Measles Update

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Although the seven Arizonans who got the measles after the outbreak that started in Disneyland are no longer infectious, state health officials are keeping an eye on the highly contagious disease. Dr. Cara Christ, chief medical officer for the Arizona Department of Health Services, and Dr. Bob England, director of the Maricopa County Department of Health Services, will talk about what they are doing to contain the outbreak of measles.

Ted Simons: Up to 1,000 people in Arizona may have been exposed to the measles in an outbreak that started at Disneyland. Health officials worry that the disease is spreading because parents are not getting their kids vaccinated. Here to talk about all this is Dr. Dr. Cara Christ, chief medical officer for the Arizona Department of Health services. And Dr. Dr. Bob England, director of the Maricopa County department of public health. Good to have you both here. I think it is good to have you both here. Glad you're both here, let's put it that way. Let's get to basics and move on. What is measles?

Dr. Cara Christ: Measles is a highly-contagious disease, one of the most contagious diseases that we know of. Virus can cause fever, cough, runny nose, red eyes and the rash that you hear about. The thing about measles is that it can have high complications or bad complications of deafness, blindness, and death. And these kiddos get very sick when you get measles.

Ted Simons: How are measles contracted? How is measles -- singular, plural, how is measles spread?

Dr. Bob England: This is a widely infectious disease. Airborne. You can contract measles being in the same room with somebody when you're way across the room. You can get measles by being in a room somebody was up to a couple of hours before you enter the room. It hangs around in the air. It is not like colds and flu where if you're staying just a few feet away, you are unlikely to get coughed on or sneezed on. This thing floats around and it is really contagious.

Ted Simons: If I'm in a room and it floats over me, how long -- can I go to another room and I'm all of the sudden a problem and don't even realize it?

Dr. Cara Christ: Not that quickly. It would take seven to 14 days for you to come down with symptoms. You are infectious before you develop symptoms. Up to four days before you get the rash, you could walk into a room, not know you're sick and in fact, nine out of 10 unvaccinated people in that room.

Dr. Bob England: Even a day or so before you have a cough or sniffle as you start your symptoms.

Ted Simons: How serious is this measles threat in Arizona?

Dr. Bob England: You know, we are still very early in this outbreak, which is a very good thing, because we have a shot at containing it right now. By knowing exactly who is infected so far, and by tracking their contact, making sure we have good information to those contacts and making sure that those individuals, if they are not immunized aren't going to child care or aren't going to school and so forth. We hope we will be able to nip this in the bud before it gets too widespread. But I'm really worried, because our overall, background rate of immunizations has been slipping over the years and that is an environment into which this, if it gets dropped especially into a school that has a really low immunization rate it could really take off.

Ted Simons: Why are vaccination rates slipping over the years? What's going on out there?

Dr. Cara Christ: Well, it -- we would love to know the exact answer. I think a lot of it has to do with parental fear. Parenting by internet and seeing a lot of this, this is one of the speculations, but there has been a fear that it is linked to things like autism or things in the vaccine can cause harm to your child. None of that has been proven. In fact, it has been disproven.

Dr. Bob England: Absolutely. This is one of the most studied questions out there in public health. We have beaten this to death. People looking to try and tie vaccines in particular MMR vaccine, but also others to long-term health consequences. It ain't there. It just isn't there.

Ted Simons: Why is the rumor, the information there? Shouldn't this eventually go away? If it is not there, why does it persist?

Dr. Bob England: You know, I think if you hear something often enough, if it gets repeated often enough, even if you are not -- even if you don't believe it, it gives you enough doubt, gives the parent reasonable doubt, I think, parents who are afraid and are delaying vaccinations, I understand where they're coming from. But vaccine is unlike any other health choice. And you need to understand that. If you decide, you know, whether or not you are going to get a screening exam or whether or not you are going to take a medication, the only person who is affected is you. If you decide not to vaccinate yourself or your kids, everyone around that is at risk. Because the way we control these diseases, we used to have 500 kids die a year in this country from measles. The way we have made that so darn rare is by getting our rate of background immunity up high enough that when one person comes into the group with a germ, it doesn't go anywhere. Whether your vaccine worked or not or if you are somebody who can't get vaccinated because of some other disease, you are still protected because you never get exposed.

Dr. Cara Christ: Herd vaccine.

Dr. Bob England: Herd immunity.

Ted Simons: Who should be vaccinated? Who doesn't need to be vaccinated?

Dr. Cara Christ: Anybody before 1957 -- like the doctor said, it -- everybody was exposed to measles. We consider most people from 1957 and earlier vaccinated or immune to measles, because they have had it or been exposed. But everybody, unless they have a medical contraindication that they should be discussing -- should be vaccinated. Vaccinated against not only measles but flu, pertussis --

Ted Simons: If someone were vaccinated for measles, 10, 20, 30 years ago, after '57, 40 years ago, whatever, do they need a booster?

Dr. Cara Christ: That would depend. Most people before 1989 when the two-dose recommendation went into effect, most people received one dose. And that is about 95 to 97% effective. You don't get that 99.5, 99.9% effectiveness until you have had two doses.

Ted Simons: Those of us who had mumps as a kid --

Dr. Bob England: Yeah, me too.

Ted Simons: I have had a measles shot since then. The simple fact of having mumps, measles as a kid, ballgame over?

Dr. Bob England: Yeah, if you have actually had the disease, you have really good protection. If you have two doses of vaccine, you have really good protection. Either way works. If you were born before '57, your parent said I don't know how you did it but you got away with it and you never had the measles and you haven't been vaccinated since, get vaccinated.

Ted Simons: Interesting. As far as the law is concerned, you talk about schools coming in, how does that -- aren't kids supposed to be kept out or away from schools if they aren't vaccinated?

Dr. Cara Christ: Absolutely. And -- we do require immunizations to get into school. And those who cannot get it for medical reasons or decide to opt out, if there is an outbreak or a child who has measles in their school, they will be excluded for the full incubation period.

Dr. Bob England: Arizona is one of the states that makes it easy for parents to simply choose I don't want to vaccinate my kid. And many parents will sign that form. Sometimes it's because they're really afraid. Sometimes it's just convenience. You know, we have a health care system here and people have to wait for appointments a long time sometimes. Some parents will sign it out of convenience. Okay. What you've got to know, if there is a case of measles in your child's school, I've got no choice but to kick your kid and any other non-immune kids out of that school until that outbreak is over. I have done it before. I hate doing it. It disrupts the kids' education. It disrupts the flow of the school. Disrupts the home life and some paints can't go -- some parents can't go to work because they have to stay home with their kids. I'm doing it to keep their kids from being a vector of disease to somebody else and keeping the outbreak going.

Ted Simons: I saw in the media, a doctor, MD, giving advice, don't take this vaccine. How do you respond to that?

Dr. Cara Christ: I completely disagree with that. I mean, in public health, this is one of the biggest accomplishments in public health is vaccination. And, so, in order to keep your child safe, to keep the kids around them safe, kids that are medically fragile or cannot receive vaccine. The babies under 12 months, kids undergoing treatment for leukemia, they can't get fully vaccinated. Not only designed to protect your child but all of the people and children around them.

Dr. Bob England: If you can get to herd immunity- that is an incredibly selfish attitude to take -- we're all in this life together. And one of the beautiful things to me about herd immunity, what's protecting me right now sitting in this room isn't so much the vaccines that I ever got is the vaccines that other people in the room got. To say that you're going to choose not to vaccinate your kid knowing that you could be putting other lives at risk, measles or anything else, is a selfish --

Ted Simons: Real quickly, is that message getting out there? Vaccination rates aren't climbing. They're going in the other direction.

Dr. Cara Christ: Right. And we have seen a decline in the vaccination rates and we're doing what we can to try to get them up. Parents have not been exposed of these diseases. Parents of today.

Dr. Cara Christ: They don't know what the risk is.

Dr. Bob England: Parents who put it off and confused, I understand, go get vaccinated now. But if you are adamantly antivaccine, you're saying that I don't care what happens to my neighbors.

Ted Simons: All right. Good to have you both here. Thank you for joining us. We appreciate it.

Dr. Cara Christ: Thank you.

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Dr. Cara Christ:Chief Medical Officer, Arizona Department of Health Services; Dr. Bob England:Director, Maricopa County Department of Health Services;

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