Measles was declared eliminated in the US in 2000, after the country went a full year without a reported case. But it could lose that status if the current outbreak, which began in October 2018, continues into this month. Leonard Mermel, DO, ScM, professor of medicine and the medical director of the Department of Epidemiology and Infection Control at Rhode Island Hospital, talks about what that would mean for him as an infectious disease physician and for the US.
It’s a sad testament to our national public health endeavor. If the rates of transmission of a vaccine-preventable illness are going up in a developed country, it suggests we lack resources and the political will to reduce the risk of transmission in public settings. The percent of the budget for public health has gone down for several decades. The public health infrastructure may be less able to deal with emerging infections than it could years ago.
Overall, the rate of new measles cases fell over the summer; the question is what will happen when kids go back to school, when so many viral infections are transmitted in crowded school settings. People should be able to send their children to school and not have to worry about them getting measles. Such safety can be assured if those kids are up to date with their measles vaccinations.
At Rhode Island Hospital, we prepare for Ebola and all sorts of things. But one of my biggest concerns is measles. Day to day, there is a risk of someone coming into our emergency department with measles symptoms that may not be immediately recognized. I’ve only seen one measles case that I’m aware of in my life. Most US-trained physicians today have never seen a case. The initial symptoms when it’s still transmissible before the rash occurs—bad, cold-like symptoms, the red, runny eyes—may not tip someone off right away. We need to remain very vigilant.