Florida's position on measles overrides expert guidance

As the measles outbreak continues in Florida, it is likely caused by: vaccine avoidancethe state's Surgeon General Joseph Ladapo contradicts public health guidance to encourage isolation of unvaccinated children.

Rather than requiring parents to withhold measles vaccinations until their children are home from school, a key tool in containing the outbreak. Ladapo advised parents to do whatever they think is best.. Pediatricians and infectious disease experts are concerned that free clinics, including in their own clinics, could encourage the spread of the highly contagious virus.

The source of the outbreak is an elementary school in Weston, where cases have occurred so far. at least 8 children, one of whom is under 5 years old. According to the Centers for Disease Control and Prevention, Approximately 91% of the 230,000 kindergarten children Floridians were receiving the required doses of the MMR vaccine. mumps and rubellafor the 2022-2023 academic year. Vaccination rates, which public health officials believe provide herd immunity against measles, are below 95%.. An estimated 4.5% of kindergartners in the state are exempt from vaccinations to prevent measles. 97% of people vaccinated,lifetime. The first vaccination is given at around 13 months of age, and the second at 4 or 5 years of age, when the child is about to start school.

“If your child is vaccinated, the chances of them getting the virus are very low,” said Dr. Lana Alissa, a pediatrician at the University of Florida Health in Jacksonville.

Unvaccinated children have no protection against measles and can spread it to others simply by sneezing or touching surfaces. In school settings, infection can spread to teachers who are unable to receive the measles vaccine because of weakened immune systems, and unvaccinated children may be unable to receive measles treatment in pediatric clinics or hospitals. If you do, you could spread the virus unless the clinic staff takes care of you. Take strict measures to separate children from other children. Some children at the clinic cannot receive the measles vaccine because they are immunocompromised or perhaps have had a bone marrow transplant.

Assuming the unvaccinated child is healthy, the measles infection will resolve itself and then develop immunity to the disease, Alissa said. But on the other hand, they can pose a significant risk to others.

“I'm not worried about very healthy children who aren't vaccinated. I'm worried about unvaccinated adults who are seriously ill,” said Alissa, vice president of the Florida chapter of the American Academy of Pediatrics. ” (AAP). “We worry about young children under 13 months of age. We worry about children with immunodeficiency diseases.” AAP Florida Chapter Encourage parents to vaccinate their children against measles As the infection continues to spread.

“I wish our Surgeon General would have been on the same page as us,” Alissa added, adding that misguided vaccine hesitancy has led some parents to give their children safe and effective vaccines. He pointed out that people may be refraining from getting vaccinated.

It's never too late for Vaxx

Symptoms of measles appear 10 to 14 days after exposure and include a sore throat, cough, runny nose, irritated eyes, fever, and a patchy skin rash. According to the Centers for Disease Control and Prevention (CDC), 20% of people have not been vaccinated. Measles prevention workers will be hospitalized if they become infected with measles.

Given the incubation period of the virus, clinicians and public health officials recommend that children remain unvaccinated. quarantine for 21 days After contracting measles at school. This advice applies to all children who are not vaccinated because their parents objected to vaccination or because it is not safe to vaccinate.

This is guidance that Surgeon General Ladapo is ignoring.

“We have a public health system, and it's great. They're the experts. Let's use it,” Alissa said. “Their recommendation is to keep unvaccinated children home for 21 days in the event of an outbreak.”

“We don't call him a doctor anymore,” said Andrew Pavia, M.D., chief of the division of pediatric infectious diseases at the University of Utah in Salt Lake City.

“It is very important that children are vaccinated before they start school,” Pavia added, as the 21-day quarantine period is stressful for both children and parents.

In a Feb. 26 statement, Marcus Plescia, MD, MPH, chief medical officer of the Association of State and Territorial Health Officials, said, “established public health practice is that no vaccinated person has been exposed to measles.'' For those who do not have one, we recommend that they stay at home for at least 21 days as a precaution.” “We expect further spread of the disease. While this will undoubtedly be disruptive for those affected, if measles returns to the United States and becomes widespread, impacting children and communities across the country, Imagine the chaos it would cause.”

Pavia stressed that it is possible to give measles vaccine to children who have not yet been vaccinated during the outbreak. But time is of the essence. Vaccination should be given within 72 hours of the first confirmed case of measles at the school.

“It's not perfect. You can still get measles, but it's much less severe,” Pavia said.

If some children are not vaccinated during a measles outbreak, their parents may seek help from their pediatrician or hospital staff when measles symptoms take hold. Clinicians should advise everyone in the home over the age of 2 to start wearing N95 masks and gloves, Alissa said. And when children come to the clinic, they should be tested in a separate room, ideally one with negative pressure and frequent filtration, Alissa added. If not, then any private room is fine as long as she doesn't have anyone else using the room for at least 2 hours.

“Measles is incredibly contagious,” Pavia said.person infected with virus Can infect 12 to 18 other people who are not protected from the pathogen.

People who have a severe reaction to measles You can receive an intramuscular injection of immunoglobulinThese tend to be uncomfortable and expensive, Pavia said.

“Vaccines are effective. Measles has been almost eradicated,” Alissa said, but parents who choose to send their unvaccinated children to school can do so if they wish.

“The fear of every pediatrician is that this will kill the child,” she says. “If you are sick, please stay home.”

Mr. Pavia reported on the advisory relationship with Sanofi Pasteur regarding the RSV vaccine. Alyssa reports no relevant financial conflicts of interest.

Marcus A. Banks, MA, is a New York City-based journalist who covers health news with a focus on new cancer research. His work has appeared in Medscape Medical News, Cancer Today, The Scientist, Gastroenterology and Endoscopy News, Slate, TCTMD, and Spectrum.