Officials: New California Measles Cases Involve Travelers

Speaker 1: 00:00 Nearly 20 years ago. Measles was declared eliminated in the United States. Now the highly infectious disease which once affected millions each year is back. More than 700 cases have been reported nationwide. The highest number since 1,994 so far about 40 cases have been reported in California though not in San Diego County. Joining me via Skype is Dr. Mark Sawyer and infectious disease specialist with Rady Children's hospital and UC San Diego. Doctor. Sorry. Welcome. Good to join you. So far there haven't been any reported measles cases in San Diego county, but health officials here still are on alert. Do you think it's just a matter of time before a measles case turns up here? Speaker 2: 00:40 Yes, it is. Just a matter of time. We've been lucky so far, but we have our fair share of unimmunized populations and all it takes is one person traveling from one of the many, many states in the United States that are having outbreaks or from other countries. If they get off their airplane here in San Diego, we're going to start to see cases here Speaker 1: 01:00 and remind us how this disease typically presents itself. Speaker 2: 01:04 So measles is a very typical viral infection of young children and pri primarily of young children. And it presents at first with a runny nose and a cough, but soon after that they'll fever develops and then the characteristic rash, which people have come to recognize as measles starts on the face and then moves down the body over three to five days. Speaker 1: 01:28 Well, officials declared an outbreak last week. Uh, some people may have been exposed, they were told to stay home, others were quarantined and most have been released. Now how would health officials here work with the county to set up a quarantine should one be needed here in San Diego? Speaker 2: 01:43 Well, we have experience with that. We had an a small outbreak in 2008 in which we exercised a lots of of the things that can be done. So the key in containing an outbreak is to identify susceptible people who've been exposed and then prevent them from subsequently exposing somebody else. So that involves checking immune status. If somebody is not immune, then they're isolated at, usually at home until they have finished the incubation period so that they will then turn around and give it to somebody else. Speaker 1: 02:14 How long they have to stay at home. Speaker 2: 02:15 Well, it can be up to 21 days after exposure. So it's a long time. And, uh, that's one of the reasons measles is so challenging is people can be infectious or contagious for many, many days. And, uh, we, uh, and if they're out in the community during that time, then they're going to spread the infection. Speaker 1: 02:35 Now, most of the cases in California been linked to travel. But how much of this latest outbreak can be blamed on parents who delay or do not vaccinate their kids, do to misconceptions about vaccines? Speaker 2: 02:45 Well, the majority of the cases of measles that we've seen in the u s this year, those 700 cases, you referred to our unimmunized individuals. Some are children's summer adults, but, uh, the children in that group are generally in category of children whose parents have decided intentionally not to immunize them. It's not an issue of people not having access to vaccine or not having had the opportunity to get vaccinated. Speaker 1: 03:10 As this has been in the news, the uh, idea of this Wakefield generation has come up and there's a big focus now on what's taking place on college campuses. Explain that to us. Uh, this generation in this particular group of individuals, Speaker 2: 03:24 well, the origin of the general concern or hesitancy about vaccine is attributed to a British researcher named Wakefield who published a paper back in 1998 I believe, linking measles, mumps, rubella vaccine to autism. Now that study has been refuted completely and many, many, many other studies have been done since then that show there is no link. But those people who you know, grew up in that era, their parents may have been exposed to this incorrect information and deciding not to immunize them. And since that was in the late nineties, early two thousands, those kids are now in college and college is a great place to transmit infection just because people are generally living in close quarters, interacting with lots of people all day long. So I'm not surprised. We've seen mumps outbreaks in college campuses as well for the exactly same reason. Speaker 1: 04:19 And there may be older adults who may be under immunized against the measles, right? Speaker 2: 04:24 Yeah. Most adults who have been immunized probably only got one dose of vaccine, and although one dose is very effective, close to 94 or 5%, it's not as effective as two doses, which gets us up to 98% of protection. So certainly adults who are traveling to places where we know measles is circulating the advices, they should get a second dose, and if they're not sure when in doubt you should get another dose of vaccine. Speaker 1: 04:51 Okay. And there is a test for that fee to find out that you're truly immunized. Right, Speaker 2: 04:56 right. A blood test can be done to determine if you're susceptible to measles. So, but for some people it's just easier to go ahead and get a second dose. There's no harm in getting a dose of vaccine, even if you're already immune. Speaker 1: 05:09 And finally the, if the number of measles cases continues to climb because the progress we've made on this disease be reversed, how bad could this get? Speaker 2: 05:16 Yeah, that's the trouble with measles. Once the genie's out of the bottle, it's really hard to get it back in because it's so contagious and because on average, each person with the measles can transmit it to between 10 and 20 other people. It blossoms very quickly and once it's up and going, it's hard to control. And, and we've seen that story play out over and over again. Right now in France, for example, they're having an extended outbreak with thousands of cases of measles because they're in an even worse situation than we are with regard to under immunized population. Speaker 1: 05:51 I've been speaking with Dr. Mark Sawyer and infectious disease specialist with Rady Children's hospital and UC San Diego. Thanks, doctor. Sorry. Thank you.