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Health leaders are urging Michiganders to check their vaccine status to ensure they’re up to date on the measles, mumps, rubella vaccine after news broke Friday that a child from Oakland County has Michigan’s first confirmed case of measles in 2024.
The infected child was unvaccinated, said Dr. Russell Faust, medical director of the Oakland County Health Division, and had traveled internationally.
“That’s typical,” Faust said. “It would be extremely unusual if somebody who were vaccinated had been infected.”
One dose of the MMR vaccine provides as much as 93% protection against illness. Two doses delivers 97% of protection, according to the CDC.
“We’re coming up on spring break time. So we are asking folks to make certain they are vaccinated if they’re going to travel, and certainly if they’re going to travel internationally,” Faust said. “They need to be vaccinated.
“In addition, this is a respiratory virus. We’re all experts now in transmission of respiratory viruses, right? And so practice great hand hygiene, wear a mask when traveling, certainly … on a plane or in a taxi or on a bus.”
Where can I get an MMR vaccine?
Vaccines are available through the Oakland County Heath Division’s north and south clinics in Pontiac and Southfield. To schedule or to get more details, call 800-848-5533. Those seeking vaccines do not need to live in Oakland County to be eligible for shots at the health division’s clinics, Faust said.
“We have folks from all over coming here,” Faust said. Often, MMR vaccines for children are available at no cost. For adults, depending on insurance coverage and ability to pay, vaccines can range in cost from the $7 administration fee up to $76 per dose.
“It’s never too late to get a vaccine,” Faust said. “The way things are now globally, with all of us living in a global village and traveling around to places where not just measles but other infectious agents are endemic, it’s never too late to get vaccinated.”
What are the symptoms of measles?
Symptoms usually begin seven-14 days after exposure but can appear as long as 21 days after exposure, Oakland County Health officials said, and can include:
- Fever, which may spike to more than 104 degrees.
- Cough.
- Runny nose.
- Red, watery eyes (conjunctivitis).
- Koplik spots, which are tiny white spots in the mouth, often on the inner cheeks, gums, and roof of the mouth that develop two to three days after symptoms begin.
- A red, raised rash with a blotchy appearance typically starts on the face and spreads to the torso, arms, and legs. It usually develops three to five days after symptoms begin.
The virus is transmissible to others from four days before the rash appears to four days after the rash appears, making it difficult to stop transmission because people often don’t know they’re infectious in the beginning.
Is measles dangerous?
The virus can be dangerous, especially to unvaccinated children and people older than 65, as well as people with compromised immune systems, Faust said.
About 1 in 20 children with measles gets pneumonia, which is the most common cause of death from measles in young children. And 1 or 2 out of every 1,000 kids who contract measles die from it, the U.S. Centers for Disease Control and Prevention reports.
It can cause ear infections, diarrhea, pneumonia and encephalitis (swelling of the brain) that can cause convulsions, deafness or intellectual disability, according to the CDC.
“My generation just kind of shrugged their shoulders over measles and considered it no big deal,” Faust said. “Every kid got the measles. The problem is there’s a very small percentage of people get measles that will be seriously ill. So the big risk is for children below the age of 5. That’s a big risk. And adults, seniors above the age of 65 — especially if, just like with COVID, they have comorbidities or other issues going on — there’s a higher risk of fatality.
“Even short of fatality, what happens is that adults can get measles pneumonia. They get pneumonitis and really struggle. The other real problem and the thing that really scares me and the big reason I’m a huge measles vaccine advocate is that children especially will get measles encephalitis or encephalopathy.
“They’ll get brain swelling and infection of the brain. … They can be permanently deafened by this and so that there are potentially long-standing life-altering sequelae or death. I’ve known people in my life who are deaf because of measles. So it’s not insignificant. It’s a big deal. The beautiful thing is it’s completely preventable.”
And a measles infection during pregnancy could cause premature birth, low birth-weight, and fetal death.
What should I do if I think I’m infected or my child is infected?
It’s important not to rush to the doctor’s office, Faust said.
“If you suspect your child has measles, and they have a typical kind of rash that starts with the face, neck and chest, and they have the weepy eyes and the sniffles and fever, don’t just whisk them off to the pediatrician’s office,” he said.
“Call the pediatric office first so they can prepare. Because the worst thing that can happen is to bring a child like that into a waiting room full of 30 other kids — some of which may be unvaccinated or undervaccinated. Some may be infants — and get them all exposed.”
The measles virus, he said, is so transmissible, that if an infected person just breathes or speaks in a room, virus particles will hang in the air or on surfaces for hours.
“What happens is the pediatric office needs to shut down,” Faust said. “They need to get everybody out. They need to decontaminate that space, and we don’t want other other people unnecessarily exposed. We’re fortunate that did not happen with this single case.”
Is there a national outbreak?
Although measles was considered eliminated in the U.S. in 2000 because of widespread vaccination, a few cases break through each year. In 2023, the CDC reported 58 cases. In 2022, the U.S. recorded 121 cases. Those cases typically are among people who are unvaccinated or undervaccinated.
Because measles is among the most infectious viruses, herd immunity occurs only when an estimated 95% of the population is vaccinated, according to the World Health Organization.
Ninety percent of people who are unvaccinated who are exposed to measles will become infected, state health leaders said, and about 20% of people who get measles will be hospitalized.
More: How Oakland Co.’s Orthodox Jewish enclave became the epicenter for Michigan measles outbreak
Michigan’s case comes as infections are being reported in other parts of the U.S., and as immunization coverage has dropped. This year alone, 35 measles cases have been reported in 15 other states: Arizona, California, Florida, Georgia, Indiana, Louisiana, Maryland, Minnesota, Missouri, New Jersey, New York, Ohio, Pennsylvania, Virginia, and Washington.
The largest outbreak since the disease was considered eliminated in the U.S. was in 2019, when 1,274 individual cases of measles occurred in 31 states, including Michigan, from Jan. 1-Oct. 1 that year.
Among those infected, the U.S. Centers for Disease Control and Prevention reported 89% were unvaccinated or had an unknown vaccine status. About 10% were hospitalized.
Who should get an MMR vaccine?
The CDC recommends that the MMR vaccine be given to:
- Children at 12-15 months old, with a booster dose administered between ages 4 and 6.
- Anyone born during or after 1957 without evidence of immunity against measles or documentation of having been vaccinated with two doses of MMR vaccine. The second dose should be given no sooner than 28 days after the first.
- People exposed to measles who cannot document immunity against the virus should get post-exposure prophylaxis — a dose of the vaccine to potentially provide protection within 72 hours of initial exposure, or immunoglobulin within six days of exposure.
More: Born between 1957-1989? You may not be protected from measles outbreak
Faust, however, said the recommendations have also been updated to encourage even people who were born before 1957 to get vaccinated. And people born between 1963 and 1967 who don’t have documentation of which type of vaccine they received also should be revaccinated.
Additionally, for many people born after 1957 but before 1989, they may have gotten only got one dose of the MMR vaccine, which might not be enough to protect them in an outbreak.
“Two doses are considered to be fully vaccinated,” he said.
Immunocompromised people, such as those with autoimmune disorders, some patients with cancer or who are undergoing chemotherapy, those using high-dose oral systemic corticosteroids, patients with HIV and those who have received organ transplants, should not get a vaccine.
That’s why it’s so important for people around them to be fully vaccinated to protect the vulnerable, Faust said.
“My big frustration is that the politicization or the politics of COVID and the COVID vaccine has had this ripple effect outward, a halo effect. It is affecting other vaccine-preventable diseases like measles. And so we’re seeing more more people with vaccine hesitancy. It’s really a frustration.”
Contact Kristen Shamus: kshamus@freepress.com. Subscribe to the Free Press.
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