More than 75 people, mostly young children, have gotten measles in the U.S. state of Minnesota. Nearly all were unvaccinated.
Measles is one of the most highly contagious diseases that exists. All it takes is a sneeze or a cough to spread the virus in tiny droplets through the air.
One person can infect up to 18 others. Each one of those people infects another dozen or so people, and it spreads from there.
Ninety percent of those exposed will get the virus, unless they have been vaccinated or have already had measles.
The measles virus can linger on doorknobs, tables, any surface for up to two hours. Touch it and you're exposed.
'Not a trivial disease'
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, says, "Measles is not a trivial disease. If you have a measles outbreak, a proportion of people are going to have serious complications."
The complications can be as serious as permanent brain damage. It can leave a child blind or deaf. Measles also kills.
Dr. Peter Hotez is a professor at Baylor College of Medicine. He's also the director of Texas Children’s Hospital Center for Vaccine Development.
Hotez told VOA, "In the pre-vaccine era, we had about 500 kids die of measles every year in the U.S. and 50,000 hospitalizations."
And that's not all. Dr. Flavia Bustreo at the World Health Organization says measles can have lingering consequences.
"Measles can lead to pneumonia, and a reduction in immune function for some time after the infection, so the child becomes weaker and more susceptible to other infections," Bustreo said.
The U.S. was declared measles free in 2000. Last year the World Health Organization declared the Americas measles free. This came after a 22-year campaign to eradicate this disease in both North and South America. The achievement was considered a historic milestone.
So, why, you could ask, have more than 75 people, mostly children, gotten measles in the Midwestern state of Minnesota?
All cases of measles in the Americas are imported. In Minnesota, the outbreak started among the Somali-American community and spread because this group had low vaccination rates for measles.
Minneapolis is an international hub where people arrive from countries around the world. As of now, no one knows the identity of the first patient with measles, whether it was someone visiting from abroad or if an unvaccinated American brought the disease home after traveling overseas.
Like most pediatricians in the U.S., Dr. Hope Scott counts herself lucky to have never seen a case of measles. "The kids who get measles are really, really sick. It’s a pretty big deal to get measles," she says.
The first signs of measles are a runny nose, cough and a fever followed by a blotchy rash that starts on the face and then spreads all over the body. Once the rash appears, the fever spikes.
An infected person can spread the virus to others about four days before the rash appears and for about four more days afterward.
About a third of the children who have acquired measles in Minnesota have been hospitalized. There is no treatment that can get rid of a measles infection, but doctors can treat the symptoms.
Patsy Stinchfield, a nurse practitioner who's overseeing care at Children's Minnesota, where these children have been treated, says they are exhausted and dehydrated when they arrive. But, she told VOA, that so far none of the children has suffered any complications.
The American Academy of Pediatrics has asked doctors to work with parents who are reluctant to get their children vaccinated.
Reston Town Center Pediatrics in Virginia allows parents to set up a delayed vaccine schedule for their children, to a point.
Scott says the practice will work with the parents until the child is about 2 years old. Then, if the child is not vaccinated and the parents don't have a plan to do so, Scott said the office sends them a letter saying their children can no longer be treated at the practice.
Measles is not just a childhood disease. Adults can get it, too, and adults are also at risk for complications.
The best protection is to get two doses of the measles vaccine. The Centers for Disease Control and Prevention recommends children get the first dose after their first birthday and the second when they are 4 to 6 years old. The two doses together provide 97 percent protection against measles.
Stinchfield said Children's Minnesota has a walk-in clinic for measles vaccinations. She said before the outbreak, about 500 children would get vaccinated against the virus in a week. Since the outbreak, 3,000 people of all racial and ethnic backgrounds get vaccinated each week.