Nurture Pediatric Newsletter | Issue 7 | June 2017
New Office Coming to Bellaire in June!
Safe Summer Travel Tips
Measles Finds the Unvaccinated!
Eradicated in the USA in 2000, measles has made its return by taking advantage of un-vaccinated groups of people.
Measles is more than just a rash.
The illness starts with a cough, runny nose, and watery eyes along with fever and body aches. A rash follows consisting of white spots (Koplik spots) in the mouth followed by red spots over most of the body.
What sets this illness apart is the high rate of encephalitis – inflammation of the brain that leads to a headache, confusion, and seizures. In the USA, 1 out of 4 people who contract the illness requires hospitalization for supportive care and management of encephalitis. 1 out of 1000 children who contract the illness will have permanent neurologic problems (cognitive deficits and hearing loss) due to encephalitis. The most recent death from measles in the USA was in 2015.
So why were we able to get rid of this serious illness in 2000, only to have it return?
- Before the MMR vaccine became available in 1963, almost everyone contracted measles before the age of 15.
- Before the MMR vaccine in the USA, measles killed 450 people (mostly children) on average every year.
- After the MMR vaccine was introduced, measles was eradicated in the USA in 2000.
- Due to under-vaccination and travel, there were 667 cases of measles in the USA in 2014.
- Our community must be vaccinated at 95% to prevent measles outbreaks.
- Currently, USA MMR vaccine rate is 92% or possibly lower.
- People are misinformed about the safety of the vaccine and some think MMR vaccine is more harmful than the illness.
- Parents have been refusing the MMR vaccine for their children due to misinformation propagated in a false study by UK physician Dr. Andrew Wakefield that has since been retracted from Lancet where it was originally published in 1998.
Measles rates worldwide are rising.
Take Italy for example, vaccination rates for measles is at a low of 83% and they are experiencing a true epidemic of measles, more than 1600 cases thus far in 2017. The US Government has issued warning about travel: all travelers should be up to date on their MMR vaccine prior to travel, even babies 6-12 months of age.
Measles outbreaks in the USA
Minnesota Outbreak May 2017
Measles found 48 unvaccinated people in an under-vaccinated Somali community in Minnesota who were taught by anit-vaxxers that the vaccine is unsafe for their children and that there is no reason to fear the illness in the USA.
California LA Measles Outbreak Dec 2016
At least 20 people contracted measles in an under-vaccinated Jewish community in the LA vicinity. Tallies for other measles outbreaks in the USA in 2016 are still being figured.
Tallies for other measles outbreaks in the USA in 2016 are still being figured.
Visitors to Disneyland were faced with 145 cases of contracted measles that proved to be the same virus serotype responsible for the Philippines Measles outbreak in 2014.
Ohio Outbreak 2014
The primarily unvaccinated Amish community in Ohio experienced an outbreak affecting 383 people.
There were 22 other smaller measles outbreaks in the USA in 2014.
What can be done to stop the measles outbreaks?
In 2015 following the California Disneyland measles outbreak, California Governor Jerry Brown signed a bill that denied students who attend public school the ability to “opt out of vaccines” for religious and personal reasons.
“The science is clear that vaccines dramatically protect children against a number of infectious and dangerous diseases,” Brown said in a prepared statement. “While it’s true that no medical intervention is without risk, the evidence shows that immunization powerfully benefits and protects the community.”
- Keep your child up-to-date on all CDC recommended vaccines.
- If you have concerns about a vaccine side-effect or safety, talk with your pediatrician.
- Avoid traveling to areas of the world in measles epidemic status without up-to-date measles vaccination.
Inform people you know about the safety of vaccines and the importance to protect their children and our community from the diseases they prevent.
Summer Safety Tips
Summer is fun! But nothing can ruin summer faster than a preventable illness or injury. Here are some safety tips for your summer adventures:
- Wear tear-free sunscreen, spf 50 and reapply it every 2 hours. Waterbabies lotion sunscreen is a good choice. Apply generously. There should be a haze of white if it is applied correctly. For infants less than 6 months of age, Desitin diaper cream can serve as sunscreen.
- Wear UV protective clothing such as “rash-guard” shirts for boys and girls and wear hats.
- Bring a 12-16 oz bottle of distilled or drinking water and reserve it for use as eye irrigation in case of sand in the eyes, cuts or jellyfish stings (see below).
- Bring vinegar or baking soda in case of jellyfish sting. After you pour on the vinegar, rinse with fresh water, pat dry and immediately apply hydrocortisone (Cortaid) cream.
- In case of a cut or scrape, rinse with fresh water then apply triple antibiotic or mupirocin ointment and cover with waterproof band-aid before re-entering the ocean.
- Bring insect repellent (Off 15% -30%) to use in case of areas with high-mosquito load.
- Consider taking a nausea prevention medicine in your travel bag. It is easy to get motion sickness or an upset stomach while traveling. A few doses of ondansetron or Dramamine can help tremendously.
- Take probiotics as a preventative if you are traveling outside the country. Choose dairy-free products that contain lactobacillus such as Gerber Soothe Infant Colic Drops, Cutlurelle for Kids, or Biogaia.
- Take a pain and fever reducer medication in your bag. Ibuprofen or Acetaminophen – consult the weight and dosing chart on the package.
- Take your child’s vaccine record and insurance card with you just in case your child needs medical care while traveling.
- Check the www.cdc.gov website for out-of-country travels at least 1 month prior to travel to ensure you have all the recommended vaccines.
- Consult with your doctor in case of anticipated travel to malaria endemic areas.
- Take a few standard things also: bandaids, antibiotic ointment, hydrocortisone cream, benadryl, sanitizer, imodium, inhalers prescribed, epi-pens prescribed and any other regularly taken prescription medications.
Thank you for reading our June Newsletter from Nurture Pediatrics!
– J. Pate, MD