Update of Measles in Texas - 2019 · Measles in Texas Measles Basics • Prior to widespread...
Transcript of Update of Measles in Texas - 2019 · Measles in Texas Measles Basics • Prior to widespread...
Update of Measles in Texas- 2019Jennifer A. Shuford, MD, MPH
Infectious Disease Medical Officer, DSHS
Measles in Texas
• Measles Basics
• Measles Epidemiology in Texas- through 2018
• Measles Epidemiology in Texas- 2019
• DSHS Response
Image courtesy of CDC
Measles in Texas
Measles Basics
• Prior to widespread vaccination, measles caused an estimated 2 million deaths per year globally1
• Responsible for ~90,000 deaths worldwide in 20162
• Measles was declared eliminated from the US in 20003
• Measles remains common in many parts of the world, including regions within Asia, Africa, and Europe
Available at: 1. https://apps.who.int/iris/bitstream/handle/10665/44855/9789241503396_eng.pdf;jsessionid=AB9998C91A86973EE2DF6A
97FFD85C57?sequence=1; 2. https://www.who.int/immunization/diseases/measles/en/; 3. https://www.cdc.gov/measles/about/history.html. Accessed 3/26/2019.
Measles Basics- Signs and Symptoms
Image courtesy of CDC, available at: https://www.cdc.gov/measles/parent-
infographic.html.
Measles Basics-Transmission
• Measles is highly contagious
• Up to 90% of close contacts who are not immune will become infected
• Spreads through respiratory secretions
• Can remain suspended in the airspace for up to 2 hours
• Incubation period ranges from 7 to 21 days
• Usually 10 to 12 days
• Infected individuals can spread measles from 4 days before until 4 days after the rash appears
Image courtesy of CDC
Measles Basics-Complications
Image courtesy of CDC, available at:
https://www.cdc.gov/measles/parent-infographic.html.
Measles Basics-Vaccine
• Measles has an effective vaccine available
• MMR- mumps, measles, rubella
• MMRV- mumps, measles, rubella, varicella
• CDC recommends children get two doses of MMR
• First dose at 12-15 months
• Second dose at 4-6 years
• Effectiveness for measles
• 93% after one dose
• 97% after two doses
Image courtesy of CDC, available at: https://www.cdc.gov/measles/travel-infographic.html
Measles in Texas-2006-2018
Measles in Texas- 2019*
• As of 4/8/19, Texas has:
• 15 confirmed cases of measles
• 9 counties
• DSHS lab has tested close to 300 specimens for measles
• Continues to receive 5-10 specimens/day
*As of 4/8/2019
Texas Measles Cases-2019*
• Total 15 confirmed cases
• 5 cases are epi-linked to one other case
• That is, 5 “pairs” of cases
• One pair involves a child, all others adults
• 12 cases are PCR-positive
• 11 have been genotyped
• 9 cases are B3
• 2 cases are D8
• Both B3 and D8 are wild-type strains and are covered by the vaccine
*As of 4/8/2019Image courtesy of CDC
Measles Genotypes- Worldwide
Notes: Data Source: MeaNS database (Genotypes) and IVB Database (Incidence) as of 2019-01-09 and covering the period 2017-12-01 to 2018-11-30 - Pie charts proportional to the number of sequenced viruses
Map available at: https://www.who.int/immunization/monitoring_surveillance/burden/vpd/surveillance_type/active/measles_monthlydata/en/. Accessed 4/9/2019.
Texas Measles Cases by Age and Vaccine Status- 2019*
* As of 4/8/2019
Age (yrs)
Total # of cases
Cases with prior vaccination
Cases with vaccinationduring incubation period
Cases who report priorvaccination, no records
Caseswho report unsure/no prior vaccine
<1 0 - - - -
1-4 5 2 2 - 1
5-17 1 1 - - -
18-54 9 1 1 4 3
55+ 0 - - - -
DSHS Measles Response
• DSHS
• Sent out health alert on 2/8/2019
• Has responded to numerous media requests
• Is maintaining an up-to-date case count by county on the DSHS website: https://www.dshs.texas.gov/news/updates.shtm
• Stands ready to assist LHDs with testing, investigations, vaccines, or other needs pertaining to measles response
Measles in Texas-Summary
• Measles can cause serious, even fatal, disease• An effective vaccine is available
• 2019 Texas measles case counts have already exceeded 2018 counts
• Public health workers and healthcare providers need to be aware of the increased incidence of measles in Texas
• DSHS stands ready to assist measles response activities in Texas
Questions?