Measles Update, Dallas County 2019

Measles Update, Dallas County 2019

Folasuyi Richardson, MPH Dallas County Health and Human Services Public Health Advisory Committee Meeting

April 18, 2019

Measles Cases in US, 1944 - 2007

? Pre-1963; More than 500,000 cases reported annually

? 48,000 hospitalizations; 4,000 cases of encephalitis; 450-500 deaths

? Vaccine introduced in 1963 ? Resurgence of cases 1989-1991 ? Declared eliminated from US in 2000

Measles: Clinical Characteristics

Courtesy J. Siegel, MD

Prodrome (lasts 1-7 d) ? High fever >101F ? Cough, conjunctivitis, or coryza

Generalized rash 3 days, occurs 2-4 days after prodrome (headextremities)

30% cases 1 complications: Diarrhea (8%), pneumonia (6%), otitis (7%), encephalitis (.1%) 18% hospitalization

Measles: Transmission

? Highly contagious

? Up to 90% of close contacts who are not immune will become infected

? Airborne spread through respiratory secretions

? Can remain suspended in airspace for up to 2 hours

? Incubation period ranges from 7 ? 21 days

? Typically 10-12 days

? Infected individuals can spread measles from 4

days before until 4 days after the rash appears

Measles: Vaccination

? Effectiveness: 93% after 1 dose;

97% after 2 doses

? Children: 2 doses MMR recommended

? 1st dose at 12-15 months; 2nd dose at 4-6 years

? Adults: 1 dose MMR for persons born in/after 1957 ? Healthcare workers: HCP born in/after 1957 should have

2 doses MMR. HCP born before 1957 presumed immune, but if without serologic immunity should have 2 MMR.

? International Travelers: All children (>12 mos) & adults --

2 doses of MMR vaccine separated by at least 28 day Infants 6-11 months of age: 1 dose of MMR



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