Why are Measles Outbreak Concerns On the Rise?

Measles has a fascinating history, beginning in the 9th century when a Persian doctor published one of the first written accounts of the disease. In its “Measles History,” the Center for Disease Control and Prevention (CDC) notes that in 1912, “measles became a nationally notifiable disease in the United States, requiring U.S. healthcare providers and laboratories to report all diagnosed cases. In the first decade of reporting, an average of 6,000 measles-related deaths were reported each year.”

According to the agency,

“In the decade before 1963, when a vaccine became available, nearly all children got measles by the time they were 15 years of age. It is estimated 3 to 4 million people in the United States were infected each year. Also each year, among reported cases, an estimated 400 to 500 people died, 48,000 were hospitalized, and 1,000 suffered encephalitis (swelling of the brain) from measles. Measles was declared eliminated (absence of continuous disease transmission for greater than 12 months) from the United States in 2000.”

Unfortunately, many health experts are concerned that the efforts leading to this historically significant victory over measles may have to be waged again.

Nonmedical Exemptions From Vaccinations Creating Hotspots

According to recently released research, a number of American states and metropolitan "hotspots" are vulnerable to outbreaks of vaccine-preventable disease because the parents of children in these areas have chosen to opt out of vaccinations.

The risk of outbreaks is rising in 12 of the 18 states that permit nonmedical exemptions from childhood vaccinations, according to a study published in June 2018 in the journal PLOS Medicine. Those states are Arkansas, Arizona, Idaho, Maine, Minnesota, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Texas and Utah.

“Over the past decade, these states have seen a rise in the number of nonmedical vaccine exemptions represented by children entering kindergarten without their shots,” said Dr. Peter Hotez, a co-author of the study and dean of the National School of Tropical Medicine at the Baylor College of Medicine in Houston.

According to news reports,

“Certain hotspot metropolitan regions also show a high proportion of nonmedical exemptions and so may be especially susceptible to outbreaks: Seattle and Spokane, Washington; Portland, Oregon; Phoenix, Arizona; Salt Lake City and Provo, Utah; Houston, Fort Worth, Plano and Austin, Texas; Troy, Warren and Detroit, Michigan; and Kansas City, Missouri.

“High numbers of unimmunized children living in large cities with busy international airports may contribute to the risk of a swift spread of disease, according to Hotez and his co-authors. Measles outbreaks in the U.S. are usually started by people when they become sick while traveling to or from a country where the virus is endemic.”

Despite the Debate the Facts Remain

While the debate about the benefits and dangers of immunization among parents and pundits will likely continue, the CDC and the American Academy of Pediatrics (AAP) recommend that healthy children get vaccinated against 14 diseases, including measles, mumps, pertussis (whooping cough), and haemophilus influenzae type b (Hib), which was once the most common cause of bacterial meningitis in kids, by age two. They also suggest an annual inoculation against the flu.

A pediatric-focused EHR is a valuable resource for this. As has been noted in an earlier post, the PCC EHR platform is the most robust pediatric-focused in the nation with intuitive logic. The immunization logic included in this software allows a pediatrician or nurse to efficiently research the clinical history of the patient and accurately determine which immunizations are due. This results in more efficient management of the process by pediatric clinical staff.

The PCC pediatric-focused EHR platform has a recall and reminder system that addresses the unique clinical needs of children – particularly the preventive care requirements outlined by the AAP’s Bright Futures standards. Each practice’s protocols should include the expected immunizations for each well visit age and PCC EHR excels at this functionality.

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Tags: immunizations, AAP Bright Futures, pediatric ehr, patient advocacy