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Measles update
1University of Arizona College of Medicine, Tucson.
Abstract:
The incidence of measles in the United States dramatically increased in the 1980s, from a low of 1,497 cases in 1983 to over 17,000 cases in 1989. Family physicians can help reverse this trend by following the revised immunization schedule, which includes a measles-mumps-rubella (MMR) booster for preschool-age children. New guidelines also recommend that either the two-dose MMR schedule or serologic evidence of immunity be required for all persons entering college or employed in the medical field. Immunization policies for physician's offices should ensure that all office staff have acquired measles immunity and that a triage policy separating patients with rash from those with other illnesses is utilized. Mild upper respiratory illness, a history of seizures, nonanaphylactic egg allergy and asymptomatic human immunodeficiency virus infection are not contraindications to measles vaccine. All cases of measles should be reported to the local health department.
Insights
Family physicians can combat the rise in measles cases by administering the measles-mumps-rubella (MMR) vaccine booster. Updated guidelines recommend MMR for preschoolers and immunity proof for college students and medical professionals.
Area of Science:
- Public Health
- Epidemiology
- Immunology
Background:
- Measles incidence in the U.S. surged in the 1980s, with cases rising from 1,497 in 1983 to over 17,000 by 1989.
- This resurgence highlighted critical gaps in measles prevention and control strategies.
Observation:
- Family physicians play a crucial role in reversing the measles trend through adherence to revised immunization schedules.
- New recommendations extend to requiring measles-mumps-rubella (MMR) vaccination for college entrants and healthcare workers.
Findings:
- The revised schedule includes an MMR booster for preschool-aged children.
- Two-dose MMR schedule or serologic evidence of immunity is recommended for specific high-risk populations.
- Physician's offices should implement immunization policies for staff and triage protocols for patients presenting with rashes.
Implications:
- Implementing these guidelines can significantly reduce measles transmission in the U.S.
- Certain conditions like mild respiratory illness, seizure history, non-anaphylactic egg allergy, and asymptomatic HIV are not contraindications for the measles vaccine.
- Mandatory reporting of all measles cases to local health departments is essential for disease surveillance and outbreak management.