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Measles 'Not Yet' an Epidemic

Health Ministry officials are reporting an outbreak of measles in Israel that began with a single tourist.
By Hana Levi Julian
First Publish: 3/31/2008, 10:30 AM

The old-fashioned children’s illness measles, not often seen in western nations where immunizations are standard procedure, has somehow managed to make its way back to Israel nevertheless.

An outbreak of the virus has hit the country and is spreading rapidly at a rate of six new cases a day, according to the Health Ministry. It is not an epidemic, but the trend, which began this time with a young passenger on an El Al flight from New York City at the beginning of March, is troubling.

Passengers on an Egged bus from Ramat Beit Shemesh a day later were also exposed. Health Ministry officials immediately asked passengers on either conveyance who had not been vaccinated for measles to visit the nearest ministry office and receive a vaccine.

Infants are generally protected from the virus for six to eight months after birth due to general immunity passed on from the mother. Afterwards, most children in developed nations receive a vaccine known as the MMR – the measles-mumps-rubella immunization, given at 12 to 15 months, and then at 4-to-6 years of age, with certain medical exceptions.

But, many families are refusing to vaccinate their children, fearing neurodevelopmental disorders such as autism and Asperger’s Syndrome.

There has been some research linking one of the components in the vaccine to the development of such conditions in a small percent of the population, and many parents don’t want to risk the chance, particularly those with a family history of developmental disorders.
 
The controversy over this issue has raged between parents who argue that a possible chance of developing a passing childhood illness does not outweigh the risk of developing a lifelong crippling development disorder, and public health officials who fear a full-scale epidemic.

An Old Virus Revived in Israel
Doctors reported this past Sunday that a patient admitted to Dana Children’s Hospital in Tel Aviv Saturday night was diagnosed with measles. Those who were in the hospital at the time have been asked to report to the Health Ministry and receive a booster shot if necessary.

A 39-year-old woman from central Israel was diagnosed with measles a week ago at Ichilov Hospital. Doctors have asked anyone who was in Ichilov's emergency room on March 24, 25 or 27 to go to their nearest Health Ministry office to find out whether they need an immunization or booster shot.

A student at Hebrew University in Jerusalem was diagnosed at the beginning of the month, leading campus authorities to warn all students who were not vaccinated to contact Health Ministry officials. The student who was diagnosed learns in the Department of International Relations.

A doctor at Hadassah Ein Kerem Medical Center in Jerusalem and a nurse attending a conference in Eilat were also both diagnosed with the virus. Both are employees of the Health Ministry. A source in the ministry reported that the doctor in question had not been properly vaccinated for measles, despite hospital protocol. He apparently had caught the virus from a patient, said the source.

There were fears that the two carried the virus into the emergency room with them when they returned to work on March 16.  Ministry officials again asked the public to report to their nearest offices if they had been in the hospital’s emergency room on that date and had not been vaccinated for measles.

Two weeks ago, the ministry announced it would speed up a program to vaccinate thousands of its workers against the virus. Officials explained that while all Health Ministry workers had been told that vaccines were recommended, some apparently had chosen not to accept the injections.

According to Health Ministry officials, approximately 900 cases of the illness have been reported since last August, 747 in the Jerusalem region alone.

Not Something to Ignore 
While measles is rarely fatal in healthy children, it is highly contagious and can kill. People living in the same household with someone who is sick with measles, and who have not been immunized, have a 90-percent chance of contracting the illness, according to KidsHealth.org site

In 2006, 242,000 children died of the disease worldwide, according to MedicineNet.

It is a virus that in most people produces fever, a rash lasting more than three days, cough, runny nose and red eyes. Complications can include pneumonia and a brain inflammation known as encephalitis.

Rubella, known as German measles, is rarely fatal but does cause birth defects. It can also cause miscarriage and fetal death.

Measles can cause complications when contracted by adults.  It can also be dangerous for people with weak immune systems, such as the elderly, the very young, those with chronic conditions or who are hospitalized with other illnesses, and people who are taking certain medications.

The World Health Organization reported three years ago that the number of deaths by measles and its close cousin, rubella – also known as German measles – had dropped 40 percent due to a United Nations immunization program in developing countries.

More than 150 million children had been vaccinated against the virus in the prior five years in order to reach that benchmark. Despite the achievement, however, a half-million children still die from the virus each year.

Measles Can Be, and Was Fatal in Jerusalem
In August 2004, a seven-year-old Jerusalem boy died of measles. It was later learned that his parents had not vaccinated him, or his siblings against the virus.

After the little boy was hospitalized with complications of pneumonia, his two sisters developed symptoms of the illness and were quickly given the vaccination. They were treated at home and survived.

During that outbreak, some 53 children in one religious-Hassidic community in Jerusalem fell sick with the virus. The rabbis of the community cooperated fully in calling on its members to vaccinate their children against measles.