HJAR Jul/Aug 2019

48 JUL / AUG 2019 I  Healthcare Journal of ARKANSAS dialogue column Director’s Desk It is becoming increasingly common to hear about people affected by diseases that were once thought to be near elimi- nation. A very recent example is measles. The United States is currently seeing the high- est number of measles cases since 1994, even though mea- sles was once considered elim- inated in the United States. An eliminated disease means there is no ongoing transmis- sion for 12 months or more. Although Arkansas has not had a confirmed case of the measles since early 2018, the increase in the United States of measles cases means that it may be a matter of when, not if, we see this deadly disease again in our state. Measles is a very contagious and serious viral disease. It is spread through coughing and sneezing. It is the most highly commu- nicable of all infectious diseases, because the virus becomes suspended in the air, and it only takes contact with a few particles to cause disease. About one in four people who get measles will be hospitalized, and it can be fatal. Almost all fatal cases are in people with no history of measles vaccina- tion. Measles starts with a high fever, runny nose, cough, red eyes, and a sore throat, and is followed by a rash that spreads over the body. It can lead to severe pneumonia or swelling of the brain resulting in deafness, blindness, or mental disability. Patients are contagious from four days before to four days after the rash appears. Before the first measles vaccine became available in 1963, there were approximately 500 deaths in the United States from measles reported every year. Fortunately, measles can be prevented by a safe and effective vaccine. Two doses of the Measles, Mumps, and Rubella (MMR) vaccine are recommended beginning at age 12 months. The second dose is usually given at 4 to 6 years of age, but it can be given sooner in an outbreak. Two doses of the MMR vaccine are 97 percent effective for preventing measles. That means out of 100 people who get both doses, 97 people will not get the measles at all if they are exposed to the virus. Some children are too young to get the MMR vaccine, and some cannot receive it because of health problems that weaken their immune system. Making sure your children are vaccinated at the recommended age is the best way to protect them against measles. Vaccination keeps your child healthy and also protects the health of your family, friends and neigh- bors. Measles spreads very quickly, and an outbreak could easily happen if just one per- son in a community gets sick withmeasles. If a high percentage of people are vaccinated against measles, then it is less likely to spread, especially to the few people who are unable to be vaccinated. This is called community (or herd) immunity. To achieve this, about 95 percent of the people in a community need to be vaccinated. If the measles virus cannot spread easily, the chance of an outbreak is less likely and, eventually, measles will again be eliminated. Even if measles is once more eliminated in the United States, continued vaccination will still be needed to prevent travelers from bringing the disease back to their communities. Today, a student must be vaccinated Important Conversations About the MMR Vaccine