An uptick in measles cases in California and other parts of the country, coupled with resistance to vaccines, has physicians and public health officials concerned that a potentially fatal disease, which was declared eradicated in the United States nearly two decades ago, might create a public health crisis.
As of Wednesday, April 10, 21 measles cases have been reported in California including one in Los Angeles County. On Wednesday, Long Beach health officials announced that a person recently traveled through Long Beach Airport while having measles, putting others at risk of contracting the highly contagious disease.
Measles typically begins with mild to moderate fever accompanied by coughing, a sore throat and red eyes. The fever might climb two to three days later, which is when patients begin to develop the red, blotchy rash, which almost always begins at the top of the head and then marches down the body.
Measles can be contagious even before symptoms start to show.
Potential for lethal complications
According to the Centers for Disease Control and Prevention, from Jan. 1 to April 4, 465 individual cases of measles had been confirmed in 19 states. This is the second-highest number of cases reported in the U.S. over the first four months of a year since measles was deemed eradicated in 2000.
Measles is a disease without treatment and there is the potential for serious complications, said Dr. Margaret Khoury, pediatric infectious diseases specialist with Kaiser Permanente Baldwin Park Medical Center.
“If you get sick with measles, you are relying on your own immune system,” she said. “In younger kids or in children whose immune system doesn’t function well, their bodies may not be able to fight it off, and could open the door for other complications.”
Those complications could range from ear infection and pneumonia to sepsis and brain infection that could prove fatal, Khoury said.
“To see children suffer or die from measles is a heartbreaking experience,” she said. “This is not like any other illness. Children really suffer and get sick for several days and often require hospitalization.”
Getting vaccinated is the best and most effective solution to prevent the disease, Khoury said, adding that parents are succumbing to misinformation about vaccines, which is plentiful online.
She criticized the practice of parents hosting “measles parties,” where children are deliberately exposed to the disease with the hope they will build immunity by contracting measles.
“It’s an extremely unsafe approach,” she said. “It’s like driving without seatbelts. It’s unreasonable to approach a potentially life-threatening disease in this manner.”
Khoury said people should get vaccinated before they get ready for summer travel, especially to other countries, such as the Phillipines, that are experiencing measles outbreaks.
Orthodox Jewish community scrutinized
New York City, particularly the Orthodox Jewish enclave in Brooklyn, has been one of the hardest hit by the measles outbreak. The Orthodox community has come under scrutiny and criticism by people who have implied that religious beliefs have prevented a number of its members from getting vaccinated.
New York Mayor Bill de Blasio issued an emergency order covering four Brooklyn ZIP codes including most of Williamsburg and Borough Park, which have seen more than 285 measles cases since October.
De Blasio referred to Borough Park as the epicenter of the measles outbreak in New York. City health officials also issued an order that anyone in Williamsburg who defies the mandatory exclusion from school for all unvaccinated children will be slapped with fines.
But Jewish community leaders say there has been a breakdown in communication between the city and the community.
“We’ve never received a single phone call from the city to ask us to organize a meeting or bring doctors, health experts, rabbis, parents and community leaders,” said Avi Greenstein, CEO of the Boro Park Jewish Community Council.
Borough Park is home to about 30,000 Jewish families, the largest concentration of Jews outside of Israel. He said the city health department’s efforts to translate health fliers into Yiddish straight off Google Translate “has been laughable.”
The measles outbreak in the Orthodox Jewish community is not because of lack of vaccinations, Greenstein said. The organization Agudath Israel of America puts the vaccination rate at 96 percent for Jewish communities across New York State, saying “vaccination is the clear societal norm in Orthodox Jewish communities.”
Greenstein said the vaccination rates among Orthodox Jews in Borough Park is comparable to that of other communities around the country and that the recent outbreak may be due to “lifestyle factors,” such as the frequency of family and community gatherings.
“We have a lot of people in a small amount of space,” he said.
A New York City Health Department spokesman said health officials “have worked closely with health care providers, religious leaders and community organizations in the affected neighborhoods since October to increase vaccination rates and prevent exposures.” He said the department has taken a number of actions — from robocalls to 30,000 households and informational letters to schools and parents, to placing ads in local papers and distributing informational booklets.
He said all measles cases have been linked to the Orthodox Jewish community.
“We’re not targeting them, but rather the anti-vax movement that is spreading misinformation and encouraging some parents to delay or avoid vaccinations for their children,” he said.
Most religions, including Judaism, approve of vaccinations, said Dr. Ilan Shapiro, director of medical education and wellness at Altamed Health Services.
“As a physician, I trained in Mexico and I saw kids dying from whooping cough and bacterial meningitis, which are preventable with vaccines,” he said. “In other countries, vaccines are a luxury. But, here in the United States, they are easily accessible.”
Vaccines help eradicate diseases, and failing to vaccinate children can have disastrous consequences, Shapiro said.
“If we continue the way we’re going,” he said, “it’s going to end in a public health crisis.”
