Introduction
In recent years, isolated cases of measles have been emerging across the United States. The latest outbreak has seen 23 confirmed cases of measles reported in Pennsylvania, New Jersey, Delaware, and the Washington, D.C. area between December 2023 and January 2024. This resurgence of the highly contagious disease has left emergency medicine physicians and departments scrambling to quickly detect and diagnose a condition that they may have never encountered before. With measles being declared eliminated in the U.S. in 2000, the lack of familiarity with the disease poses a significant challenge for healthcare professionals.
The State of Measles in the U.S.
Measles is an extremely contagious disease that can be spread to up to 10 close contacts by an infected individual. The initial symptoms of measles include a fever, cough, and conjunctivitis, followed by a rash that typically starts at the hairline and spreads downwards. About one in five people who contract measles in the U.S. will be hospitalized, and the disease can lead to serious health complications, especially in children under the age of 5. These complications include ear infections, diarrhea, pneumonia, encephalitis, and even death.
The Importance of Measles Vaccination
The first measles vaccine was introduced in the U.S. in 1963, significantly reducing the number of cases. Currently, the Centers for Disease Control and Prevention (CDC) recommends two vaccine doses for optimal protection. However, vaccination rates have been lagging, leading to outbreaks in under-vaccinated pockets of the country. The rise in international travel and declining global immunization rates have contributed to the resurgence of measles as a once-eradicated disease in the United States.
Doctors Unfamiliar with Measles
Despite being a common childhood disease in the past, many medical students and emergency room doctors have never seen or recognized symptoms of measles. While they may have learned about the disease in school, the lack of hands-on experience makes it challenging to identify early-stage cases. To address this issue, hospitals have been developing response plans and partnering with infection prevention and control departments to ensure that emergency room doctors are adequately prepared.
Teaching a New Generation
Medical professionals are working to educate healthcare staff about measles and familiarize them with its symptoms and proper precautions. This includes reminding doctors to consider measles as a possible diagnosis for patients presenting with a fever and rash. By raising awareness and providing guidance, healthcare workers can improve their ability to diagnose and treat measles cases effectively.
Dr. Nicholas Cozzi, EMS medical director at Rush University Medical Center in Chicago, emphasized the importance of keeping measles on the forefront of physicians’ minds. Without considering measles as a potential diagnosis, cases may go undetected and untreated.
