Measles outbreak in central Ohio soars to more than 50 children, fueled by ‘vaccine shortage’

CNN
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A measles outbreak is growing in central Ohio, with more than 50 children sickened and many requiring hospitalization, according to the data was updated Tuesday by Columbus Public Health.

Not a single child was fully vaccinated against measles.

At least 58 measles cases have been identified in Columbus and Franklin, Ross and Richland counties since the outbreak began in November, and there have been 22 hospitalizations, according to Columbus Public Health.

Of these cases, 55 were in unvaccinated children. The other three were only partially vaccinated, meaning they received one dose of their MMR or vaccine against measles, mumps and rubella when two are required for a person to be considered fully vaccinated.

Experts recommend that children receive two doses of the vaccine: the first between 12 and 15 months of age, and the second between 4 and 6 years of age. One dose is about 93% effective in preventing measles if you come in contact with the virus. Two doses are about 97% effective.

Nationwide, more than 90% of U.S. children are vaccinated against measles, mumps and rubella by age 2, according to US Centers for Disease Control and Prevention.

“Measles can be very serious, especially for children under the age of 5,” Columbus Public Health spokeswoman Kelli Newman wrote in an email Monday.

All of the Columbus cases were in children: 12 in infants younger than 1 year, 28 in toddlers 1 to 2 years of age, 13 in children 3 to 5 years of age, and five in 6 to 17 year olds.

This corresponds to approximately 71% of reported cases in children aged 1 to 5 years.

Although the specifics of each hospitalized measles case may vary, “many children are hospitalized for dehydration,” Newman wrote. “Other serious complications can also include pneumonia and neurological conditions such as encephalitis. There is no way of knowing which children will become so ill that they need to be hospitalized. The safest way to protect children from measles is the MMR vaccination.”

Some children visited a grocery store, church and department stores at the mall while they were contagious, according to Columbus Public Health’s list of places of exposure.

Measles is a highly contagious disease that can spread through the air when an infected person coughs or sneezes, or if someone comes into direct contact or exchanges germs by touching infected objects or surfaces.

“Measles can be a serious illness and can commonly lead to complications requiring hospitalization, especially in young children,” Dr. Matthew Washam, medical director of epidemiology and infection control at Nationwide Children’s in Columbus, wrote in an email Tuesday.

In the Ohio outbreak, hospitalized children were seen at Nationwide Children’s Hospital.

“Most children can usually recover at home with supportive care and can receive antibiotics for less serious complications, such as ear infections. Some children develop more severe complications, such as dehydration requiring intravenous fluids, pneumonia and/or croup requiring respiratory support, or rarely more serious complications such as encephalitis,” Washam wrote.

“The mainstay of treatment for all children with measles is supportive care,” he added. “In hospital, this may include intravenous fluids, antibiotics for secondary bacterial infections and respiratory support among other supportive measures. Some children with measles may also be treated with vitamin A due to the association with lower vitamin A levels with more severe measles disease.”

The measles outbreak is “very concerning,” said Dr. Nora Colburn, an adult infectious diseases physician at Ohio State University Wexner Medical Center in Columbus, who has closely followed the outbreak along with her colleagues.

“What’s really driving this is unfortunately the lack of vaccination, which is just heartbreaking,” said Colburn, who also serves as medical director of clinical epidemiology for the Richard M. Ross Heart Hospital at OSU Wexner Medical Center.

“As for measles, it’s the most contagious disease we have,” she said. “It’s very troubling as an infectious disease doctor, as a mother of a young child, and as a community member.”

During the early days of the Covid-19 pandemic, with most people staying at home and some health facilities closed, many children missed their routine vaccinations, including the MMR vaccine – and still may not have received all the recommended shots. This is as true all over the world as it is in the US.

“It’s worrying that we’ve had this global decline in vaccination coverage as a result of the pandemic, probably not really because of reluctance or refusal to vaccinate, but just that there were a lot of kids who missed their checkups during the pandemic, and we really didn’t fully catch those kids.” , said Dr. Sean O’Leary, chairman of the Committee on Infectious Diseases of the American Academy of Pediatrics and professor of pediatric infectious diseases at the University of Colorado School of Medicine and Children’s Hospital Colorado.

“Measles is such a contagious disease that when you see those declines, we really worry about the possibility of large outbreaks,” he said. “You have to really keep vaccination coverage high to prevent the spread of measles.”

About 90% of unvaccinated people who have been exposed to measles will become infected, according to Columbus Public Health, and about 1 in 5 people in the US who get measles will be hospitalized.

As the measles outbreak spreads through central Ohio, the United States is battling a wave of respiratory illnesses, such as influenza and RSV, or respiratory syncytial virus, and the ongoing Covid-19 pandemic.

Pediatric hospitals across the country have been overwhelmed by this surge in respiratory infections and are bracing for the possibility of even more cases during the holiday season.

“I can’t even imagine if your hospital is already full and suddenly you have to deal with measles, because measles is also a very problematic situation for infection control. You need negative pressure rooms, everyone has to wear N95 masks, and in a hospital it’s incredibly contagious,” O’Leary said.

“There is a big risk, especially for immunocompromised patients who are also in children’s hospitals,” he said. “That’s a real problem.”

Nationwide Children’s Hospital confirmed to CNN in an email Tuesday that it has seen an increase in other respiratory illnesses, such as the flu and RSV, but is still able to care for patients.

“The current increase in respiratory diseases such as influenza and RSV is visible locally. Although we do have some measles-related visits and admissions, the numbers are relatively low compared to influenza and RSV. “Measles places a greater strain on resources associated with public health efforts, including contact tracing, containment, education and immunization,” the hospital said in a statement. “Even though it is busy, our hospital is still able to continue to provide patient care.”

With each of these respiratory illnesses, it can sometimes be difficult to tell which infection a person has because the symptoms – such as fever, cough and runny nose – can be similar.

“Having RSV, flu, Covid at the same time as the holidays, and now we have measles on top of that, which can have overlapping symptoms of fever, cough and fatigue, it can be really challenging to distinguish which infection is which,” Colburn said, adding that it is important that everyone with symptoms stay home and get tested.

Measles symptoms can include fever, cough, runny nose, watery eyes, and a red-spotted rash. In rare cases, it can lead to pneumonia, encephalitis or death.

“Wearing a mask, especially in crowded places, is very important, especially for our immunocompromised patients. “I’m really worried about measles in adult patients who can’t get the MMR vaccine,” she said. “We cannot give it to patients with severely weakened immunity or pregnant women. So it is very important that everyone else gets vaccinated to cocoon these very vulnerable people and reduce the circulation of measles in our community.”