Old infection causes new problems
By Shannon Geistman, R.N. - Guest Column
April 16, 2017 at 7 p.m.
Updated April 16, 2017 at 11:20 p.m.
Measles is an acute viral infection that is highly contagious. Measles is spread through the respiratory tract. That means when someone has measles and they cough or sneeze, tiny droplets are released into the air. Someone can become infected when they breathe in those tiny droplets.
The first symptoms of measles are fever, cough, runny nose and red eyes. Symptoms usually begin 10-14 days after exposure. Then a person will develop a rash that starts at the top of the head and moves down and out, reaching the hands and feet. Other symptoms include loss of appetite, diarrhea and swelling of the lymph nodes.
Outbreaks of measles are less common in the United States than in developing countries. A more recent outbreak was reported in May of 2016 in Arizona. Another outbreak was reported in Los Angeles at the beginning of 2017. These cases are thought to have started by someone already infected coming into the US from a developing country.
Another viral infection that is spread through the respiratory tract is mumps. Symptoms usually begin 12 to 25 days after exposure. Symptoms include headache, fever and muscle pain. The most telling symptom is swelling of the face called parotitis. It can be on one or both sides of the face. Parotitis may first be noted as an earache or tenderness along the jaw. Symptoms usually last seven to 10 days. Some complications of mumps include deafness, inflammation of the brain and spinal cord and swelling of the testicles in males.
Outbreaks of mumps have been reported recently in the United States. Arkansas reported 2,878 cases. Missouri reported 396 cases since an outbreak started in August of 2016. More than 150 of those cases were contracted this year. Washington has 586 cases so far this year, with most cases in Spokane and Seattle.
Rubella is another viral infection that is spread through the respiratory tract. Symptoms usually begin 12 to 23 days after exposure and may be very mild. Symptoms may include low-grade fever, fatigue and swelling of the lymph nodes. The rash usually starts on the face and progresses from head to foot. This rash is more faint than a measles rash and is more prominent after a hot shower or bath.
Complications are not common with rubella but may include arthritis and swelling of the brain and spinal cord. The most profound complication is Congenital Rubella Syndrome. This happens when a pregnant women is infected with rubella and the infection is passed to the fetus. Infection with rubella is most severe in early pregnancy. Infection may affect all organs of the fetus. Defects include deafness, eye and heart problems, small head and brain, bone problems and liver and spleen problems. Outbreaks of rubella have not occurred recently in the United States. The few cases that have been reported to the CDC are from foreign travelers.
Vaccination against measles, mumps and rubella is the first line of defense against these diseases. In 1971, the FDA licensed the combination measles, mumps and rubella (MMR) vaccine. The MMR is a two-dose series. The first dose is given between 12 and 15 months. The second dose is given between 4 and 6 years of age. The MMR vaccine is 95 percent to 98 percent effective in preventing measles, mumps and rubella. Vaccination is also a requirement for school entry in elementary school, and proof is required for college admission.
Some people should not receive the MMR vaccine, including people who had an allergic reaction to a previous dose, pregnant women and anyone with a condition that compromises their immune system. Talk to your health care provider about whether you are protected against measles, mumps and rubella.
The Crossroads Immunization Action Coalition is involved in promoting immunizations in our area. If you are interested in joining in this important work, please call the Victoria County Public Health Department at 361-578-6281.
Shannon Geistman, R.N., is with the Victoria County Public Health Department. She may be contacted at at firstname.lastname@example.org.