In light of the measles outbreak in Lakewood, residents are concerned about their own wellbeing and that of their children. CHEMED has been inundated with calls from people seeking guidance on how to protect their families. The following are the most frequently asked questions. The guidance below has been approved for publication by Dr Jeffrey Kaminetzky, Director of Internal Medicine at CHEMED and Dr. Chaim Kaweblum, Director of Pediatrics at CHEMED.
What are the symptoms that most commonly indicate a potential case of measles?
Fever, cough, conjunctivitis (pink eye), and a rash which usually starts on the face and neck and spreads to the rest of the body – though not necessarily all of these symptoms are present in each patient.
If I have symptoms that may suggest measles, what should I do?
You must contact your provider – whether CHEMED or another practice – in advance before coming into the office, and tell them that you suspect a potential measles case. They will take precautions ahead of the visit to protect other patients from potential exposure. It is crucial that you see a doctor promptly, even if you were vaccinated.
How long is someone with measles contagious for?
As per the CDC ”infected people can spread measles to others from four days before through four days after the rash appears”
Can one catch measles by coming in direct contact with a measles patient or their bodily fluid?
Yes. Measles can be transmitted through the air. The virus remains contagious up to two hours after the exposure, particularly if the area is indoors.
Is measles really that dangerous?
Approximately 30% of reported measles cases have one or more complications. Possible complications are Encephalitis (inflammation and swelling of brain), pneumonia or a subacute sclerosing panencephalitis (SSPE) a severe disease of the nervous system. Complications are most common among children under 5 years of age and adults 20 years and older. Measles illness during pregnancy results in a higher risk of premature labor, spontaneous abortion and low birthweight infants.
Is it safe for me to visit CHEMED?
Yes it is. We are working closely with the Department of Health and the CDC in order to implement protocols and procedures to minimize exposure of suspected cases. In addition CHEMED is taking steps to vaccinate as per the outbreak protocols of the New Jersey Department of Health and to administer vaccines to those who have not been adequately vaccinated.
Who needs to be vaccinated for measles?
Everyone born after 1957 requires vaccination in order to be protected from measles. The first MMR (Measles, Mumps, Rubella) shot is given at around 12 months, and the second MMR shot is given at around age 4. The first shot provides a 95% level of protection and the second shot raises it to 97%.
However during this current outbreak the Department of Health has modified the dosing schedule as follows:
Children 6 to 11 months of age should receive Dose #1 now, Dose #2 at 12 months of age at least 28 days after the first dose and Dose #3 at least 28 days after the second dose – there will be no dose needed at 4 years of age
Children 12 months of age and older who have not receive any doses of MMR should immediately receive a dose and receive Dose #2 at least 28 days after the first dose no dose will be needed at 4 years of age.
Children 12 months to 48 months who have had one dose of the MMR should receive should receive dose #2 immediately if it is at least 28 days after the first dose.
Teenagers and adults who do not have evidence of immunity against measles should get two doses of MMR vaccine separated by at least 28 days.
Who is most vulnerable to measles?
Obviously, anyone born after 1957 who was not vaccinated is at severe risk of exposure, especially when there are several cases in a particular community. Another vulnerable population are those whose immune systems are compromised either as a result of a disease, or due to immunosuppressant medications given to treat a disease. An immunocompromised individual has a higher risk, even if he/she has been vaccinated and should contact their primary care provider for further guidance during this outbreak.
I did not get vaccinated when I was supposed to. Can I be vaccinated now?
Yes, one can effectively receive the MMR vaccines at any age.
I was not vaccinated and am currently pregnant. What should I do?
Currently the CDC does not recommend that you receive the MMR vaccine while you are pregnant. Contact CHEMED’s Women’s Health Department or your OB/GYN immediately.
I do not know whether I was vaccinated.
Contact your childhood pediatrician. If that is not possible, or the physician does not have the necessary records, contact your primary care provider who will be able to order a blood test to see whether you are immune.
CHEMED is closely monitoring developments on the measles front in Lakewood and the surrounding areas. We are working closely with county, state and federal health authorities to take all appropriate action to protect our region’s men, women and children. We will continually update the public in the event of any further developments.
Does anyone know if Dr. Shanik agrees that a child above 18 months should receive the second dose?
I would like to offer a side comment to the first sentence, although not related to measles: “Residents are concerned about their own well being and that of their children.”
There is a tendency to focus on what to do AFTER a child (or adult) gets sick. It may be prudent to equally focus on what can be done to avoid getting sick, b’ezras Hashem. Here are some suggestions for both adults and children:
1. Wash hands with soap and water before eating a meal or a snack.
2. Make sure that all shuls, schools, and other locations have soap dispensers filled with soap.
3. Avoid eating and drinking items loaded with sugar and artificial coloring as much as possible. Sugar weakens the immune system and thus makes it harder for the body to fight germs and viruses that come its way. Of course, it is very hard to eliminate all the unhealthy nosh, but limits can be set and followed. And there are plenty of healthy nosh alternatives available that can be given instead.
4. Schools, teachers and camps should not be giving out candy, lollipops, etc (especially with artificial food coloring) as a reward or prize. It is giving the wrong message to children to give them something that could harm their health. Instead give them stickers and the like. (Grandparents can do the same!)
5. Kiddushim, simchos, birthday parties, etc. should not be over-inundated with these unhealthy nosh items. Kids do not have limits at these occasions and it is hard for parents to control what their kids put into their mouths. Offer more healthier nosh alternatives instead.
6. Simchos Torah is another occasion where things get out of hand in this regard. Try to limit the unhealthy nosh items that go into those bags.
7. Eat more fruits and vegetables that are so vital to good health.
8. Do some research on which food items boost the immune system. Again, with a strong immune system, a body can better fight germs and viruses that it can come into contact with, b’ezras Hashem.
(Some immune-boosting foods are: almonds, greek yogurt, sunflower seeds, kiwi, green tea, papaya, red bell pepper, citrus fruit, broccoli, garlic, ginger, spinach, turmeric.
9. You can also give yourself and your children vitamin c and vitamin D3, as well as elderberry with sambucus – all available from kosher vitamin companies (try to avoid sugar substitutes in the ingredients).
10. Drinking ginger tea every day (with some lemon and honey to mask the taste) is a great way to boost the immune system. You can make this tea from fresh ginger (boil up peeled, cut-up pieces in some water) or from ginger powder (put into boiled water). You can add it to your children’s beverage (or ice-pops) in a small amount so they won’t even know it is there!) or you can just sprinkle some ginger powder into their drinks in a small amount and they will not even taste it!
11. Getting the right amount of sleep is also helpful to staying healthy.
12. Use your seichel! What goes into your body can either harm you or help you..make the right choices! The more people that make this the norm, the more others will follow. (Just like we guard ourselves from harmful spiritual things, we should do the same with physical things.)
Anyone want to offer some more tips for staying healthy? Of course, davening to Hashem is number one !!
#1 get vaccinated*** get your children vaccinated
that is #’s 1-99
LK
I just thought of a very good idea how to find out if Dr shanik agrees . It really took a lot of thought and time to figure this idea out so I hope you use it
CALL HIS OFFICE!!!
I was at Pediatric Affiliates today and was told that as per the instructions from Dr. Shanik, my 13 month old who got the first dose of MMR today should come back in 28 days for her 2nd dose.
IZZY,
I have been trying to get through for the last 24 hr and have not gotten through yet. Due to the measles outbreak
Been trying to reach Dr Shanik office all morning to get my 19 month old’s vaccination records and check if she needs 2nd dose and can’t get thru!