Nearly 2 decades after measles was declared “eliminated” in the United States (US), we find ourselves in the midst of an unprecedented measles outbreak in the modern era of vaccination. As of July 25, 2019, a total of 1,164 active cases of measles have been confirmed in 30 states. As one of the most contagious human diseases, measles can lead to serious health complications such as pneumonia, encephalitis, and even death. Given its highly contagious nature, the measles resurgence has public health officials on high alert.

Once relegated to the history archives thanks to a widely effective immunization program, measles is an acute respiratory illness spread through coughing or sneezing. The virus can linger for up to 2 hours after an infected person leaves an area. Symptoms typically begin 1 to 2 weeks after a person becomes infected. High fever, cough, runny nose, and red/watery eyes are followed after a few days by the hallmark red rash. Patients are considered contagious from 4 days before and after the rash appears. It is so contagious that following exposure, about 90% of unprotected individuals will develop measles.

According to the Centers for Disease Control and Prevention (CDC), the measles outbreak has proliferated due to factors including international travel and unvaccinated individuals. Unfortunately, measles is common in many parts of the world, and Europe is experiencing an ongoing spike, which is contributing to the measles surge in the US. In late April 2019, the CDC reported that, of the 44 “imported measles” cases that came into the US this year, 34 cases were in primarily unvaccinated US residents traveling abroad. The majority of imported measles cases in the US have been from popular travel spots such as the Philippines, Ukraine, Israel, Thailand, Vietnam, and Germany. In June 2019, the CDC issued a Level 1 Global Measles Outbreak Notice, alerting US travelers to the current situation and reminding them to check their immunizations before traveling internationally. Regardless of destination, the CDC recommends visiting their “destinations” site to view valuable traveler’s health updates to safely plan for travel.

Insufficient measles vaccination coverage, the other culprit in this outbreak, has also been fueling US circulation of the disease. The majority of measles cases in the US have been among unvaccinated individuals. CDC statistics show that there are pockets of unvaccinated close-knit communities in certain US jurisdictions, such as in parts of New York, experiencing an outbreak. Measles spreads quickly through these populations, making it difficult to limit transmission. Personal and religious beliefs, complacency, and unproven risks thought to be associated with vaccines, are among the reasons behind vaccine hesitancy and avoidance, leading to undervaccination in vulnerable communities. Moreover, unfounded concerns regarding vaccines and autism, which have been refuted by scientific evidence, have also led to skepticism in select groups.

In the pre-vaccine era, an estimated 3 to 4 million people in the US contracted measles each year, resulting in significant deaths and hospitalizations. In modern times, a vaccine is the strongest weapon to combat measles. For best protection, 2 doses of the measles, mumps, and rubella (MMR) vaccine are recommended and are approximately 97% effective at preventing measles; 1 dose is roughly 93% effective. The MMR vaccine is part of routine childhood immunizations. Measles vaccine recommendations for all age groups, as well as for international travelers, are available on the CDC website.

The CDC deems a disease “eliminated” after 12 continuous months of no active transmissions. If the current outbreak, which started in New York in October 2018, is not contained by October 2019, the US risks losing its measles elimination status. Whether traveling abroad or enjoying a summer staycation, individuals and communities should guard against the measles virus. The best protection against the “21^st century measles outbreak” is immunization. Armed with awareness, education, and appropriate vaccinations, this preventable disease can once again be banished to the history books.

Disclaimer: The content in this blog article is not a substitute for professional medical advice. For questions regarding any medical condition or if you are in need of medical advice, please contact your healthcare provider.

“We are often asked in interviews what our most memorable experience has been as a pharmacist,” said Marc. “I used to have a go-to story I thought was amazing, but now that story has been replaced.”
Marc Ream
Clinical Pharmacist, Magellan Rx

This month, we’re celebrating our amazing pharmacists and the work they do to impact members at virtually every point along the patient-care continuum. Today we’re sharing a story from clinical pharmacist Marc Ream, who partnered with the commercial pharmacy team to go above and beyond the call of duty for a family in need.

Although he did not know it then, when Marc Ream took a call late on a Friday afternoon, he was about to experience what would become the most rewarding moment in his career as a pharmacist.

The call came from a mother with an urgent request for an oncology drug approval for her 10-year-old daughter, Jane.* Jane, who lives with Leukemia, needed a specific medication that is relatively rare and not easily accessible. The family was leaving on their long-awaited vacation the next day, so they needed the medication that same day. Marc quickly realized that  getting this medication to the member quickly would require collaboration with the prescribing oncologist, as well as with multiple parties including the health plan, account managers, technicians, pharmacists, physicians and the dispensing pharmacy.

Marc quickly went to work, placing a call to the prescribing oncologist to gather a comprehensive history on the young girl, as well as the necessary clinical rationale to make the approval. Typically, once a medication is clinically approved, the pharmacist’s job is complete and the prescription can be filled by a local pharmacy. However, this particular oncology drug was classified as a limited-distribution medication, typically dispensed only through mail-order facilities. Realizing that the family would not have time to wait, Marc contacted a specialty pharmacy in the area to try to come up with a quicker solution.

He reached out to the pharmacy’s lead oncology pharmacist and confirmed that the medication was in stock, and they conferenced in Jane’s physician to place the order.  Marc worked with the oncology pharmacist to schedule delivery of the medication to the family. When they called the mother to tell her the good news, they could hear the emotion and gratitude in her voice. Thanks to the swift and diligent work of many, Jane and her family were off on their dream vacation with this important medication in hand.

Thank you to Marc Ream and the commercial pharmacy team for this empowering story that shows just how passionate and committed we are to leading humanity to healthy, more vibrant lives.

*Details around the specific circumstances of this story have been changed to protect the identities of both Jane (not her real name) and her family.