Spread of Measles Heightens Concerns over Years-Old Vaccinations

Spread of Measles Heightens Concerns over Years-Old Vaccinations

County doctors report jump in calls, questions about the virus

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Measles symptoms include a fever and rash.

Maryland Department of Health

Concern among adults over contracting measles is surging in Montgomery County following reports of outbreaks of the virus in Maryland and areas of New York with large Orthodox Jewish communities, according to health professionals.

County health officials and physicians report a steady flow of inquiries from patients asking about the viability of the measles immunization, which some received decades ago.

Maryland has reported five cases of measles this year – all from the Pikesville area north of Baltimore, county health officials said.

“There has been a heightened suspicion with clinicians monitoring fevers and rashes, particularly in young folks,” county Health Officer Travis Gayles said. “Providers have called in to our office for further guidance.”

Recently county officials hosted a vaccine clinic at a Silver Spring synagogue where more than 276 people – primarily adults – were vaccinated.

“Due to the increased risk of cases in the state and New York, and guidance from the state health department, we held a [measles] vaccine clinic at the Young Israel Shomrai Emunah Synagogue,” Gayles said.

Rabbi Dovid Rosenbaum of the Young Israel synagogue said the vaccines were largely a precaution.

“The reason we had that clinic is because there were cases of measles in other orthodox communities,” Rosenbaum said. “We have a lot of travel between orthodox communities. We get together for holidays all the time. . . The vast, vast majority of our community follows regular vaccine schedules.”

The Centers for Disease Control reports 880 individual cases of the measles have been confirmed in 24 states as of May 17. The highly contagious virus can lead to serious health complications, such as pneumonia, brain damage, deafness and death.

“This is the greatest number of cases reported in the U.S. since 1994 and since measles was declared eliminated in 2000,” the CDC reported on its website.

The largest onset of recent measles cases originated in Orthodox Jewish communities, health providers said.

A Silver Spring physician said her office has been receiving phone calls since two weeks before Passover.

“We are getting many, many calls,” Dr. Ruth Kevess-Cohen of Cameron Medical Group said. “We have lots of patients who belong to this [Jewish Orthodox] community. They are worried they would be exposed.”

Some Orthodox Jews may be considered at greater risk because of cultural identities that insulate their community from modern secular society, including making them more susceptible to anti-vaccine propaganda, according to some doctors and scholars.

Health officials believe the return of the virus stems from people who have traveled abroad to areas where there are large measles outbreaks.

Kevess-Cohen said her practice is administering 10 measles vaccinations a week, but it’s not just her Jewish Orthodox patients that are expressing concern.

“[Other patients] heard measles is coming back and is in the area,” she said.

“Patients are calling in asking about their status,” Kevess-Cohen said. “It depends on a person’s age.”

Kevess-Cohen and other doctors said people born in 1957 or after should consider having a blood test to determine if they are immune to the measles.

“Persons born before 1957 are considered to be immune to measles, in general,” Kevess-Cohen said. “Back then measles were extremely common. There was no vaccine available. Most people either had a clinical case that was obvious or had a mild case and developed antibodies. That’s kind of the rule of thumb from CDC.”

Ira Berger, a physician with Rockville Internal Medical Group, said his practice has received at least 200 inquiries in the last two months following the New York outbreak.

“You should have had two shots as a child,” Berger said.

Berger said if a person has documentation that they’ve had at least two of the live vaccines, they are likely immune to the disease. But a “killed” vaccine that was distributed in the 1960s was not as effective.

“If you received a measles vaccine in the 1960s, you may not need to be revaccinated,” a CDC spokesperson said. “People who have documentation of receiving LIVE measles vaccine in the 1960s do not need to be revaccinated. People who were vaccinated prior to 1968 with either inactivated (killed) measles vaccine or measles vaccine of unknown type should be revaccinated with at least one dose of live attenuated measles vaccine. This recommendation is intended to protect those who may have received killed measles vaccine, which was available in 1963-1967 and was not effective.”

A member of the Montgomery County Medical Society, a professional organization,  said she believes the concerns have plateaued.

“In Montgomery County, the risk is low,” said Carolyn O’Conor, a doctor at Comprehensive Primary Care in Rockville. “We have a high vaccination rate. Eighty-eight percent of the cases nationally have occurred in very specific areas, none of which are Montgomery County. The cases in Maryland have [also] been concentrated in certain ZIP codes.

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