Four cases of measles have been recently documented in New York City. Specific patient details are protected, but the New York City Department of Health has alerted local medical personnel that three cases came from overseas (China, Djibouti, and Europe) and one case was a consequence of travel on an airplane carrying the infected passenger from China. Of the four cases reported in July 2015, two were adults and two were unvaccinated babies. As a result of delayed diagnosis and the highly contagious nature of the disease, hundreds of people in New York City have been exposed to measles. It takes 7-21 days after exposure to develop symptoms, but most people get sick between 8-12 days. The contagious stage begins four days before symptoms appear.
If you are unvaccinated and develop a high fever (greater than 101 degrees, usually between 103-105 degrees), see spots in your mouth, and notice a skin rash on your hairline, face, and neck, progressing to your chest and spreading to your arms and legs, then wash your hands and strap on a mask. Call your medical provider’s office, an urgent care clinic, or your local emergency room immediately. The practitioner will ask you some questions, instruct you what to do about exposed friends or family, and tell you how to proceed. Measles is an airborne virus and you do not want to infect anyone on the way to the clinic or in the waiting room. Once there, your blood will be tested. However, the markers (measles IgM antibodies) won’t be detectable for three days after the rash began. Because of this, expect additional testing which might include a urine sample or a nasal swab.
Although unlikely, it is possible for vaccinated individuals to contract measles. Of the two adult NYC cases, one had documented MMR vaccinations and the other had “unknown vaccination status” according to the Department of Health. If you are unsure of your immune status, a blood test (measles IgG titer) is available. Ask your primary care provider about it especially if traveling outside the United States. [Read this about the hepatitis A vaccine if you’re headed to Mexico.]
Measles must be taken seriously. Three of the four recent NYC measles cases were hospitalized. One patient developed hepatitis while another suffered complications of both hepatitis and pneumonia. Because patient information is kept private, it is unclear whether the hospitalized patients were adults or babies, vaccinated or unvaccinated.
It is also unclear how and where the patients spent their time in NYC before being admitted to the hospital. However, if you are unvaccinated and think you’ve been exposed, call your care provider right away. If exposure was within the last three days, your practitioner will likely recommend an MMR (mumps, measles, rubeola) vaccine as a preventative measure. If the exposure was beyond three days, and you were actually infected, you might be contagious and passing the virus to others.
Note: This post relates to healthy adults, not special populations (elderly, immunocompromised, pregnant, babies, or children).