In 1978, the Centers for Disease Control (CDC) set a goal to eliminate measles from the United States by 1982. Although the goal of complete elimination was not met, widespread use of measles vaccine drastically reduced the disease rates and measles was declared eliminated (an absence of continuous disease transmission for greater than 12 months) from the United States in 2000. This elimination was possible thanks to a highly effective vaccination program and better measles control in the Americas region.1
Why has this goal of complete elimination never been met? Because measles is still common in other countries. The virus is highly contagious and can spread rapidly in areas where people are not vaccinated. Worldwide, an estimated 20 million people get measles and 146,000 people die from the disease each year—that equals about 400 deaths every day, or about 17 deaths every hour. 1
According to CDC, the recent efforts to improve hospital preparedness during the recent Ebola outbreak do have relevance for measles. First, recording travel history when a person presents with a febrile illness or rash is important to identify many infections common around the world. Second, we have learned from the Ebola and measles outbreaks that we need strong infection control measures in hospitals. It is vitally important that hospitals are diligent in protecting other patients and employees from the spread of the illness from infected patients.2
In the United States, there is a notable difference between protecting ourselves from Ebola versus measles. With Ebola, our best protection is to fight outbreaks where they originate. For measles, we have the ability to protect ourselves.
The measles vaccine is a safe and effective vaccine that has been given for more than 50 years. Between 2001 and 2010, a median of 60 cases of measles were reported in the U.S. annually, but in recent years, there has been a higher number of reported cases. In 2014, the U.S. reported 644 cases from 27 states. This year, from January 1 through February 20, 154 cases of measles have been reported to the CDC from 17 states.
The majority of people who got measles were unvaccinated and measles spread most rapidly when reaching a community in the U.S. where groups of people are unvaccinated. 3 In the most recent outbreak, an analysis of the cases in California showed about 20% of confirmed cases had been hospitalized.4
With measles still common in many parts of the world and travelers with measles continuing to bring the disease into the U.S., do you think hospitals could do more to protect their patients, employees and communities? The CDC reported that only seven states in 2012 had regulations that required hospitals to ensure employees are vaccinated with the measles/mumps/rubella (MMR) vaccine.5
Could hospitals create more urgency and take the lead to require employees be current on measles vaccination? Could hospitals be doing more to educate the public on the importance of protecting ourselves and our communities?
About the Author
Danielle Sebastian, PharmD, BCPS is a Pharmacy Clinical Program Manager with Pharmacy OneSource. Danielle has 13 years of hospital pharmacy experience with clinical practice experience in critical care, pain management and infectious disease. Danielle served for 9 years as the Pharmacy Clinical Manager at an acute care hospital in Montana and was responsible for transitioning from a pharmacy practice model focused on order entry to a patient-centered model focused on drug therapy management. These changes resulted in a significant increase in the interventions completed by pharmacists and a subsequent decrease in pharmacy supply expense.
Danielle is a member of the American Society of Health-System Pharmacists (ASHP), the American College of Clinical Pharmacy (ACCP) and has received a leadership award from the Montana Pharmacy Association and Society of Health-System Pharmacists. Danielle has contributed to published articles in the American Journal of Health-System Pharmacists and the Journal of Health-System Pharmacy Residents on her work in antimicrobial stewardship and implementation of a pharmacy clinical practice model.
Danielle earned her Doctorate of Pharmacy from the University of Montana College of Pharmacy. She is a Board Certified Pharmacotherapy Specialist with extensive Antimicrobial Stewardship training and certification through MAD-ID.