Have you heard about the measles outbreak that started in Disneyland? Here’s a quick timeline of the events. Measles is a highly contagious virus spread by airborne droplets with the majority (90 percent) of people who come in contact with the virus for the first time becoming infected. Can you imagine, then, the impact of one contagious inmate in your jail or prison? Measles outbreaks among the incarcerated are not unthinkable. As recently as 2013 there was an outbreak in a large prison in Queensland, Australia and city jails was involved in the 1990-1991 New York City measles outbreak. That is why vulnerable locations like the County Jail in Port Angeles, WA are taking steps to vaccinate their population and staff against this dangerous disease.
Maybe you had measles as a kid and are unconcerned. Some of us spent our youth prior to the late 1960’s when the vaccine entered common use in this country. Indeed, in 2000, the US declared measles eradicated due to vaccine use. However, that was premature as an insurgence of concern for vaccine safety led some parents to avoid vaccination for this and other infectious conditions in recent years. Many of our inmates have had little contact with the healthcare system and may not be vaccinated, either. So, depending on the location of your workplace and the pattern of outbreak, you may need to brush up on your measles knowledge and consider the potential for harm should the virus enter your facility.
Are you harboring false information about measles? Here are 5 myths about measles that you need to eliminate from your thinking. This information comes from the Center for Disease Control and Prevention (CDC), National Foundation of Infectious Disease (NFID), and the World Health Organization (WHO).
Myth #1 – The measles virus is not dangerous
Fact: Maybe memory has faded or maybe the prevalence of the vaccine decreases understanding of the damage the measles virus can cause. Measles complications can occur in every organ system and there is no antiviral treatment available. Treatment options can only address symptoms such as reducing a high fever. Measles complications include blindness, seizures, and death. About 20 percent of children contracting measles will develop some form of complication and one in every 1000 of these will die. Measles contracted by a pregnant woman can result in premature delivery or a low-birth-weight newborn.
Myth #2 – Adults don’t get measles – kids do
Fact: Surely measles is a childhood virus and not a concern in an adult population like ours, right? Back in the day (let’s say the 1950’s) most adults contracted measles as a child and build up a natural immunity. Many adults today have not been in contact with the virus and may not have been immunized either, making them vulnerable to the infection. Measles in adults is more severe and, as noted before, without a treatment other than symptom relief. That is why the NFID recommends the following adults be vaccinated:
Adults born in 1957 or later who do not have a medical contraindication should receive at least one dose of the MMR vaccine, unless they have documentation of vaccination with at least one dose of measles-containing vaccine or other acceptable evidence of immunity to the disease.
College and university students, healthcare personnel, and international travelers are at increased risk for measles, and should receive two doses of the MMR vaccine to ensure adequate protection.
Myth #3 – The measles vaccine is more dangerous than getting measles
Fact: The dangers of vaccination have been circulating in the popular press in recent years so you may have concerns about being vaccinated. It is easy to be misguided by stories from parents about children becoming autistic after vaccination. The relationship between autism and vaccination was touted in a small study of 12 children published in a reputable medical journal. This study was later repudiated and retracted from the journal, but the information is still circulated even though several large scale studies have shown no higher incidence of autism among children who have been vaccinated and those who haven’t. In addition, the side effects of the measles vaccine are milder and less frequent than the effects of contracting the virus.
Of course, there are some individuals for which vaccination is dangerous and should be avoided:
- Infants under 1 year
- Pregnant women
- Those with a weakened immune system or on long-term steroids
Myth #4 – It is harmful to be vaccinated again
Fact: Adults who have no proof of vaccination should get vaccinated against measles but may be concerned about the safety of getting vaccinated if they were so as a child. Fortunately, there is no harm in additional vaccination if you already have immunity. This is good news for those of us working with the incarcerated patient population, who may not remember or have documentation of vaccination.
Myth #5 – Nobody gets hurt but me if I don’t get vaccinated
Fact: It would be nice if we lived in a world where all our decisions only affected us. In that case, we could have true individual freedom of choice. Unfortunately, we live in the real world where our decisions for things like vaccinations affect those around us, whether family, friends, workmates, or inmates, especially in the close living and working quarters of correctional facilities. If you never had measles and are unvaccinated, you put yourself at risk, true. However, a person with measles is contagious up to four days before a rash appears. That is 96 hours of spreading a highly contagious illness to vulnerable others, especially infants, unborn children, and immunocompromised individuals like those on chemotherapy or with AIDS.
Fact Sheets for Staff and Inmates
Staff and inmates need to know the truth about measles and the measles vaccine to remain safe and healthy. Although the CDC has not yet produced prison-specific patient and staff information sheets, these documents from the UK for prison staff and inmates may be helpful.
What do you look for if you think an inmate has measles? I talk about that in my next installment…
So, do you think measles may be an issue in your correctional facility? Share your thoughts in the comments section.
