Blue Promise: Should We Still be Concerned About The Measles Outbreak?

It's back to school season for families across Texas. This year, there's one immunization that is more important than ever. In this episode of Blue Promise, we discuss the impact of the measles outbreak with Dr. Philip Huang, Director of Dallas County Health & Human Services. 

You can listen to the complete discussion on Apple Podcasts  , SoundCloud  or wherever you listen to podcasts. You can also watch the video recording of this podcast on YouTube 

Blue Promise is a podcast and online video blog that aims to address complicated health issues with candid conversations from subject matter experts. New editions are published regularly and are hosted by Dr. Dan McCoy, President of Blue Cross and Blue Shield of Texas, and his co-host, Ross Blackstone, Director of Strategic Influence. 

Show Transcript

DAN: It’s back to school season for families across Texas and this year there's one immunization that is more important than ever. In this episode of Blue Promise, we'll be discussing the impact of the measles outbreak.  

Thanks for tuning into Blue Promise. I'm Dr. Dan McCoy. I'm the President of Blue Cross Blue Shield of Texas. Today I'm honored to have a public health expert here in the studio, Dr. Philip Huang, Director of the Dallas County Health and Human Service. Phil, thanks for being here.  

PHILIP: My pleasure.  

DAN: So, I have to tell you, when I went to medical school I kind of thought these diseases were eradicated in the United States so what happened? What's going on with measles? 

PHILIP: Well you know actually measles was declared eradicated in the United States in 2000. But you know the problem is there's these pockets of people not getting vaccinated. A lot of misinformation on social media. Things like that that are disseminating that maybe we don't need to get vaccines anymore. But I mean we're really a victim of our own success with that. You know people forget that before the measles vaccine was around it's estimated about three to four million cases of measles in the U.S. each year. Five hundred thousand reported a year and then 450 to 500 deaths due to measles every year. 

DAN: And this is due to a disease that we have a vaccine for? 

PHILIP: Exactly, it's entirely preventable and if you look at the data after 1963 when the vaccine was introduced I mean dramatic drops in cases and again in 2000, we declared it essentially eradicated. 

DAN: OK. So, let's get some misconception right out of the boat here. So, the virus hasn’t changed, right? It hasn't gotten resistant, right? This is solely because people are electing to either delay or deny vaccination. 

PHILIP: Right. It's preventable. I mean the vaccine is very effective.  

DAN: Does it last or does it wane after a few years? 

PHILIP: Yeah. The vaccine is there, it lasts, I mean you know you get two doses, it's estimated 97 percent efficacy and that lasts for life. 

DAN: It's not the fact that adults are getting it. This is really a mostly an issue with children. 

PHILIP: Well you know it's very transmissible, very communicable. And so, if someone who is susceptible is exposed to someone who has the disease. I mean it's estimated, 90 percent of people who are susceptible to or around someone who has it, would get infected. Even in a room you know a couple hours after the person has left. 

DAN: OK. So, what's going on? Why are people deciding not to get a vaccination? 

PHILIP: Yeah. Well again you know there's a lot of misinformation out there when social media, the internet and people forget you know why this is so successful. And like you've got a whole generation of parents and physicians and nurses even that have never seen you know what I was talking about. How bad a disease this was before the vaccine was here. So, they start to question, do I really need this? And then there was you know a false study that was out there linking the measles vaccine to autism, which has been entirely discredited and was retracted. Falsified data things like that but that story still is out there. 

DAN: So, it could still get shared in persistent social media?  

PHILIP:  Correct. 

DAN: As people go back to school, do the schools require vaccinations today to attend the public school? 

PHILIP: It is required in Texas. And so, we're in the middle of back to school right now as you know. It’s crazy because people wait till the last minute. But you're required to be up to date on your vaccinations. However, there are medical exemptions for actual medical reasons. But then there's also profoundly religious reasons and philosophical exemptions that are allowed. 

DAN: OK. So, when these diseases don't occur for a long time. And I'll be honest with, you know, as a dermatologist, I never saw measles within residency training because nobody had it. And later on, in my career I did see a few cases here and there that were sporadic mostly from people from foreign countries who came to the United States and weren't vaccinated. So, what are the signs and symptoms of measles? So, how would you know you have it? 

PHILIP: Yes, so usually it begins about ten to twelve days after exposure. Starts out you know nonspecific symptoms like fever, cough, red eyes, sore throat, sort of runny nose. And then you get a rash and starts at the hairline goes down the face and neck and then down to the rest of the body. 

DAN: Okay. So. all that sounds like oh, okay just a rash. But it's actually a pretty serious illness. 

PHILIP: Yeah. I mean that's where the complications can be: pneumonia, you know swelling of the brain and death. As I mentioned you know, we used to have about 450 to 500 deaths each year in the United States. 

DAN: That's crazy. So, earlier this year we had, it seemed like an epidemic. I don't know if I would call it that because I'm not an expert like you are. You can tell me if it was an epidemic or not. It seems to have slowed a little. Are we in the clear? 

PHILIP: You know we really don't know. Some of the outbreaks that have been seen across the country, the ones in Washington, New York have been controlled through public health efforts. But you know we don't know. A lot of it is where people who are not protected. They, as you mentioned, go to foreign countries where there is a lot of measles still around. You know I think we've seen in the Philippines, Ukraine, Israel, some of the people coming back from those areas. They get exposed and then come back and then if they're in a susceptible population then it spreads. 

DAN: I think you mentioned this before, but I want to make sure that the audience knows it. It sounds like to me though if you're an adult for sure, or even if you have children. If you have the vaccine, you're kind of OK. 

PHILIP: Exactly. I mean it's, this is preventable. You get two doses of the vaccine, then you’re protected. But you know there are some populations that legitimately can't or aren't protected whether it's children before the age when it's recommended to get the first dose and then other you know medical contraindications where there’s immunosuppression and things. So those people are susceptible. That's why a decision for someone to not get the vaccine doesn't just affect them, it also affects the people around them. 

DAN: OK. So that kind of leads into my next question. It sounds like to me that part of your job is of course correcting these big issues that are going on today. But I suspect you get asked a lot. OK. What's the future look like in the forecast? So, what's it look like? Does it look like we're going to have another measles outbreak anytime soon or any ideas? 

PHILIP: Well you know with these issues; this effort and education is really important. Because we all care about the you know the health of the children. And you know I think the parents who choose not to are getting this misinformation because out of sincere concern obviously for the health of their kids. But we need to be able to have the dialogue and explain that you know and really look at some of the misinformation and correct that. 

DAN: So, what are some of the efforts that your office is doing to help raise awareness around measles? 

PHILIP: We do have a lot of information on our website. We work on meetings with community groups. These sort of efforts, media messaging but then we also provide immunizations to populations that don't have access. You know what's nice is there's a lot more access to some of these, but you know we try to fill in the gaps 

DAN: So, we'll share this on our video portion of the website related to this blog. What's the website you tell people to go to if they wanted to find more information? 

PHILIP: You know, CDC at the federal level has great information. The Texas Department of State Health Services and then Dallas County Health and Human Services has some really good information.  

DAN: Phil, thanks very much for being here today and sharing some really important information about measles. Before we close, I want to remind our audience of another resource that's available. Families have different motives for declining vaccinations. It could be based on religious beliefs or personal conviction, but a lack of money should never be the reason. That's why we sponsor the caring Foundation of Texas Care Vans, which deliver thousands of vaccinations to Texans each year. You can learn more at Dr. Huang, thanks for being here and thanks for joining us for this episode of Blue Promise. 

PHILIP: Thank you. 


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