CNN
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A measles outbreak in central Ohio is growing, sickening more than 50 children, many of whom require hospitalization, according to data updated Tuesday by Columbus Public Health.
None of the children had been fully vaccinated against measles.
Since the outbreak began in November, at least 58 measles cases have been identified in Columbus and Franklin, Ross and Richland counties, and there have been 22 hospitalizations, according to Columbus Public Health.
Of these cases, 55 involved unvaccinated children. The other three were only partially vaccinated, meaning they received one dose of their MMR or measles, mumps and rubella vaccine when it takes two for a person to be considered fully vaccinated.
Experts recommend that children be vaccinated in two doses: the first between 12 and 15 months and the second between 4 and 6 years. One dose is about 93% effective in preventing measles if you come into contact with the virus. Two doses are approximately 97% effective.
Nationally, more than 90% of children in the United States have been vaccinated against measles, mumps and rubella by age 2, according to the United States Centers for Disease Control and Prevention.
“Measles can be very serious, especially for children under 5,” Columbus Public Health spokeswoman Kelli Newman wrote in an email Monday.
All of the Columbus cases were in children: 12 in infants under the age of 1, 28 in toddlers between the ages of 1 and 2, 13 in children between the ages of 3 and 5, and five in children between the ages of 6 at 17 years old.
This corresponds to about 71% of reported cases in children 1 to 5 years old.
While the specifics of each hospitalized measles case may vary, “many children are hospitalized with dehydration,” Newman wrote. “Other serious complications can also include pneumonia and neurological conditions such as encephalitis. There is no way of knowing which children will become so ill that they will need to be hospitalized. children against measles is to ensure that they are vaccinated with MMR.
Some of the children visited a grocery store, church and department stores at a mall while infectious, according to Columbus Public Health’s list of exposure sites.
Measles is a highly contagious disease that can spread through the air when an infected person coughs or sneezes or if someone comes into direct contact with germs or shares them by touching contaminated objects or surfaces.
“Measles can be a serious illness and can often lead to complications requiring hospitalization, especially in young children,” Dr. Matthew Washam, medical director of epidemiology and infection control at Nationwide Children’s in Columbus, wrote on Tuesday. .
During the Ohio outbreak, hospitalized children were seen at Nationwide Children’s Hospital.
“Most children can usually recover at home with supportive care and can receive antibiotics for less serious complications, such as ear infections. Some children develop more serious complications, such as dehydration requiring intravenous fluids, pneumonia and/or croup requiring respiratory support, or rarely more serious complications such as encephalitis,” Washam wrote.
“The mainstay of treatment for all children with measles is supportive care,” he added. “In hospital, this may include intravenous fluids, antibiotics for secondary bacterial infections, and respiratory assistance, among other supportive care measures. Some children with measles can also be treated with vitamin A given the association of lower levels of vitamin A with more severe measles.
The measles outbreak is “very concerning,” said Dr. Nora Colburn, a physician specializing in adult infectious diseases at Ohio State University Wexner Medical Center in Columbus, who has been following the outbreak closely with her colleagues. .
“What’s really driving this unfortunately is a lack of vaccination, which is just heartbreaking,” said Colburn, who is also medical director of clinical epidemiology for the Richard M. Ross Heart. Hospital at OSU Wexner Medical Center.
“For measles, it’s the most infectious disease we have,” she said. “And so that’s very concerning as an infectious disease doctor, as a mother of a young child, and as a member of the community.”
At the start of the Covid-19 pandemic, when most people stayed at home and some health facilities were closed, many children missed their routine vaccinations, including the MMR vaccine – and they didn’t. still may not have received all recommended vaccines. This is true all over the world as well as in the United States.
“The problem now is that we had this global drop in vaccine coverage as a result of the pandemic, probably not actually because of vaccine hesitancy or refusal, but there were just a lot of children who missed their exams during the pandemic, and we really haven’t fully caught up with those kids,” said Dr. Sean O’Leary, chair of the American Academy of Pediatrics infectious disease committee and professor of infectious disease. pediatrics at the University of Colorado Medical School and Colorado Children’s Hospital.
“Measles is such a contagious disease that when you see these drops, we really worry about the potential for large outbreaks,” he said. “You really need to maintain high vaccination coverage to prevent measles from spreading.”
About 90% of unvaccinated people who are exposed to measles will become infected, according to Columbus Public Health, and about 1 in 5 people in the United States who get measles will be hospitalized.
As the measles epidemic spreads through central Ohio, the United States battles an outbreak of respiratory illnesses, such as influenza and RSV, or respiratory syncytial virus, and the Covid-19 pandemic In progress.
Children’s hospitals across the country have been overwhelmed by this increase in respiratory infections and are bracing for the possibility of even more cases over the holiday season.
“I can’t even imagine if your hospital is already packed and all of a sudden you have to deal with measles, because measles is also a very problematic infection control situation. You need negative pressure rooms, everyone needs to wear N95 masks, and it’s incredibly contagious in a hospital,” O’Leary said.
“There are a lot of risks, especially for immunocompromised patients who are also in children’s hospitals,” he said. “It’s a real problem.”
The Nationwide Children’s Hospital confirmed to CNN in an email Tuesday that it has seen an increase in other respiratory illnesses, such as influenza and RSV, but remains able to continue caring for patients.
“The current outbreak of respiratory diseases such as influenza and RSV is observed locally. Although we know of some measles-related visits and admissions, the volumes are relatively low compared to influenza and RSV. Measles places greater strain on resources related to public health efforts, including contact tracing, containment, education and vaccinations,” the hospital statement read. “Although busy, our hospital remains able to continue to provide patient care.”
With each of these respiratory illnesses, it can sometimes be difficult to determine which infection a person has because the symptoms – such as fever, cough and runny nose – can be similar.
“To have RSV, flu, Covid at the same time as the holidays, and then now we have measles on top of that, which can have overlapping symptoms of fever, cough and fatigue, it can be really difficult to sort. infection is what,” Colburn said, adding that it is important that anyone with symptoms stay home and get tested.
Measles symptoms can include fever, cough, runny nose, watery eyes, and a rash of red spots. In rare cases, this can lead to pneumonia, encephalitis or death.
“Wearing your mask, especially in crowded areas, is really important, especially for our immunocompromised patients. I’m really worried about measles in adult patients who can’t get MMR vaccines,” she said. “We cannot give it to severely immunocompromised patients or pregnant women. So it’s really important that everyone gets vaccinated to protect these very vulnerable people and reduce the circulation of measles in our community.
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