now, coming up with a conspiracy theory about efforts to keep people from watching the episode.

Are CBS and Hulu part of a conspiracy to silence anti-vaccine folks?
Are CBS and Hulu part of a conspiracy to silence anti-vaccine folks?

The episode, Is There a Doctor in the House?, aired during season 1 on December 26, 1969.

For reference, this was just after the updated measles vaccine was approved in 1967, and when there were at least 25,826 measles cases in the United States and 41 deaths.

Why didn’t they talk about any of that during the episode?

Although some folks read a lot into the episode, it was basically about how Carol and Mike each called separate pediatricians to the house for the kids, one for the boys and one for the girls, instead of just calling one for the newly formed Brady bunch.

But think about it… If measles is so mild, why did they have to call their pediatricians?

And if nothing else, remember that it shows how contagious measles really is. All of the kids got sick!

But was the episode removed so that you can’t watch it anymore?

Where's Episode 13?!? Where are episodes 5, 6, 9, 10, 15, 17, and 18? Were they all about measles too?
Where’s Episode 13?!? Where are episodes 5, 6, 9, 10, 15, 17, and 18? Were they all about measles too?

Since a lot of other episodes are missing, and not just from season 1, it doesn’t seem very likely.

Why did they pull Season 6, Episode 4 Little Ricky Gets Stage Fright of I Love Lucy? Was that the one where he was got a smallpox vaccine?
Why did they pull Season 6, Episode 4 Little Ricky Gets Stage Fright of I Love Lucy? Was that the one where he was got a smallpox vaccine?

And keep in mind that it’s not uncommon for there to be missing episodes when you try to stream these older shows online.

Mostly remember that when you think that everything is a conspiracy, everything looks like a conspiracy, even when it is easy to find a more reasonable explanation.

More on the Brady Bunch Measles Episode Conspiracy