Measles, Mumps, Rubella – Oh My!

Why should we vaccinate?

From a growing  2019 measles outbreak in Seattle, the Centers for Disease Control now reports outbreaks in Washington and New York states, with more reported cases in Texas so far this month. While measles are caused by a virus – as is the mumps and rubella, whooping cough is caused by bacteria.

What is the first sign of measles, mumps, rubella or whooping cough?

Measles starts with fever, runny nose, cough, red eyes, and sore throat. It’s followed by a rash that spreads over the body. Measles is highly contagious and spreads through coughing and sneezing. One infected person can infect 9 out of 10 non-vaccinated people. The measles virus can live for up to two hours in the air and on surfaces after an infected person leaves.

Mumps starts with fever, headache, muscle aches, tiredness and loss of appetite. Then, most people will have swelling of their salivary glands. This is what causes the puffy cheeks and a tender, swollen jaw.

Rubella (German measles) includes a low-grade fever, sore throat, and a measles-like rash that starts on the face and spreads to the rest of the body. Some people may also have a headache, pink eye and general discomfort before the rash appears. Rubella can cause a miscarriage or serious birth defects in an unborn baby if a woman is infected while she is pregnant.

Pertussis (whooping cough) starts with cold-like symptoms, including a low-grade fever, runny nose and a mild, occasional cough. After 1 to 2 weeks, the traditional cough with a “whoop” appears. Patients may be exhausted and vomit after prolonged coughing spells. The disease can last for up to 10 weeks. Pertussis is very contagious.

The best prevention is vaccination.

Before the measles vaccination program started in the United States in 1963, an estimated 3 to 4 million people got the measles each year, according to the Centers for Disease Control and Prevention. Of those, 400-500 died. Measles can have complications of encephalitis.

Mumps outbreaks still occur, especially at schools, colleges and camps.

The CDC adds that the last major outbreak of rubella in the United States was in 1964-65. Rubella has been considered eradicated in the United States since 2004. But unvaccinated travelers may bring rubella – or measles or the mumps – home with them from countries where the diseases still persist.

Whooping cough (pertussis) occurs more frequently in the United States; it is especially dangerous to babies. This is why the CDC recommends pregnant women should receive a Tdap dose between 27-36 weeks’ gestation. This will pass antibodies to the infant and offer some protection after birth.

“Vaccination is the most effective strategy available to prevent infections, which is why we don’t see as many people infected with measles, mumps, rubella, and pertussis today in the United States,” says Dr. Jason Bowling, Hospital Epidemiologist for University Health System.

If a large percentage of the population is vaccinated, it limits the spread of infection by making it difficult to continue the chain of person-to-person transmission, he adds. This can also help protect those people who are unable to get vaccinated or respond to the vaccine due to health problems.  This is called “herd immunity” and is important to limit outbreaks of infection.

Are vaccines safe?

Many parents have concerns about vaccine safety. Understand, the MMR vaccine is safe. It requires two doses to be about 97 percent effective against measles, 88 percent effective against the mumps and 97 percent effective against rubella.

The DTaP/Tdap vaccines also are safe. Babies require three doses; young children require two boosters. Adults require a Td booster every ten years to protect against tetanus. The vaccine is 95-100 percent effective for ten years. For pertussis, it is recommended that everyone age 19 or older should receive one pertussis booster (Tdap dose) in place of their 10-year tetanus dose.

The Centers for Disease Control and Prevention have a website that examines vaccine safety. You can find peer-reviewed studies and research into reactions and safety for all vaccines, including the MMR.

If you were born in the early 1970s, you might consider having your titers drawn to check your immunity levels. Some doses of the MMR vaccine from that era were found to be ineffective. You may need an MMR booster.

If you do not have immunization records or lab confirmation of prior infection, you should have your titers checked, specifically a serum IgG level for measles, mumps and rubella, says Dr. Jason Bowling, Hospital Epidemiologist for University Health System.

Minors who want to be vaccinated without parental permission should refer to the laws of their state. Some states permit a minor to be vaccinated with the permission of an adult who is a family member, but not a parent. The Texas Medical Association explains the requirements in Texas.

Not sure if you have all of your shots? The Centers for Disease Control and Prevention has a tool to help you determine which vaccines you may need.

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