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Dear USET/USET SPF Family,
There is growing concern of the U.S. Measles outbreak reaching Indian Country. The USET Office of Tribal Public Health is dedicated to providing you with factual information, best practices, and resources so that you can develop the best prevention and response strategies for your communities. This is critically important as vaccine hesitancy and misinformation increases. Multiple studies from around the world have already found no link between vaccines and autism. Efforts to misrepresent decades of research poses a threat to the health of Indian Country. USET calls on the U.S. government to promote the benefits of vaccines and urges the CDC to remain autonomous in its ability to publish research and evidence based recommendations. For more information, please contact Jewel Hunte, USET OTPH Epidemiology Manager, at jhunte@usetinc.org. Below are links to more information and resources.
What is Measles?
Measles is a highly contagious disease that spreads between humans through respiratory secretions. Measles is considered a childhood illness and initial symptoms usually begin as early as 6 days but may not begin until 21days after exposure and include:
- High fever (may spike to more than 104° F)
- Cough
- Runny nose (coryza)
- Red, watery eyes
- Rash (3-5 days after symptoms begin)
- 2-3 days after initial symptoms appear
- tiny white spots (called Koplik spots) may appear inside the mouth.
- 3-5 days after initial symptoms appear
- a flat red rash typically appears on the face around the hairline then spreads downward over the whole body.
- Rash spots may have small, raised bumps
- The spots may join together as they spread from the head to the rest of the body. N
Serious Complications:
- About 1 in 5 unvaccinated people will require hospitalization.
- Pneumonia in as many as 1 in 20 children that contract measles.
- Brain swelling in about 1 out of every 1,000 children that get measles.
- Death in nearly 1-3 out of every 1,000 children.
- Premature birth and low birthweight babies in people who contract measles while pregnant.
Community Immunity:
- Measles was essentially eradicated from the U.S. due to high vaccination rates across the country resulting in generations of medical providers that have never seen a case. More recently, however, vaccination rates have been dropping among certain populations and measles cases are on the rise.
- Generally, measles outbreaks only occur when community vaccination rates fall below 97%. Falling below this threshold is especially dangerous to infants too young to be vaccinated and those who are unable to take the vaccine for health reasons like allergies or compromised immune system.
- 95% of people who are unvaccinated and exposed to measles will contract the disease.
- 3% of people with one dose of the vaccine and are exposed to measles will contract the disease.
- 2% of people with two doses of the vaccine and are exposed will contract the disease.
Ensuring that at least 95% of the population are fully immunized helps keep the entire community healthy. As a reminder, the current vaccine recommendation is:
- First dose between 12-15 months of age
- Second dose between 4-6 years of age.
Please note that this recommendation may change based on local transmission and instances of international travel to certain locations.
USET OTPH Guidance:
- Ensure children are vaccinated on schedule.
- Please check your Clinical Reporting System (CRS) report to see your childhood immunization rates.
- Create panels in Icare to identify unimmunized or under-immunized people and create a follow-up plan. If you need any assistance, please contact usetepi@usetinc.org
A Note on Vitamin A Supplementation:
Claims that vitamin A supplementation as potential treatment of measles is irresponsible and dangerous for populations living in the United States. Vitamin A is stored in fat cells and can accumulate to toxic levels if too much is taken. Vitamin A treatment is generally only indicated in severely malnourished populations. In the U.S., vitamin A deficiency is extremely rare as it is readily available in many foods we eat, including breakfast cereals, eggs, dairy products, butter, organ meat, and many plant-based foods. In a few very rare instances in developed countries, vitamin A supplementation under the strict supervision of a physician may be indicated to prevent blindness and death. Vitamin A accumulates in fat cells and excessive levels can lead to serious complications, especially in children. USET’s OTPH strongly advises against vitamin A supplementation as a routine measure.
Resources - Proactive Measles Prevention Strategies in American Indian and Alaska Native Communities
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