Rachel C. Orscheln, MD The Importance Of Pediatric Immunizations April 16, 2015 Once upon a time, there was a Magic Kingdom…. Children and families from all over the world visited this magical place….. Unfortunately, an unwelcome visitor was also circulating… Measles Virus http://www.telegraph.co.uk/news/worldnews/northamerica/usa/10834778/Massive-dose-of-measles-virus-kills-cancer-cells.html Index Case • 11 y.o. unvaccinated child who had visited 2 theme parks in Orange County, CA was hospitalized with measles in December of 2014 Measles • Measles: RNA virus with 1 serotype – Transmission: By direct contact with respiratory droplets – Epidemiology: Incidence in the US is low, <120 cases/year, usually imported – Illness: Acute illness characterized by: • Fever • Cough • Runny nose • Conjunctivitis • Erythematous maculopapular rash • Koplik spots – Complications: pneumonia, otitis media, croup, diarrhea, encephalitis (1/1000 cases), death (1-3/1000 cases), SSPE (rare degenerative CNS disease) – Treatment: Vitamin A supplementation is associated with reduced morbidity and mortality Redbook, 2006 Confirmed Measles Cases by Date of Onset http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6406a5.htm?s_cid=mm6406a5_w#Fig Measles Cases by State and Year http://graphics.wsj.com/infectious-diseases-and-vaccines/ Most cases had NO documented measles vaccine • California cases: – 45% were completely unvaccinated • 67% intentionally unvaccinated for personal belief • 23% were too young to be vaccinated – 5% had one dose of measles vaccine – 7% had two or more doses of measles vaccine – 43% unknown vaccine history • Twenty percent of patients were hospitalized