At this point, there are no known cases of the measles in Kosciusko County, according to County Health Nurse Deb Frank.
State health officials, however, are investigating a measles outbreak in northeast Indiana, according to an Associated Press story.
The Indiana Department of Health has confirmed five cases of the highly contagious respiratory disease in Noble County. Surrounding counties of Allen, DeKalb, Elkhart, Kosciusko, LaGrange, Steuben and Whitley may also be affected, according to the Associated Press.
In her 17 years in Kosciusko County, Frank said she’s not dealt with any cases of the measles.
Frank said if a local doctor finds a case, the state and local health department would know right away. She said the health department then would contact the media because the measles is a big deal.
Asked about measles prevention, Frank said generally children are given their first measles/mumps/rheubella shot between 12 and 15 months old. Their second shot is due by the time they are 4 or 5 years old, before they enter kindergarten. “Being vaccinated is the best bet,” Frank said.
She said cases of the measles now are being brought to the U.S. by foreign-born people who were never vaccinated.
“Getting vaccinated is the best and safest way to protect our young ones,” Frank said.
According to the Immunization Action Coalition website www.immunize.org, provided by Frank, the U.S. is “currently seeing an increased number of measles importations into the U.S. due to recent increases in measles cases in countries commonly visited by U.S. travelers (e.g., France, India). During 2001-08, a median of 56 measles cases were reported to CDC each year. By contrast, during the first 19 weeks of 2011, 23 states reported 118 cases. Of the 118 cases, 89 percent were associated with importation from other countries.
“Of the 118 cases, 47 (40 percent) resulted in hospitalization. All but one hospitalized patient were unvaccinated. The vaccinated patient reported having received one dose of measles-containing vaccine and was hospitalized for observation only.”
Frank said Noble County has a lot of residents from foreign countries, which may have contributed to the measles outbreak. The Amish also don’t always get their vaccinations in a timely manner, which also may contribute to a measles problem.
“If people choose not to get vaccinated because of religious reasons, they may choose to go out and get vaccinated (for measles now),” Frank said.
Measles can lead to serious complications, including death, according to Frank.
According to the Immunization Action Coalition website, the 1989-91 measles outbreak in the U.S. resulted in more than 55,000 cases and more than 100 deaths. Frank said the measles can also result in encephalitis or pneumonia.
Symptoms of the measles, according to the IAC website, include “a febrile rash illness and the clinically compatible symptoms of cough, coryza (symptoms of a head cold), and/or conjunctivitis (red, watery eyes).”
The website states that a clinical case of measles is defined as an illness characterized by a generalized rash lasting three or more days, a temperature of 101 degrees or higher, and cough, coryza and/or conjunctivitis.
Frank said a the tongue of a person with the measles will have what looks like strawberry protruding marks. A case of the measles can’t be confirmed until a blood test is done.
“A lot of time people are contagious before they break out,” Frank said. A person can be contagious four to five days prior to breaking out, and four to five days afterward.
According to IAC, “Providers should be especially aware of the possibility of measles in people with fever and rash who have recently traveled abroad or who have had contact with international travelers.
“Providers should immediately isolate and report suspected measles cases to their local health department and obtain specimens for measles testing, including viral specimens for confirmation and genotyping. Providers should also collect blood for serologic testing during the first clinical encounter with a person who has suspected or probable measles.”
Measles is highly infectious. It is primarily transmitted from person to person via large respiratory droplets, according to IAC. Airborne transmission via aerosolized droplets has been documented in closed areas for up to two hours after a person with measles occupied the area.
Frank said the measles is communicable up to 90 percent of susceptible people.
It takes an average of 10 to 12 days from exposure to the appearance of the first symptom, which is usually fever, according to IAC. The measles rash doesn’t usually appear until approximately 14 days after exposure, and two to three days after the fever begins.
