Tuesday, May 31, 2011

Measles Q&A with Mark Pasternack, MD

The Massachusetts Department of Public Health has confirmed recent cases of measles in the area. Mark Steven Pasternack, MD, unit chief of the MassGeneral Hospital for Children Pediatric Infectious Disease Program, answers common questions about measles and the current situation.

Q: What is measles?

A: Measles is a contagious viral illness that infects individuals who have not been adequately vaccinated. It is highly contagious through viral particles that are transferred when an infected person coughs or sneezes into the air. Someone who has not been vaccinated against measles may contract the illness if those particles get into the eye or are breathed in.

Measles initially produces symptoms of a bad cold with runny nose, conjunctivitis, and high fever which is followed by a rash. The rash is a prominent red, spotted rash that typically starts in the face and the head and descends through the body. Doctors always look for white spots on the inner cheeks when examining children with possible measles. People with measles are contagious four days before and four days after the rash appears.

The main complications of measles can be pneumonia, (viral or bacterial pneumonia) and less common, but very serious forms of neurological or central nervous system infection. There is no direct antiviral treatment for this condition, so major emphasis is put on prevention. Individuals who are ill with measles are treated supportively with fluids and fever control. If they show suspected bacterial pneumonia, they are treated for that.

Q: Is my child at risk for getting the measles? How can I protect my child against the illness?

A: Children who are over 1 year of age and have been immunized in the routine fashion with the measles, mumps, rubella (MMR) vaccine have a very high rate of protection against infection. The vaccine guidelines now call for a second dose at 4-6 years of age, which increases the protection even higher. School-age children and adults who have grown up in the United States and been vaccinated should be well protected. Parents should verify their measles immunity status with their primary care providers if they are unsure.

The risks to children in general are presently theoretical only. It’s  a good reminder that parents whose children may be behind in their immunizations should use this opportunity to make sure they are up-to-date. Prevention is really a key thought process.

For more information about the measles, mumps, rubella (MMR) vaccine visit: http://www.cdc.gov/vaccines/Pubs/vis/downloads/vis-mmr.pdf

Q: What should I do if I suspect my child might have measles?

A: Parents should be vigilant that children who seem to get a cold or flu-like illness with prominent runny nose, conjunctivitis, and cough who develop a rash should alert the pediatrician that the child should be evaluated for possible measles. Parents should recognize that the illness is highly contagious and they should limit contact between their child and other individuals until the child is evaluated by his/her physician.

If children are chronically ill and have a weakened immune system, either because of their underlying disease or medications given to treat their condition,  parents should be particularly attentive to make sure their immunizations are up-to-date and to report any illness to their pediatrician.

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