Recent Measles Outbreaks in the US Spark Concern as Doctors Struggle to Recognize Symptoms
In recent years, the United States has seen isolated outbreaks of measles, a highly contagious disease that was declared eliminated in the country in 2000. However, between December 1, 2023, and January 23, 2024, there have been 23 confirmed cases of measles reported in Pennsylvania, New Jersey, Delaware, and the Washington, D.C. area. This resurgence of measles has raised concerns among doctors who are struggling to recognize the symptoms of the disease.
Measles is a viral infection that can spread rapidly if individuals are not protected through vaccination or wearing masks. The Centers for Disease Control and Prevention (CDC) states that every person infected with the virus can spread it to up to 10 close contacts. The incubation period for measles is around 11 to 12 days, and the early symptoms include a high fever, cough, and conjunctivitis.
One of the key indicators of measles is the characteristic rash that follows the initial symptoms. The rash typically starts at the hairline and then spreads downward to the hands and feet. It lasts for about five to six days and may result in severe lesions that peel off in scales. Measles can cause serious health complications, especially in children under the age of 5, including ear infections, diarrhea, pneumonia, encephalitis (inflammation of the brain), and even death.
The first measles vaccine was introduced in the U.S. in 1963, leading to a significant decline in cases, hospitalizations, and deaths. Currently, the CDC recommends two vaccine doses for optimal protection against measles. However, vaccination rates have been lagging in certain pockets of the country, contributing to the recent outbreaks.
Despite being a once common childhood disease, many medical students and even emergency room doctors have never encountered measles or can recognize its symptoms. Dr. Keri Cohn, a pediatric emergency room physician at the Children’s Hospital of Philadelphia, highlights that while medical students learn about measles in school, it is different from seeing and understanding the disease in a clinical setting. This lack of familiarity with measles has made it challenging for doctors to consider it as a possible diagnosis when children present with fever and rash.
To address this issue, hospitals have been developing response plans to ensure that emergency room doctors are prepared to handle measles cases. In Philadelphia, the bioresponse program at the Children’s Hospital has partnered with infection prevention and control to develop a comprehensive response strategy. This involves bringing together experts from various departments to address the needs of patients, families, physicians, and staff during an outbreak.
Dr. Nicholas Cozzi, EMS medical director at Rush University Medical Center in Chicago, emphasizes the importance of raising awareness among healthcare workers about measles. He co-authored a paper in the Journal of the American College of Emergency Physicians, which provides guidance on recognizing early-stage cases of measles and sharing critical information within hours of suspected cases. Dr. Cozzi urges healthcare workers to consider measles as a potential diagnosis when a child presents with fever and rash, as failing to think of it may result in delayed diagnosis and treatment.
The recent outbreaks of measles in the United States have highlighted the need for healthcare professionals to familiarize themselves with the symptoms of the disease. By improving recognition and understanding of measles, doctors can ensure timely diagnosis and appropriate management, ultimately preventing further spread of the virus.
