Measles At The Super Bowl

Like the makings of a Hollywood movie, I learned this week that there were an estimated 200,000 people in Super Bowl Village this past weekend in Indiana. Amongst them on February 4th, was one (or maybe two) child with infectious measles. Fortunately, the child didn’t attend the game. Yet, measles is highly contagious. The period of infectivity starts before symptoms in some cases and usually 4-5 days before the typical rash, when many think they have just a bad cold. Measles is spread by the respiratory droplets infected people share when breathing, coughing, or sneezing. And the virus can survive for about 2 hours on surfaces or in the air after a person leaves the room. Measles has a wild history and although most children/adults do well after recovering from the illness, measles can result in severe complications like pneumonia or encephalitis. Fortunately, the majority of those in attendance last weekend who may have walked by or been near the infected person were protected by the measles vaccine.
The incubation period (the time it takes to get sick after being exposed) is about 10 days with measles. So if unprotected people contracted measles last weekend, they may get sick this weekend or early next week. Hopefully, we’ll hear of no one.
Measles spreads easily. There are reports of measles infecting every single unvaccinated person at a picnic. The public health department, even here in Seattle, sent an advisory email last night with instructions for what we doctors should do if we suspect measles in someone who was in Indiana last weekend.
But this is a global thing not just a US national sport thing. Starting in 2009, the number of cases of measles rose sharply in Europe. In 2010 for example, there were over 30,000 cases of confirmed, reported measles and in 2011 (through October), there were over 25,000 cases, with over 14,000 cases in France alone. Fifty percent of those with reported measles were children, less than 14 years of age. Immunization rates for measles have declined in Europe and public health officials point to waning vaccination as one reason for the surge.
This is not to scare, but to state the obvious: it turns out the last place you would want to be with your infant (too young to be immunized against measles) or your unvaccinated child is the Super Bowl. At least in 2012. And we never know where next. But that’s the beauty of living in a time when vaccines prevent these opportunities for infection.

How To Protect Yourself & Your Children From Measles:

• Measles is a vaccine-preventable illness. Fortunately, most children are protected, but some who are either too young or too sick to be immunized aren’t. Children are immunized against measles first at 12 months of age and then again at 4-6 years of age. After one shot, about 95% of people are protected against meales, and after 2 shots, 99%. In the US, we immunize against measles with the MMR shot (Measles-Mumps-Rubella). Some states do carry single-virus shots (measles only, for example) but here in Washington State, we use MMR.
• If you are going to travel internationally with your children, it is now recommend that babies between 6-11 months of age get the MMR shot prior to travel. They will still get their 12 month and 4-year doses.
• Toddlers & preschool travelers over 12 months of age should get the second dose of the MMR shot prior to leaving the country. Don’t wait until they are 4 years old if you’re traveling out of the US. Toddlers/preschoolers who get the 2nd dose early WILL NOT HAVE TO REPEAT IT AT AGE 4 YEARS.
• Two doses of MMR vaccine are recommended for all school students and for the following groups of persons without evidence of measles immunity: students in post–high school educational facilities, healthcare personnel, and international travelers who are ≥ 12 months of age.
• Read more about measles and the MMR shot at CDC website, the AAP website or CHOP Vaccine Education.

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