EAST PROVIDENCE, RI, (July 15, 2019): With the increase in measles outbreaks in the U.S., Brown Medicine’s Division of Infectious Diseases took the opportunity to share guidelines for adults, particularly when traveling.
Measles (also called Rubeola) is a viral disease with symptoms that can mirror the common cold including fever, runny nose, cough, red eyes, and sore throat but with a characteristic rash that spreads all over the body. It is one of the most contagious infections and spreads from sneezing and coughing. People are infectious from about four days before the rash to about four days after it develops, so they are likely to infect others before showing specific signs of measles.
“Adults born after 1957 who did not have measles as a child or a known immunization should have a dose of the measles vaccine if they are traveling – especially outside of the U.S. – as they are at higher risk of being exposed to measles,” states Natasha Rybak, M.D., “They should also prioritize vaccination if they have an incomplete immunization history or if health authorities have recommended vaccine due to ongoing local measles outbreaks. We recommend confirming immunity to measles or getting a vaccine prior to a trip.”
The Centers for Disease Control reports that measles cases are still common in many parts of the world, and the disease can spread in the U.S. from travelers who continue to bring it here. It also spreads within U.S. communities where groups of people are unvaccinated. Measles is widespread in Europe primarily due to a combination of low vaccination rates and frequent travelers through the area who have active measles disease.
Adults born before 1957 are thought to be immune based on the high rates of measles infection prior to broad-based administration of the Measles, Mumps and Rubella (MMR) vaccine. “There is no official recommendation for adults to receive a routine dose of MMR,” continues Dr. Rybak. “In Rhode Island, there is no outbreak of measles because our state has had a very high rate of MMR vaccination, at over 95%. Adults with an immune-compromising condition or who are planning pregnancy should talk to their medical provider to see if a vaccine is needed. The state maintains an immunization data directory, called KIDSNET, for children born after January 1, 1997 therefore does not have information for adults and it can only be accessed by a health provider.”
If proof of vaccination is needed, laboratory confirmation of immunity or antibodies to measles can be obtained through a blood test from a patient’s current doctor. “Documentation of receiving one or more doses of the MMR vaccine through a place of work would be in your medical records if you worked in a medical facility, attended school or have a medical provider who has these records,” Dr. Rybak states. “Two doses are preferred if you are traveling, work in a health facility, or are attending college.”
Usually administered as a combination vaccine with measles-mumps-rubella, the MMR vaccine is highly effective, with 93% protection after a single dose and 97% after two doses. Although often confused with measles, Rubella (also known as German measles) has similar symptoms like a fever and rash but is milder. Rubella is included in the vaccine because it can cause severe birth defects in children born to mothers who develop the disease while pregnant. Mumps causes a fever and swelling in the salivary glands of the jaw, can cause more severe inflammation in the brain and genitals and, in rare cases, cause male infertility.
“Adults who have had two measles vaccines do not need to get another vaccine,” states John Lonks, M.D., “People who have had only one measles vaccine may need to get the second immunization if they are in an area with an ongoing outbreak of measles or will be traveling outside the country. If people do get an extra measles vaccine, there is no added risk or health issue associated with an additional vaccine. Note that the MMR is a live vaccine, so it’s not recommended for those who are pregnant, have HIV with a CD4 count less than 200, are severely immune-compromised, or have had a severe reaction to a prior MMR vaccine or to neomycin.”
If you are an adult over the age of 18 who is concerned about immunity, are traveling in the upcoming months, or need to provide an immunization history for health records, contact the Brown Medicine Division of Infectious Diseases at (401) 793-2928 located at 1125 North Main Street in Providence; or call the Brown Medicine Travel Clinic at 401-649-4080, located at the Brown Physicians Patient Center, 375 Wampanoag Trail Suite 201 in East Providence, RI.