Here is more information regarding the case of measles identified in the Pittsburgh area last week:
On February 19, 2014, the Allegheny County Health Department (ACHD) was notified of a measles case in a fully vaccinated (two doses in childhood) 22-year-old Allegheny County PA Department of Health resident who works in a research center, which is housed in a large cancer hospital, in Allegheny County. The case-patient was exposed on 1/31 to a confirmed measles case in New York State.
The case-patient developed a fever on 2/14 peaking at 102.5°F (39.2°C) on 2/16, a dry cough and sore throat on 2/15, and a facial maculopapular rash on 2/18.
The rash resolved by 2/21. Measles infection was confirmed by positive IgM, positive IgG, and positive urine RT-PCR.
Times, dates and locations where people may have been exposed to the case include the following:
* The 64 Port Authority bus on Friday, February 14, between 9 and 11 a.m.
* Main entrance to the Hillman Cancer Center in Shadyside on Friday, February 14, between 9:30 a.m. and 3:30 p.m. and between 7 and 9 p.m.
* Bridgeside Point II Building in the Pittsburgh Technology Center on Friday, February 14, between 12 and 3 p.m.
* 5215 Centre Avenue in Shadyside, the building that houses Stull, Jarvis and Spinola medical practice and the Shadyside Family Health Center, on Tuesday, February 18, between 11:00 a.m. and 2 p.m.
Based on the dates of exposure, it is possible that symptoms in infected contacts could develop between now and March 11.
Tracking of known contacts in all of these settings has been undertaken to reduce the potential for additional measles transmission. Media coverage has been promoted to notify the general public.
It is possible that members of the public were exposed to the ill person in other unrecognized settings. In light of this possibility and the overall increase in measles cases being seen in the United States in recent years, the Allegheny County Health Department and Pennsylvania Department of Health requests that all health care providers maintain a high index of suspicion for measles in persons with a febrile rash illness, especially in those with no history of measles vaccination.
There are a few points here that are worth discussing:
- Just because you have been immunized doesn’t mean you are completely protected. MMR vaccine is given twice in the United States — at 15 months of age and five-years-old. The man described above had both doses and yet he still contracted the infection. How? Not everyone’s immune system responds to vaccines in the same way. He apparently had less than 100% protection from his vaccines: enough to protect him from severe symptoms and secondary complications of measles but not enough to protect him completely. Other vaccines (like tetanus and pertussis) lose effectiveness over time and need to be re-upped with boosters.
- Not everyone can be immunized against childhood diseases. Children younger than 15 months of age ride buses also. So do children who are immune-suppressed due to chronic illnesses and cancer treatments. So do adults who may be at risk due to the same illnesses. So do the elderly.
- People continue to get sick and die from vaccine-preventable illnesses every day — even in the United States. This guy was lucky. What if he was 22-days-old and developed pertussis — too young to receive the vaccine? What if he was 22-months-old and developed H. influenza or pneumococcal meningitis because the parents thought vaccines were poison? How about a 12-year-old with tetanus? Or diphtheria? What if he was a completely immunized 12-year-old who contracted chicken pox while undergoing chemotherapy treatments for cancer? What if he was a 32-year-old who developed liver cancer from hepatitis B because his parents refused vaccination? What if he was your 82-year-old grandfather with broken ribs from the violent, spasmodic “100-day whooping cough?”
- Someone exposed this immunized-but-not-completely-protected young man to this life-threatening infection. Eventually, drilling down to the source of exposure will lead to an un-immunized person — probably a child — who didn’t get vaccinated for whatever excuse given to the pediatrician.
Parents have a responsibility to protect their children. Not immunizing children does not protect them! Not immunizing children puts others at risk. We have a duty as adults — and parents — to protect not only our children, but each other.
Please immunize your children — completely, and on time!
(Photo: Ned Ketyer)