With the measles outbreaks expanding across the county, Tennessee has one reported case. John Adams M.D., a board-certified infectious disease physician with Covenant Health, spoke with me on the urgency of paying attention to the one case.

While most measles cases in the country have been related to international travel, the origin of the Tennessee case has not been identified, and there is no way to predict the secondary cases that will follow due to the 21-day incubation period.

According to Dr. Adams, “Measles is one of the most contagious diseases known to man.” Airborne by droplets and droplet nuclei, the measles virus is suspended in the air for several hours. For example, a person who has measles can leave a room and a non-immune person may enter the same room hours later with no contact to the sick individual, but will still be exposed to the virus. 90% of the non-immune people who get exposed will get measles.

An immune person cannot pass the measles virus even if exposed. An immune person is one who has had measles, had two doses of MMR vaccine, or had a titer drawn that shows a level of antibodies that exceed the protective threshold for immunity. Also, a person born before 1957 is presumed to be immune.

Anyone can contract measles, but the very young, old, frail, health compromised or pregnant individual is most at risk for complications that can be devasting including brain infection, viral pneumonia and death. Not only is there a 2 in 1,000 chance of death; there is a chance for complications a decade after a seemingly unremarkable recovery: SSPE (Subacute Sclerosing Panencephalitis) is a nerve degenerative disorder directly caused by measles: untreatable and fatal.

Cases occurring in places that have good overall immunity will limit cases. If a non-immune group has a case, then substantial cases could develop as has in Texas. Two deaths have resulted from the outbreak in their non-immune communities.

Dr. Adams explains the onset of measles. “Early on, the measles starts like cold or flu with fever, sometimes very high, sore throat, runny nose, red eyes but less overall aches symptomatic with flu. As the virus progresses, white spots will appear in the mouth followed by small red bumps on the face, neck and head that move down the body. This communicable disease can infect non-immune individuals or groups 4-5 days before the rash appears and 4-5 days after.”

An infected or exposed non-immune person should quarantine away from social settings until the illness is cleared or the incubation period has passed.

The MMR vaccine, like the Small Pox and Polio vaccines, is considered a sterilizing vaccine which means the vaccinated person cannot get the illness, not like a Covid or influenza vaccine that provides a reduced risk of getting sick.

Dr. Adams reiterates: “People who have been hesitant to vaccinate or are not vaccinated should get vaccinated to limit spread in the state. Vaccination protects yourself, your family and your community.”

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