TMC PULSE

t m c » p u l s e | j u n e 2 0 1 7 22 Symptoms The most common symptoms of measles are a high fever, cough and runny nose. Three to five days later, a rash breaks out, starting on the face and head and spreading downward. Fever can spike to over 104 degrees. Children under five and adults over 20 are most likely to experience complications from measles. One in every 10 children will develop an ear infection, which can result in per- manent hearing loss. One in every 20 children will develop pneumonia, the most common cause of death from measles. One in 1,000 will experience encephalitis, brain swelling that can leave a child with lifelong disabilities. The most serious complication is subacute sclerosing panencephalitis (SSPE), a progressive, deadly brain disorder. SSPE takes seven to 10 years to develop after contracting measles. Throughout those years, the person may seem fully recovered, until symptoms like forgetfulness, unusually poor school performance and sudden personality changes appear. It is most common in children who contracted measles under the age of 2. While SSPE is rare, recent studies have shown it is not as rare as once thought. Original estimates had it affecting 1 in 100,000. A study of cases stemming from a major measles outbreak in California in the late 1980s indicates 1 in 1,400 children under five and 1 in 600 infants under age 1 later developed SSPE. "Measles is a killer infection, and the ones that are the most vulnerable are infants below the age of 1 who are not eligible to receive the vaccine," Hotez said. "Those are the ones who are going to get sick, and those are the ones who could die." Ariel Loop's son, Mobius, recovered from his bout with measles. Today, he is a happy toddler who is developing normally. But Loop still worries about SSPE. "I have to worry about that for such a long time," Loop said. "I know it's a pretty rare complication, but it's hard not to think about that sometimes, that he could drop dead out of nowhere in the next 10 years." After Mobius recovered, Loop had a new mission: lobby- ing California state lawmakers to require all schoolchildren to be vaccinated barring any medical issues. She testified before California legislators, and Senate Bill 277 was signed into law June 30, 2015. Within two years, the measles vaccination rate among the state's kindergarteners had risen from a danger- ously low 92.6 percent in 2014 to 97.3 percent in 2016. "It's the silver lining," Loop said. "Ultimately, the goal is to prevent other children from having to go through this. I'm glad that something positive has been able to come from it." Texas lawmakers debate vaccines Watching the vaccination rates rise in California has medi- cal professionals in Texas thinking state lawmakers should follow suit. "We need to close all non-medical exemptions," Hotez said. "The California legislature woke up and said, 'Enough is enough.' The Texas legislature needs to do the same." Vaccines have been a hot topic in the state capitol in 2017. House Bill 1124 proposed granting parents the ease of filing for an exemption online. It was an alarming step in the wrong direction for health experts. "Well-meaning people are introducing measures for more freedom for exemptions," Lyn-Cook said. "That may work for some things but it doesn't work for vaccination. That's like saying it's optional for you to wear a seatbelt." Lindy McGee, M.D., a Texas Children's Hospital physician and assistant professor at Baylor College of Medicine, is co-chair of the physician advisory board of The Immunization Partnership. As part of the organization's goal "to eradicate vaccine-preventable diseases by … advocating for evidence-based public policy," McGee testified against HB 1124 in front of the House Committee on Public Health. "Plenty of data from other states show that anything you do to allow exemptions to be easier increases the rate of unvaccinated children," McGee said. "We are extremely concerned about any legislation that would make it easier to get an exemption." During the meeting, she was grilled by committee mem- ber Rep. Bill Zedler, who claimed more people have died A 1-year-old boy receives the measles vaccine at the Aldine Community WIC. It's a global world, and higher immuniza- tion rates are safeguards to keep us from being susceptible to these diseases. Parents may be thinking they're doing the right thing for their child, but they're inadvertently harming the community. — BRIAN REED, M.D. Director of disease control and clinical prevention at Harris County Public Health and Environmental Services

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