With more than 550 cases of measles in 20 states across the country — including four confirmed cases in Pikesville — members of Baltimore’s Jewish community are understandably alarmed about the outbreak of the disease.

Exposure points in this area include an office building at 4000 Old Court Road, Seven Mile Market at 201 Reisterstown Road and Maven Market at 1630 Reisterstown Road.

A highly contagious disease that once affected approximately 500,000 people annually in the United States, measles was essentially eradicated by 2000 due to the highly effective measles vaccine. But the disease has experienced a resurgence in recent years because some parents, fearing potential side effects, are unwilling to vaccinate their children.

In particular, measles cases have affected tight-knit Orthodox Jewish enclaves disproportionately in states such as New York and New Jersey — and in Israel — due to lower vaccination rates in those communities. A letter signed by more than 500 doctors who serve Jewish communities in North America strongly advocated vaccinations among Orthodox adults and children.

What do people need to know about measles, the vaccine, and how to protect their children and themselves from contracting the disease? Jmore spoke recently to Dr. Steven J. Czinn, a nationally-known pediatric gastroenterologist.

Dr. Czinn is chair of the Department of Pediatrics at the University of Maryland School of Medicine and director of the University of Maryland Children’s Hospital.

Jmore: What are the symptoms of measles?

Dr. Czinn: The symptoms of measles are similar to many other illnesses — coughing, fever, malaise — until breaking into the classic measles rash after a few days. The rash usually begins on the face, sometimes behind the ears, and then spreads to the rest of the body. The rash can be small red dots, some slightly raised. … The problem is that any child who has a cough, fever or runny nose won’t know if it’s just a cold or it’s measles until a few days later when the rash does or doesn’t break out. During those days before the rash breaks out, that’s when the person with measles is contagious.

What makes this disease so dangerous?

The measles infection can cause very significant issues. Before we had the vaccine, kids would die, go blind, deaf, have brain damage. … In many parts of the world where kids are not vaccinated, measles occurs and causes death. This is not just a little cold. It’s a life-threatening illness.

How does the measles vaccine work?

Measles vaccine
There have been 285 reported cases of measles in Brooklyn’s Orthodox Jewish community since October, 246 of which are children, the Department of Health reported in early April,. (Hannah Smith/KOMU/Flickr)

Measles vaccines work like many other vaccines. Their purpose is to trigger immune responses in the body. This allows you to develop antibodies to the measles virus. If you get two vaccines, the vaccine is 97 percent effective. It’s an almost 100 percent likelihood that you’ll develop antibodies that will protect you and destroy the virus.

What is ‘herd immunity’?

If we can get 95 percent of the population vaccinated, then herd immunity kicks in. That’s sufficient to prevent an outbreak. Because so many are protected, it blocks the virus.

Why are some parents reluctant to vaccinate?

Unfortunately, there is a subset of parents concerned about vaccinating because they feel it may cause autism or other problems. There is no scientific evidence for this. There were one or two papers published [that claimed vaccines caused autism], but they were retracted because it wasn’t true.

But the myth lives on.

How can people protect themselves and their children?

Vaccinate yourself and your children. If you have concerns about vaccination, you must go see your pediatrician or a medical practitioner and have a conversation that lasts until all your questions are answered, and you understand that should your child get measles, there is a risk of life-threatening consequences.

It is important to know that one vaccine doesn’t suffice. You must get two vaccinations.

How can adults vaccinated decades ago know if they have immunity to the disease?

There was a period of time when the policy was to only vaccinate once. Now, there’s a campaign to vaccinate adults because if you were born between 1957 and 1989, many kids only got one vaccine. If you’re an adult [born between those years], and you’re not sure if you had two vaccines, it’s best to get vaccinated. If you did have two vaccines but didn’t know that, getting another vaccine will not harm you.

What about infants who haven’t received their vaccines?

You cannot vaccinate a newborn under six months. So those babies are at risk. I know Passover is coming, but new moms need to be very careful about going out in crowds.

If you have a baby over six months but under 1 year old, we generally don’t give the first vaccine until the baby is a year old. But because there is an active [measles] infection [in the community], we recommend giving the vaccine earlier to give the baby some antibodies. That will protect them now, but you’ll still need to vaccinate the baby twice more later on. That first shot before age 1 won’t count as one of the two vaccines the child needs.

If you have a child over 1 year old who has gotten their first vaccination, we generally don’t give the second vaccine until ages 4 to 6. But [because of the active infection in the community], we are now recommending that kids between 1 year and 4 years old get the second vaccine now. You just need to wait a month between the first and the second vaccine. It is safe to do that and the vaccine will count toward the two that are necessary.

Families in Baltimore are fortunate because there are lots of great health care facilities. There’s lot of good advice and opportunities in the city to get vaccines and find resources. We need to do everything possible to prevent people from getting measles.

For information, visit health.maryland.gov/measles or call 410-767-1368 or 410-767-3536.

Check the Maryland Department of Health’s Twitter feed for updates.

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