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Preventing Measles And Hepatitis A Amid National Outbreaks

May 29, 2019

The Centers for Disease Control and Prevention has reported more than 900 cases of measles in the United States this year, including two in Florida. Meanwhile the number of cases of Hepatitis A in the state continues to rise.

Health News Florida's Stephanie Colombini talked with infectious disease expert Dr. Vilma Vega from Vega Consulting about how to prevent the spread of these illnesses.

Measles and international travel

Vega explained the measles outbreak is largely due to people travelling internationally, contracting the disease abroad and then bringing it back to the United States, where they then spread it to others who are either poorly vaccinated or never received any vaccines.

“We’re realizing that there are a lot more people in the United States that are unvaccinated, especially children,” she said.

Measles is a potentially deadly illness that can spread quickly when people who aren’t protected from the disease come into contact with someone infected with it.

“It’s so infectious that it doesn’t require a lot of contact to then contract the virus,” Vega said. “In fact, you only need a few minutes around that person. Someone could cough in your space and that virus actually stays in the area where that person coughed or sneezed for two hours, that’s how easily you can catch this virus.”

Vega said some countries known to be hotbeds for measles are Israel, Ukraine and the Philippines.

The situation in Israel has a lot to do with the large measles outbreak in New York’s Orthodox Jewish community.

The most recent case in Florida involved an elderly man from Pinellas County who had recently travelled to Cambodia.

“We do know that in Asia in general, we see an uprise in measles,” Vega said.

Recommendations for the measles vaccine

Vega said she doesn’t believe there is enough education about how people can medically prepare themselves before travelling internationally, and credits misinformation about the side effects of vaccines as to why some people choose not to receive them.

“The benefits of vaccines are immense, and when you look at the benefits versus the risk, the benefits far, far outweigh the risk,” she said.

Vega said one in four children who contract measles are hospitalized, and one or two in every thousand die from it.

She recommends all kids receive the measles, mumps, rubella (MMR) vaccine.

“The first shot should be given between 12-15 months of age, and the second should be given between four and six years of age,” she said.

Credit CDC

Adults born before 1957 are presumed to have contracted the virus and developed immunity.

“However if you are unsure, you can ask your doctor or health care provider to check your measles titer,” she said. “They can check in your blood stream to make sure you are fully vaccinated and protected against measles.”

Vega cites her father, who was born during this period and recently contracted mumps when travelling to India, as an example of why older adults should always check their level of immunity before travelling internationally.

Adults born between 1963 and 1967 should get a booster, Vega said, because at that time, vaccines consisted of a killed, inactive virus.

Modern vaccines are made with a live virus, and Vega said anyone vaccinated with the proper doses after 1967 should be protected for the rest of their lives.

For more information on measles, check out the CDC website.

Other diseases to watch for

In addition to being an infectious disease expert, Vega is also a seasoned missionary, and said she frequently receives questions from patients and those interested in joining her on foreign mission trips about how to prepare for travelling.

She recommends they visit their local health departments, which typically have computer programs that list what vaccines are necessary for specific countries.

Vega said yellow fever, typhoid and hepatitis A and B are some other diseases that commonly require special protection for international travel.

“And this is important even here in the United States because we’ve had cases of new hepatitis A, in pockets that have occurred especially in certain populations of immunosuppressed and immune-weak individuals,” she said.

Hepatitis A in Florida

Florida had 92 cases of hepatitis A reported last week, bringing this year’s total to over 1,300, according to the state Department of Health website.

Vega frequently works with patients with HIV and AIDS and said those populations have been particularly affected by the recent outbreak due in part to their weakened immune systems.

“It is a food-borne disease, but the other problem is that when you’re in close contact with someone, or have sexual contact, it can be transmitted in many different ways,” she said. “That is why we really need to put a rush on getting as many patients vaccinated as possible.”

Vega said the amount of hepatitis A cases in the United States is very low compared to the rest of the world, which affects Americans' immunity.

“The developing world has anywhere between 70-90 percent of people who are exposed to hepatitis A,” she said. “In the United States, only 20-30 percent of people are exposed, therefore our immunity is almost nil.”

There is no treatment for hepatitis A. Vega said the disease resolves on its own in 90 percent of cases.

“There is a small percentage of patients who do develop what’s called fulminant hepatitis A, or fulminant liver disease, which is overwhelming liver disease and they die from that, which is the reason why you want to get them vaccinated,” Vega said.

“Plus the fact that it takes you out of work for about two months – if you catch this, even if it resolves on its own, it can be quite debilitating for a long time.”

For more information on heptatis A, check out the CDC website.