by Kimberly Allen, RN
Last month there began a significant outbreak of the measles in Texas involving at least 21 people that attend the Eagle Mountain International Church in Newark, Texas because a pastor at the church has concerns about there being a link between autism and vaccinations, however since the out break changed his mind and began recommending member get their children vaccinated against this potentially deadly disease.
Why you don’t mess with measles
Measles is a very serious, potentially deadly disease that had been practically eliminated in the US by 2000 due vaccination. Then people started opting to not get their children vaccinated and the disease is making a comeback. Despite the fact that there is a safe and cost effective vaccine available. “Measles is one of the leading causes of death among young children”. There were 158,000 deaths from the measles worldwide in 2011, most of which were children less than 5 years of age. Before the vaccine became widely available the measles was responsible for approximately 2.6 million deaths every year. In fact between 2000 and 2011 worldwide vaccination for the disease resulted in a 71% drop in deaths from measles.
Measles is a highly contagious disease that is caused by a virus that is a member of paramyxovirus family. The virus lives in the mucous that lines your throat and nose. What makes the measles so contagious is that by the time you realize you have it you have already spread it to people around you. Once you become infected with the virus you with the virus you are contagious from 4 days before symptoms develop until 4 days after. The virus that causes measles also spreads very easily. If you sneeze, cough or even talk you release a spray of infected moisture droplets into the air. Once the infected droplets are in the air anyone in the vicinity can inhale them and become infected or the droplet can also land on surfaces in the area and this virus stays active as well as contagious for several hours on those surfaces. This means that someone can come by hours later and touch the door knob or the back of the chair where you were standing and if they touch their mouth, nose or eyes they can also become infected.
The symptoms of measles can develop anywhere from 7 to 14 days after being exposed to the virus. In most cases the first symptom of measles is a high fever which can last from 4 to 7 days. The fever is usually accompanied by typical symptoms of a cold including a hacking cough and runny nose and red, watery eyes. Then after a few days of these symptoms many people develop little spots in their mouth known as Kepliks spots. They resemble little grains of white sand with a red ring surrounding them. You can usually see them on the inside of your cheek towards the back of your mouth. Approximately 3 to 5 days after your symptoms begin most people develop a skin rash. The rash consists of flat or slightly raised red spots. It usually starts at your hairline then moves down your face and neck. During the next few days the rash will move down and cover your whole body, including your hands and feet. The rash generally lasts around 5 or 6 days. As your rash fades frequently you will notice a fine flaking of your skin. The rash also fades starting near your hairline and progressing down your body.
One of the reasons measles is such a serious illness is that in around 30% of the cases there is an associated complication. These complications can range from diarrhea and ear infections to pneumonia or acute encephalitis even blindness.
Because measles is caused by a virus there is no specific treatment, antibiotics will not help a viral infection. Treatment is focused on symptom relief including the use of acetaminophen and ibuprofen to reduce the fever. It’s also important to stay hydrated and get sufficient rest, especially until the fever resolves. Secondary infections like pneumonia or ear infections may require antibiotics if caused by a bacteria. People that have low levels of vitamin A, especially children, should be given vitamin A supplements.
Whopper of a whooping cough outbreak
According to the CDC the incidence of whooping cough could reach a 50 year high after it reached epidemic proportions in Texas. So far this year Texas has reported almost 2,000 cases of whooping cough and the number is expected to rise above their most recent high of 3,358 back in 2009. In 2012 49 states reported they had an increase in the number of whooping cough cases, however this year most states have reported lower numbers so far. Although 16 of those states are now reporting that they have more cases than last year. Experts attribute this increase in the number of whooping cough cases to a reduced number of children being vaccinated as well as a newer pertussis vaccine which is considered safer but not as effective over the long term.
Whooping cough also known as pertussis is an acute and highly contagious bacterial infection. It is caused by the Bordetella bacterium. It usually affects infants and young children though adults can also develop whooping cough if they have either not been vaccinated or the immunity from their childhood vaccine has diminished over time.
The bacteria that causes whooping cough is transmitted in the moisture droplets that are released into the air when someone that is infected coughs or sneezes. Whooping cough is highly contagious and is usually spread during the early stages of the infection before you realize that you have whooping cough. This is one of the reasons it’s so contagious.
The symptoms of whooping cough develops in 3 stages. In the first stage, also known as the catarrhal stage a person that is infected will demonstrate symptoms of an upper respiratory infection including a low grade fever, runny nose and sneezing as well as an occasional mild cough. Most people in this stage believe they simply have a common cold. This stage usually lasts anywhere from 1 to 2 weeks. After a week or two the cough becomes more severe indicating the start of the second stage. The second stage is also called the paroxysmal stage and is usually the stage when whooping cough is first suspected and the diagnosis is usually made. During this stage you would experience either numerous quick coughs or bursts of coughing . This occurs because the mucous is thick and difficult to expel from the airways in your lungs. These episodes of coughing will usually increase in frequency during the fist week or two and then remain constant for the next 2 or 3 weeks before beginning to gradually decrease in frequency. These bursts of coughing can be so severe that you can turn blue from a lack of oxygen. Infants and young children have a particularly difficult time and can become very distressed. After these bursts of quick coughs there is a long inspiration that usually has the well known high pitched whoop sound that gives the disease it’s name. These coughing bursts tend to occur more often at night and there is usually around 15 to 24 of these bursts during a 24 hour period. Some people, especially infants and young children will experience what doctors call post-tussive vomiting after an attack as well as exhaustion. This stage generally lasts anywhere from 1 to 6 weeks, however it can last for as long as 10 weeks. The recovery stage is the third stage. This stage is gradual as the coughing bursts eases and resolves which can take 2 to 3 weeks. However, the coughing bursts can return with any subsequent respiratory infections for several months.
The standard treatment for whooping cough is antibiotic therapy. While older children and adults are usually treated at home infants and young children are usually hospitalized for treatment because the disease is more dangerous for that age group. frequently family members are also treated with antibiotics as a preventative measure.
Before the development of the pertussis vaccine in the 1940’s there were more than 250,000 cases of whooping cough in the US every year with as many as 9,000 deaths a year. Then with the introduction of the vaccine the incidence of whooping cough had decreased by over 99% in the US by 1976. Then in the 1980’s the incidence began to rise and has risen steadily since then with epidemics occurring every 3 to 5 years. In 2010 there was an epidemic of whooping cough in California of 9,143 cases which included 10 infant deaths. Vaccinated is the key to controlling this disease children should be vaccinated at 2, 4 and 6 months with another between 15 and 18 months as well as a booster between 4 and 6 years of age for a total of 5 doses. Pregnant women should be vaccinated in their third trimester to provide maternal antibodies to protect the infant after birth for the first few months of life. Family members and caregivers that received their vaccination over 10 years ago should get a booster.
However, recently there has been some debate as to the effectiveness of the pertussis vaccine. In 2010, an outbreak of 332 cases of whooping cough in San Diego revealed a problem with the vaccine. Of the 332 cases, 197 of them involved patients who were up to date with their pertussis immunization. Also, the next highest group of infected with the disease were children aged 11 to 18 who had five immunization shots but no DTaP booster. The CDC responded by noting that whooping cough vaccines had been made less strong in recent years because of the reactions children had when they were made stronger. The CDC recommended getting several booster doses of the vaccine over several years to make sure the vaccine works effectively.
The best way to combat these diseases is through prevention. And despite the reported problems with ineffectiveness or contamination, the best way to prevent these potentially deadly illnesses is through vaccination. The problem is in recent years there has been much talk about a connection between vaccines and other conditions like autism and Alzheimer’s making people wary of vaccines. In addition to that, the CDC has made revelations about potentially deadly ingredients in some vaccines. However, it is important to note that many of these vaccines were developed in the 1940’s and with the advances in technology and medical science scientists have gained better knowledge and are working to improve these vaccines. While I am not a fan of the big drug companies and their unquenchable thirst for profit, it is also important to remember each person is an individual and will not react the same as the person next to them to many medications and as much testing as they do to perfect a new drug or vaccine there is no possible way to prevent all allergic reactions to any medication or vaccine so it’s important to discuss what vaccines your child needs and when he/she should receive them with your doctor.