First measles case since 2020 confirmed in Massachusetts

THE GLOBAL WARNING ABOUT MEASLES. HOSPITALS HERE SAY THAT THEY’RE ON HIGH ALERT FOR EARLY SIGNS OF AN OUTBREAK. AND HERE TO EXPLAIN IS DOCTOR KRISTEN MOFFAT, INFECTIOUS DISEASE SPECIALIST AT BOSTON CHILDREN’S HOSPITAL. DOCTOR, IT’S GREAT TO SEE YOU. YOU KNOW IT. IT’S KIND OF STRANGE TO SAY MEASLES. IT’S JUST 2024. THE CDC BY THE WAY, ALSO ISSUED A NATIONAL ADVISORY THIS WEEK. SO WHAT IS IT CHANGING FOR YOU AND YOUR COLLEAGUES IN THE E.R.? YEAH, I MEAN, IN OUR DOORS, IT’S NOT CHANGING TOO, TOO MUCH BECAUSE AS YOU COULD IMAGINE, RASH AND FEVER, TWO OF THE MOST COMMON SYMPTOMS OF MEASLES ARE ALSO JUST REALLY, REALLY COMMON PEDIATRIC SYMPTOMS IN GENERAL. AND WE CARE FOR A LOT OF CHILDREN WHO ARE TOO YOUNG TO BE IMMUNIZED OR WHO ARE IMMUNOCOMPROMISED. SO WE HAVE BEEN NEEDING TO HAVE PRECAUTIONS IN PLACE TO PROTECT THESE INDIVIDUALS FOR A VERY LONG TIME. SO WHAT IT MEANS IS THAT WE ARE STILL ADHERING TO ALL OF OUR INFECTION PREVENTION PRACTICES, TRYING TO PREVENT THE SPREAD OF MEASLES, AND IT MAKES IT ALL THAT MUCH MORE IMPORTANT THAT WE ARE PAYING VERY CLOSE ATTENTION TO THESE BOTH LOCAL AND NATIONAL HEALTH ALERTS, SO THAT WE CAN BE EVEN MORE PREPARED FOR A CHILD TO POTENTIALLY WALK THROUGH OUR DOORS WITH MEASLES. SO, DOCTOR, IF A CHILD GOES TO CHILDREN’S HAS MEASLES, TAKE US THROUGH IT. WHAT HAPPENS NEXT? YEAH. SO WE WE OFTEN WON’T KNOW THAT THEY HAVE MEASLES. RIGHT AWAY. OR MAYBE WE DO. MAYBE THEY HAVE BEEN ALREADY EVALUATED OVER THE PHONE OR VIA A VIDEO. UH, EVALUATION WITH THEIR PHYSICIAN. AND MEASLES IS ALREADY OF HIGH CONCERN. UM, BUT REALLY, WE WE WOULD ANY CHILD WITH RASH, FEVER AND POTENTIALLY OTHER CONCERNING FEATURES WOULD BE ISOLATED RIGHT AWAY. WE WOULD MAKE SURE ANY STAFF INTERACTING WITH THEM WERE WEARING AN N95 AND THEN WE WOULD START TO TRY TO GET SOME MORE INFORMATION AND KEY PARTS OF THAT ASSESSMENT WILL INCLUDE THEIR VACCINATION STATUS. UM, UNIMMUNIZED OR UNDER-IMMUNIZED INDIVIDUALS, OR CERTAINLY THE ONES WE’D BE MOST WORRIED ABOUT, AND WE’D BE GETTING A TRAVEL HISTORY TO SEE IF THEY’D BEEN ANYWHERE WHERE WE KNOW MEASLES IS SPREADING, IT CAN TAKE A LONG TIME FOR THE CONFIRMATORY TESTING FOR MEASLES TO COME BACK. SO WE WOULD INVOLVE OUR DEPARTMENT OF PUBLIC HEALTH COLLEAGUES PRETTY EARLY IF WE HAD A HIGH CLINICAL SUSPICION FOR MEASLES BECAUSE IT’S REALLY EARLY TO GET THAT CONTACT TRACING UNDERWAY. MEASLES IS MOST CONTAGIOUS IN THE DAYS BEFORE THE RASH, EVEN APPEARS. SO THERE ARE A LOT OF STEPS IN THAT PROCESS THAT NEED TO BE THOUGHT OF RIGHT AWAY. AND ENACTED UPON. WELL, AND DOCTOR MOFFAT, AS YOU KNOW, THE THE ONLY AGE GROUP THAT’S NOT ELIGIBLE FOR THE MEASLES VACCINE IS BABIES YOUNGER THAN SIX MONTHS. RIGHT? CORRECT. YES. SO, SO WHAT’S YOUR ADVICE FOR PARENTS WHO HAVE BABIES THAT ARE YOUNGER THAN SIX MONTHS? YEAH. AND FRANKLY, AT MOST INFANTS DON’T GET IMMUNIZED AGAINST THE MEASLES UNTIL 12 MONTHS OF AGE. IT’S TO IMMUNIZE THEM OVER SIX MONTHS. BUT MOST DON’T START UNTIL 12 MONTHS. SO INDEED, I CAN UNDERSTAND THAT PARENTS, PARTICULARLY IF MEASLES DID BEGIN CIRCULATING OR WE HAD CASES HERE, WOULD BE CONCERNED. SO THE FIRST THING THEY COULD DO IS TO SORT OF BUILD THAT COCOON AROUND THEIR OWN INFANT AS MUCH AS POSSIBLE. AND THAT MEANS DOING THEIR BEST TO ASSURE EVERYONE THAT DOES SPEND TIME WITH THEIR INFANT IS FULLY IMMUNIZED, AND THAT STARTS IN THEIR HOUSEHOLD. IF THEIR CHILD ATTENDS A GROUP CARE SETTING OR A DAYCARE CENTER, IT IS COMPLETELY APPROPRIATE TO REVIEW WITH THAT CENTER WITH THEIR OWN IMMUNIZATION POLICIES ARE FOR THEIR STAFF AND FOR OTHER CHILDREN. IT’S ALSO TOTALLY APPROPRIATE TO ASK THEM HOW A FAMILY WOULD BE INFORMED IF THERE WAS A POTENTIAL MEASLES EXPOSURE IN THAT SETTING. THERE ARE A NUMBER OF INTERVENTIONS THAT MIGHT BE OFFERED IF A CHILD HAD BEEN EXPOSED. SO IT’S REALLY IMPORTANT THAT THAT A CENTER PLACE WHERE INFANTS MIGHT SPEND THEIR TIME, UH, IS DOING EVERYTHING POSSIBLE AND UTILIZING ALL THE INFORMATION POSSIBLE TO KEEP THOSE CHILDREN HEALTHY, ESPECIALLY IF THEY’RE TOO YOUNG TO BE IMMUNIZED THEMSELVES. A GOOD REMINDER, AN IMPORTANT REMINDER J