When a man like Dr. Cheryl Bettigole, the health commissioner of Philadelphia, says something like, “We’re at a stage where we’re holding our breath,” you tend to worry. Especially as a resident of the city.
However, Bettigole did say that, and he meant it because Philadelphia may be on the brink of a measles outbreak. Yes, this is happening even though there is a very effective vaccine that works against measles and has been around for decades.
A virus causes measles, and it is extremely infectious. Just one person with measles can infect about 18 people with ease. This is because it spreads via tiny aerosol-like droplets that can infect people in the same airspaces.
There does not even have to be direct contact. After an infected patient visits a room, it usually takes two hours before it’s safe for uninfected people to enter too. Early symptoms typically include high fever, cough, runny nose or red, watery eyes, or pinkeye.
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A few days later, the infected develop a higher fever, and a reddish or hyper-pigmented rash starts to appear. It starts at the hairline on the face before spreading downward to the neck, trunk, arms, and legs. Some people can also develop tiny white spots, called Koplik spots, in the mouth.
The deadly virus had been loose in the city for about two weeks before authorities got whiff of the exposures at the day care facility. By the time word of the outbreak arrived, it was too late for children and adults at the facility to get a measles vaccine if they didn’t already have one.
The first case was an infant who a patient at Children’s Hospital of Philadelphia between December 6 and 9, with an infection that later turned out to be measles. The infected infant seemingly contracted the virus while abroad though it’s unclear what country or region the child’s family visited.
The family returned to the Philadelphia area, and doctors at Children’s Hospital treated the child for fever and respiratory symptoms. However it was measles. It quickly spread, infecting three unimmunized patients in adjacent rooms, setting off the outbreak.
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There were no other exposures at Children’s Hospital. People suspected of exposure to it got post-exposure prophylaxis immune globin. It uses plasma containing antibodies to immediately protect against measles.
Unfortunately, just before Christmas, more cases sprung up around the city. By then, those with sick children had visited several health facilities in Philadelphia and surrounding suburbs before the city health department received notice of their infections, putting additional institutions on notice for possible exposures to the virus.
Authorities are now looking for possible infections in the area of the daycare center and other parts of the with low vaccination rates. The city has also listed exposures at several health systems:
- Children’s Hospital of Philadelphia’s emergency room on Dec. 28 and New Year’s Day.
- Nemours Children’s Hospital, in Center City, on Dec. 29.
- Christopher’s Hospital for Children, in North Philadelphia, in the emergency department on Dec. 30-31 and its inpatient unit between Dec. 31 and Jan. 3.
- Nazareth Hospital’s emergency department, in the city’s northeast, on Dec. 31 and Jan. 2.
- Jefferson Abington Hospital’s emergency room and Holy Redeemer Pediatric Urgent Care, both in suburbs just north of Philadelphia, on Jan. 3.
Little wonder the city is holding its breath, the situation could prove deadly. About a fifth of people who get measles will be hospitalized. 1 in 1,000 develops encephalitis, or swelling of the brain, which can lead to convulsions, deafness, or intellectual disabilities.
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Deaths are commonly caused by pneumonia and dehydration. Expect about 1 to 3 in 1,000 children with measles to die from respiratory or neurologic complications. Measles has not been commonplace in the US since the early 1960s when the vaccine was developed.
Vaccination against the virus provides near-total protection. However, rates have declined nationwide due to misinformation and conspiracies around vaccines. Such theories will have to be shelved and those vaccines will have to be taken to prevent a full blown pandemic.
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