A case of measles has been confirmed in Maryland, and the Maryland Department of Health has issued a warning for those who might have been exposed to the infectious respiratory disease.
Anyone who visited 4000 Old Court Road in Pikesville between 9 a.m. and 1 p.m. on April 2 could have been exposed, according to a news release from the state health department that also notes people can develop the measles between seven and 21 days after exposure. The department is directly reaching out to people suspected of being exposed at other locations.
“Carroll County residents should take this notice seriously,” said Dr. Henry Taylor, Carroll County deputy health officer. “If they have reason to suspect they were at that location, of if they have been contacted that they may have been in a place they might have been exposed, they should follow through with the recommendations.”
The only confirmed case of measles in Maryland in 2018 was due to someone traveling to the country of Georgia, according to the release.
Carroll Hospital is taking this measles case seriously, announcing Thursday that it will temporarily allow no visitors younger than age 14 and will temporarily relocate its Breastfeeding and Postpartum Support Groups to the Robert Moton Center, at 300 S. Center St. in Westminster. Those attending are asked to bring newborns only and no older siblings.
Why such caution after a single case?
“The public may have forgotten the widespread outbreaks of measles and other childhood diseases many years ago,” Taylor said, “but this reminds us that measles is one of the most contagious of the respiratory viruses.”
Epidemiologists study how contagious a virus is using a term called reproduction number, Taylor said, that is defined as the average number of secondary cases generated per typical infectious case.
One review of studies of seasonal flu outbreaks found that the flu virus has a reproduction number of 1.28 — so that one person with flu typically infects 1.28 other susceptible people.
The reproduction number of measles is between 12 and 18.
The Centers for Disease Control and Prevention website notes that a person can catch measles just by being in a room where a contagious person was within two hours of their being there.
According to the state health department release, measles symptoms include fever, runny nose, cough and a fine red rash on the face that spreads to the rest of the body, and a person with measles is considered contagious from four days before the rash appears to four days after.
Anyone developing a fever and a fine red rash, Taylor said, should see their doctor, especially if they have not received the measles vaccine.
The vaccine is typically given as a component of the Measles, Mumps and Rubella, or MMR vaccine, which according to recommendations is given in two doses — the first around 12 months of age, and the second between four to six years, he said.
“Children who are six months of age who are going to travel might benefit from receiving the vaccine earlier,” Taylor noted.
Vaccination can help prevent the spread of measles outbreaks — the CDC is currently tracking seven travel-related measles outbreaks in five different states — as well as protect individuals from potentially severe complications.
“Children younger than 5 and adults older than age 20 are more likely to suffer complications,” Taylor said. “Common are ear infections and diarrhea.”
More severe complications include pneumonia, affecting one in 20 children with measles, according to Taylor, and about one in 1,000 may develop encephalitis, where the measles virus infects the lining of the brain.
“It can result in seizures, deafness and blindness,” he said. “For every 1,000 children who get measles, one or two will die from it.”
Unlike New York City, which is seeing a measles outbreak due in part to a large community of unvaccinated people, Carroll County is largely well vaccinated, according to Taylor.
“Historically, Carroll County has had very high vaccination rates at school entry, 97 percent plus,” he said.
But there are those who, for one health reason or another, cannot get the vaccine, and rely on the high vaccination rates of the community for protection.
“It is contraindicated for people who are pregnant or immuno-compromised, certain people with HIV,” Taylor said.
Children one year or younger may also be unable to take the vaccine, according to the state health department news release, and such vulnerable, unvaccinated people can be treated with immunoglobulin if given within six days of exposure to the measles.
For more information, visit www.cdc.gov/measles/index.html.