Measles Outbreak An Unseen Risk for Some Cancer Patients

by Jane Ashley

You may be wondering why we are talking about measles and cancer. But the recent measles outbreak reminds us that measles is a potentially dangerous disease was thought to have been eliminated in the United States.

Highly Contagious

History of the Measles Vaccine

Measles was first identified in recorded history in the 9th century by a Persian doctor. In 1757, a Scottish doctor (Francis Home) discovered measles was an infectious disease carried in the blood of patients.

In 1912, measles officially became a notifiable disease in the U.S. During the first 10 years after measles was declared a notifiable disease, some 6,000 deaths in the U.S. were attributed to measles.

So most of us who are “Baby Boomers” had the measles as children. In the decade before 1963, virtually every child contracted measles before they were 15. Some 3-to-4 million children contracted measles every year — resulting in 400-to-500 deaths annually, almost 50,000 hospitalizations annually and 1,000 cases of encephalitis (swelling of the brain), a serious complication of the measles.

The first measles vaccine was developed in 1963. By 1968, an improved measles vaccine combined with mumps and rubella (known as MMR) became the standard vaccine and is still in use today.

By 2000, measles was declared “eliminated” (absence of continuous disease transmission for greater than 12 months) in the United States.
2019 Outbreak Facts

By early April, over 450 cases of measles have been reported to the Centers of Disease Control and Prevention (CDC).
Measles is HIGHLY contagious. That means that more than 90 percent of people who are not immune (because they had measles as a child or were vaccinated) will contract measles.

Measles is a serious disease, resulting in the hospitalization of one out of every four people who contract measles. There is no treatment — doctors can only treat the symptoms like ear infection (which can result in hearing loss), pneumonia and encephalitis.

The bad news is that measles can be spread up to four days before a person has symptoms.

Measles Is Contagious4 Days Before

Why are We Experiencing a Measles Outbreak?

Parents are refusing to have their children vaccinated. Reasons for not vaccinating include:
Will overwhelm child’s immune system
Vaccines contain toxins
Vaccines don’t work – comparing childhood vaccines to flu vaccines
Vaccines are a way for doctors and pharmaceutical companies to make more money
Vaccine side effects are worse than the disease
Vaccines cause autism
Violates parent’s rights
Against religious beliefs
Violates personal or philosophical beliefs

Because measles are communicable four days before symptoms, any unvaccinated child exposed in day care, kindergarten or school has a 90 percent chance of contracting measles.

Are Measles a Risk for Cancer Patients?

Some cancer patients are immune-compromised because of the treatments they had for their particular type of cancer. These patients are at extremely high risk.

Stem cell transplants. Stem cell recipients lose the protection they had from their past vaccinations. They have to be revaccinated, usually beginning about 6-to-12 months after the transplant. They have to delay some vaccinations that use a live virus for even longer. During this period before revaccination, they are vulnerable.

Bone marrow transplants. Bone marrow transplant patients can’t get the measles, mumps and rubella (MMR) vaccine for at least two years afterward. They are at high risk for serious complications if they contract measles.

Stem Cell Bone Marrow

Pediatric cancer patients. Children in active cancer treatment can’t receive their vaccinations until they are out of cancer treatment. A young pediatric cancer patient may have received that first dose of the MMR vaccine but is too young (less than four years old) to receive their second dose. A pediatric cancer patient may be a bone marrow or stem cell transplant recipient and lose the immunity from their first MMR vaccine.

Neutropenia. Patients with extremely low white counts should avoid any contact with someone who has measles and avoid crowds if their community has experienced a measles outbreak. Avoid contact with children (including your grandchildren) if they have recently received a live virus vaccine – MMR is a live weakened virus vaccine.

The Bottom Line …

Use good judgment.

Bone marrow and stem cell transplant patients need to be extra cautious; it’s probably best to decline invitations to events where there are lots of children. Be sure to talk to your transplant team about the risk of measles and the precautions you should take.

Be extra cautious if you are the parent or grandparent of a pediatric cancer patient.

What if you are exposed to a person with measles? If you are in active treatment for cancer, tell your oncologist immediately. They may give you measles immune globulin, a blood product containing measles antibodies that will help prevent measles from developing.

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