Measles has been found in Florida as well as Texas, and you may be wondering where next?
Florida’s Surgeon General Dr. Joseph Ladapo is under fire for allowing unvaccinated students to attend school during an outbreak. Dr. Ladapo, and also HHS Secretary Robert F. Kennedy, Jr., support requiring informed consent for vaccines, and respecting parents’ choices.
Dr. Rana Alissa, vice president of the American Academy of Pediatrics in Florida, criticized the decision. “When you have an outbreak, to contain it you have to follow the public health and safety recommendations, not give people a choice. Frankly, giving people a choice is what got us here.”
Some facts to remember: No vaccine is 100% effective. Persons vaccinated with MMR may still be susceptible to measles, either because the vaccine did not work for them, or immunity has worn off. You cannot catch measles from a person who does not have it, even if that person is unvaccinated. Vaccinated persons may be carrying infectious virus in their secretions even if they don’t get sick. Persons who recently received MMR (a live virus vaccine) may be contagious.
All vaccines have side effects. One cannot obtain a single-antigen measles vaccine in the U.S., but only Merck’s MMR. The rubella component, for example, can cause arthritis (usually but not always transient) in up to 26% of adult women. Mumps vaccine can cause inflammation of the testicles, nerve deafness, Guillain-Barré Syndrome (GBS), and other rare but serious effects.
For both vaccinated and unvaccinated persons, the following are sensible actions:
* Keep infected persons home. The first symptom of measles is likely a dry cough, appearing days before the rash.
* Consider the use of nasal sprays and mouthwashes with potential antiviral effects, including those with povidone iodine, hydrogen peroxide or xylitol.
* Take adequate vitamin A. For persons diagnosed with measles, CDC recommends two doses of high-dose vitamin A: 50,000 IU for infants younger than 6 months of age; 100,000 IU for infants 6-11 months of age; and 200,000 IU for children 12 months of age and older. For those who don’t like to take pills, one cup of carrot juice contains nearly 40,000 IU of vitamin A.
* For persons diagnosed with measles, particularly immunosuppressed persons, measles immune globulin can provide temporary passive immunity.
* Consider repurposed drugs. Nitazoxanide, an antiparasitic agent, appears to be a broad-spectrum antiviral agent with activity against measles virus.
* Consider high-dose intravenous vitamin C.
* Watch for and treat concurrent bacterial infections, such as pneumonia.
Additional Information:
Information on measles and on the MMR vaccine: Physicians for Informed Consent