Unfortunately, we have gotten to the point of managing measles in student dorms of gap year programs. As most of you know, there is currently a measles outbreak in Israel (and concurrently in Jewish communities in the New York area).
According to the Israel Ministry of Health, as of December 10th, 2018, there were 2400 reported measles cases in Israel, but many more cases go unreported. Most cases have been in Jerusalem (1200+), Tzfat, Tel Aviv, and Petach Tikva, although almost every region has been affected. Since August, the number of people with Measles has doubled every month from 116 cases in August to 321 cases in September to 735 cases in October.
This is consistent with a significant outbreak. 76% of the cases have been in children ages 0-19 years old, although people from all age ranges have contracted the disease. To date, one unvaccinated toddler died of measles in Jerusalem.
Measles is one of the most contagious diseases in the world.
Someone who has not been vaccinated has a 90% chance of catching measles if exposed to the virus, so the need to vaccinate has never been more critical. According to the World Health Organization, herd immunity, or passive protection for unvaccinated people, exists only in age-populations where 95% of the age-population has been fully immunized. In many communities (and sub-communities), this threshold has not been met, leading to our current outbreak, affecting Israel and many Jewish communities in the US and abroad.
Complications from Measles
Common complications from measles include pneumonia, ear infections, bronchitis, and diarrhea. Less common but deadly side effects are widely publicized when they occur. One in a thousand people who contract measles will develop acute encephalopathy or inflammation of the brain, which often results in permanent brain damage. One or 2 children per thousand affected by measles will die of complications, usually respiratory or neurological. Most people don’t know that 7-10 years after having measles, people can develop Subacute sclerosing panencephalitis, a degenerative disease causing neurological deterioration and seizures.
People at risk for measles complications include infants and children under age 5, adults over age 20, pregnant women, and people with compromised immune systems. Because of the high susceptibility of young adults and children, MMR vaccines have become mandatory before admission to US colleges and most higher education institutes internationally.
How can someone catch measles?
Measles transmits via airborne microscopic droplets that go in the air when we talk, cough, sneeze, and even breathe. The droplets are so light that they can remain in the air for up to 2 hours. The droplets travel over a meter from the person transmitting the illness. People are contagious for 4 days before the rash appears until about 4 days after the rash appears. So many people are exposed before the sick individual knows they are sick. The rash usually appears about 14 days after exposure to the disease. Some immunocompromised people do not develop a rash but remain contagious and at risk for severe complications.
What can I do to prevent my children from getting measles?
VACCINATE. Measles is absolutely a preventable illness that has resurfaced because of specific populations that are under-or un-vaccinated.
BLOOD TEST. If you are unsure about immunity to measles, it is possible to test for measles antibodies. EMA Care is here to assist in getting this blood test. It will not be covered by student insurance, but it will give you peace of mind.
Beginning next year, the Ministry of Health has informed us that Gap Year programs will be required to ensure that international students have 2 MMR vaccines before attending school in Israel. EMA Care w will send a notice to schools in the coming weeks.