Oh, for all the things from yesteryear that are coming back again…

We’ve seen this from bell bottom jeans and vinyl records to Star Wars movies. In medicine, however, we’re seeing some infections making a return into the public and healthcare community’s eye.

Measles, also known as “Rubeola,” has been in the news lately because of its re-emergence—most notably in the New York City area. This recent outbreak has been strong enough to prompt the State of New York legislation to eliminate religious exemptions from immunizations.

Due to the efficacy of immunizations, many practitioners have not seen Measles, so here are some key points about the disease:

• Measles is a highly contagious virus spread via respiratory droplets and may remain infectious for 2 hours in an air space.
• Symptoms include the 3 Cs—cough, coryza, and conjunctivitis along with fever.
• Development of Koplik spots in oral mucosa.
• Followed by development of exanthema, a maculopapular erythematous rash that may grow together, typically starts from head down to toes.

If you receive calls regarding possible Measles, it is important to refer them to their health care practitioner for evaluation, diagnosis, and health department contact. Given the possible need for quarantine and to limit possible spread of the disease to others, it is preferred to call your health care provider’s office first for instructions.

Most health care practitioners will probably get calls regarding immunizations, and most patients will believe they have already had it, although they will not be able to remember or have their records handy.  Below are some key points about immunizations:

• If you were born before 1957, have had 2 doses of measles-mumps-rubella (MMR) vaccine, or have lab evidence of immunity/disease, you are presumed to be immune.
• For the prevention of Measles, one dose of MMR is 93% effective, and two doses are 97% effective.

If not certain of your status, blood work can be performed to prove immunity, or a single dose of MMR can be given.

Joseph Chow, MD, is the Adult Medical Director for AccessNurse and serves on the QI Committee where he oversees all call center quality improvement initiatives. He is board-certified in family practice and provides executive guidance to the clinical risk management programs.