Blog | Monday, March 2, 2015

Mickey, Minnie, measles


It's a world of measles, a world of flu.
It's a world of mumps and pertussis too.
It's a world that we share,
but please stand over there.
It's a small world after all.
—My new proposed lyrics for the ride ‘It's A Small World’

In December I wrote that 2014 was a banner year for measles in the U.S.. Take a moment to read that post if you want a refresher on the symptoms and history of measles.

Well, gentle reader, if you were hoping that 2015 would be the year that humans make inroads against measles, I fear you'll be disappointed. So far, it looks like 2015 will be a year in which unvaccinated people gather in large groups and get infected. We've had more measles cases in California in January than in all of last year.

The California Department of Public Health has counted 59 cases of measles in California this year. 42 of these cases, including 5 Disney employees, are associated with an initial exposure at the Disney amusement parks in Anaheim in December. It is known that subsequently some patients visited the parks in January while infectious.

Vaccination status is known for 34 of the 59 cases. 28 of the 34 were unvaccinated. Six were infants too young to be vaccinated. Health officials are still investigating multiple people who may have come into contact with known patients.

This outbreak has led the Department of Public Health to advise that unvaccinated people not visit crowded places with a large number of international visitors. That's a reasonable start. Vaccinating everyone in line at “It's A Small World” might be even better.

What to do if you don't know if you've been vaccinated? If you were born before 1957 it's safe to assume you're immune, since virtually everyone in that generation was exposed to measles. Everyone else should have 2 doses of MMR. The first dose is usually given at 12 to 15 months of age, and the second at age 4 to 6.

If you're not sure if you received both doses, your doctor can just give you another MMR dose, or she can check a blood test to see if you're immune. When it comes to infectious diseases, wishing upon a star might not be enough.

Learn more:
Disneyland Measles Outbreak Hits 59 Cases And Counting (NPR)
Unvaccinated People Warned to Avoid Disneyland Resort (Wall Street Journal)
Measles advisory (California Department of Public Health)
Measles Makes a Comeback (my post in December)

Albert Fuchs, MD, FACP, graduated from the University of California, Los Angeles School of Medicine, where he also did his internal medicine training. Certified by the American Board of Internal Medicine, Dr. Fuchs spent three years as a full-time faculty member at UCLA School of Medicine before opening his private practice in Beverly Hills in 2000. Holding privileges at Cedars-Sinai Medical Center, he is also an assistant clinical professor at UCLA's Department of Medicine. This post originally appeared at his blog.