Infant Is San Diego’s First Confirmed Measles Case This Year

Speaker 1: 00:00 County health officials are not wasting any time in their response to the first reported case of measles in San Diego this year. An 11 month old child was diagnosed with a highly contagious disease. Early this week. Officials believe the child may have been infected during a family trip to the Philippines where there's been an outbreak of the disease. The county has not released information about the condition of the infant health officials are now working to track down those exposed to the sick child to avert the kind of outbreak seen in several areas of the u s this year. Joining me by Skype is Dr. Mark Sawyer and infectious disease specialist and professor of pediatrics at UC San Diego and Dr. Sorry, welcome to the program. Speaker 2: 00:41 Thanks. It's great to join you. Speaker 1: 00:43 There really have been significant measles outbreaks in the country this year. Is that largely in New York? Speaker 2: 00:50 The biggest outbreak has been in New York, but across the country we have had more than 1000 cases of measles this year, which is many more than we've seen in the last 20 years. So we're really starting to become afraid that we've got a growing problem of pockets of our population that are susceptible to measles and once it gets into a community, it really spreads quickly. Speaker 1: 01:13 Can you remind us how contagious measles is? Speaker 2: 01:17 Oh, measles is perhaps the most contagious of all infectious diseases in a household. If one child gets measles, it's almost guaranteed that every other susceptible child will also get the measles Speaker 1: 01:29 and it's an airborne illness, isn't it? Speaker 2: 01:32 Yes. It literally spread through the air. So if you, if you don't have to have direct contact with someone to become infected. In fact, if someone was in a, an exam room, for example, in a medical setting with measles and had already left the room, if you went into that room for a period of one to two hours, you could still get the measles simply by breathing the air in that room. Speaker 1: 01:56 What are the symptoms of measles? Speaker 2: 01:59 The most typical symptoms are fever and rash, and the rash is characteristic in that it starts on the face usually and moves down the body. It lasts a period of five to seven days total. Most children are pretty irritable when they get the measles because they don't feel well and have high fever. Speaker 1: 02:16 And how soon after exposured can symptoms appear? Speaker 2: 02:21 The standard incubation period is a 10 to 21 days. So if you want to keep one number in mind, it's basically two weeks after the exposure is when you would expect to see disease if it's going to happen. Speaker 1: 02:34 How dangerous is the disease? Speaker 2: 02:37 Well that's the thing people forget about. Since we haven't seen much measles, the community is sort of been lulled into complacency and thinking that it's not a serious disease. But when we had widespread measles, uh, around one or two children per thousand who got measles actually died from the measles and several more and were put in hospital with either pneumonia or a brain infection and encephalitis that measles can cause. So it's a serious infection that you really want to avoid Speaker 1: 03:08 considering how contagious this diseases, Dr Soria, the baby who was admitted to Kaiser Hospital earlier this week, what measures does a hospital have to take one of measles patient shows up? Speaker 2: 03:20 Yes. Hospitals are especially equipped with rooms that contain the airflow so that the an airborne infection like measles cannot spread inside of the hospital. The other thing that all health providers are being alerted to do by the county is to screen people to try to intercept them before they come into a waiting room or a group setting when they made have the measles. So anybody with fever and rash, particularly if they've traveled internationally and may have been an increased risk of exposure, then we need to worry that they might have the measles and, and isolate them until we figure it out. Speaker 1: 03:58 And what's the significance of this baby's age? 11 months in terms of being vaccinated? Speaker 2: 04:05 Well, yeah, that's the trouble. We don't start giving measles vaccine until 12 months of age. It's not as effective in younger children. So the standards age for getting backs in Adrian is 12 to 15 months of age. So this baby was too young to get immunized. And this is exactly the group that we worry the most about when there's an outbreak of measles, because we can't really protect infants under a year of age in any way except to keep everybody around them immunized so they don't get the measles and bring it home to the babies. Speaker 1: 04:38 And if you have been vaccinated for measles eye, which I believe most people have, does that give you complete immunity? Speaker 2: 04:46 The vaccine is very, very effective. It's one of our best vaccines, but you really need two doses, or at least children need two doses to be fully protected. So that is the recommendation. And if people are concerned about possible exposure or, or if we start to see more cases in San Diego, they should just make sure that everybody has had two doses of the measles vaccine. Speaker 1: 05:08 An older adults can check by having a, what's called a tighter, Speaker 2: 05:13 the other is a titer is a blood test that can detect prior immunity to measles. And that can be done, uh, in, I think anyone who's wondering if they're at risk, who just consult with their physician. Sometimes it's simpler just to go ahead and get another dose of the vaccine if you're unsure. But it is certainly possible to test somebody's blood to see if there are immune already. Speaker 1: 05:36 When will San Diego County know that it's out of the woods as far as an outbreak goes? Speaker 2: 05:41 Well, the maximum incubation period is three weeks after measles. So if we don't see any more cases after three weeks from now, then I think we've dodged the bullet. But it's inevitable that more cases will show up in San Diego as well as you started with, there's outbreak ongoing in New York, and there are international outbreaks in many countries, and people travel, especially in the summer. So if you come, go to a country where measles is spreading and you're not protected, you may bring it back unexpectedly and then develop it here in San Diego. I've been speaking with Dr. Mark Sawyer and infectious disease specialist and professor of pediatrics at UC San Diego. Dr. Sawyer. Thank you. Thank you. Speaker 3: 06:27 [inaudible].