June 2019; Volume 8, Issue 6
Pedi Points - Tia Dickson, RN, BSN, Primary Children's Hospital
Measles, Mumps, Pertussis, Oh My!
We are seeing a surge in measles outbreaks across the country. Eighteen cases of mumps have been confirmed in Utah this year and whooping cough (pertussis) is also on the rise. These preventable and contagious diseases are making headlines and as caregivers you may be asked questions about these outbreaks.
Increased public awareness is a double-edged sword. Diagnosing measles is best done by providers who are very familiar with the clinical presentation and this often means children are referred to Primary Children's Hospital. IDEALLY THESE PATIENTS SHOULD NOT BE TRANSPORTED IN AN AMBULANCE UNLESS THEY ARE CRITICAL. Providers should not send patients suspected of having measles to a lab or ED unless you have discussed the situation with infection prevention and made a plan for isolation.
If you do find yourself transporting a patient with suspicious symptoms (discussed below) be sure you follow appropriate isolation practices to decrease the risk of exposure to you and everyone with whom your patient may come into contact. PPE is extremely important.
Preparedness and precaution is vital. These diseases are extremely contagious. Measles can stay in the air for as long as two hours after a patient leaves an area or ambulance. If measles is suspected immediately encourage the patient to wear a mask. If the patient cannot tolerate a mask, he or she should cover their mouth with tissue or a blanket. Call ahead to the hospital and request a negative pressure room (if available).
What is measles?
Measles is a highly contagious virus that lives in the nose and throat mucus of an infected person. It’s spread in the air by people coughing and sneezing or by touching a surface where droplets from coughs and sneezes have landed. The virus can live for up to two hours in the air where an infected person has been and 90 percent of those who are not immune will catch the illness when they are exposed.
How can I be protected from measles?
The best protection against measles is the measles-mumps-rubella (MMR) vaccine. The vaccine is safe and has been proven to be the most effective way to provide protection against all strains of measles.
Children should get two doses of MMR vaccine, starting with the first dose at 12 to 15 months of age and the second dose at 4 to 6 years of age, although the second dose can be given as early as one month after the first dose. Teens and adults should also be up to date on their vaccines. According to the U.S. vaccination schedule, the Centers for Disease Control and Prevention (CDC) considers people who received two doses of measles vaccine as children protected for life, and they generally do not need a booster dose.
The MMR vaccine can be administered by your local health care provider, some pharmacies, and your local health departments.
How long do measles outbreaks last?
The duration of a measles outbreak depends on the level of vaccination in the affected communities and how quickly contacts can be identified and quarantined. It’s important to stay at home for four days after the measles rash develops. Since the rash tends not to appear for 14 days after being exposed, those who have been exposed who are not immune can be infecting others without knowing they have the virus and need to limit their contact with others in order to prevent the spread of the virus.
The quicker a community becomes fully vaccinated, the faster the outbreak can be stopped.
Can I still get measles even if I've been vaccinated?
As long as you have a good immune system and you’re vaccinated, it’s very rare to get measles once you've had two doses of vaccine. One dose is 93 percent effective, two doses are approximately 97 percent effective. That means three out of 100 people who are fully vaccinated and are exposed to the virus will catch the disease compared with 90 out of 100 people who are not immune. The good news is fully vaccinated people who get measles tend to have a milder illness and are less likely to spread the disease to other people.
Is my child going to get measles?
If your child is not vaccinated and is exposed to someone with measles, they have a nine out of 10 chance of catching the virus.
What if I travel to a place having a measles outbreak?
If you travel to places having measles outbreaks and are in contact with others who may have measles such as in a plane coming from a place where measles is circulating, you have a greater chance of being exposed and catching measles. Your best option for protection is to get vaccinated against measles with two doses of vaccine before traveling.
Intermountain Blog Network What You Need to Know About Measles
Ask Our Doc
Happenings - EMSC Day was a huge success despite the drizzle
A Word From Our Program Manager - Jolene Whitney
My goodness Utah has experienced a wet and cool spring! I must admit I like cooler weather and I've enjoyed the temperatures and the vibrant green colors resulting from the rain. However, I realize the dangers we now face because of this extra moisture. Streams and rivers are flowing high and fast. Flooding is becoming a concern especially when we know the temperatures will rise and the mountain snow will melt adding to the already overflowing waterways.
Jeff Johnson, Safety Officer with the Division of Emergency Management, recently sent out a reminder about swift water safety. He warns “the longer the weather stays cool and/or wet, the greater the chance there is for higher flows when the snow does start melting.” Temperatures are expected to rise and the snowpack will be melting, resulting in water that will be ice cold. Not only is drowning a cause for alarm during this season but hypothermia can occur quickly and can incapacitate someone who has fallen into the water.
Please remind community members, family, and friends that the water can be deceptive. The current in just a few feet of water can cause instability. River banks can also easily give way with unseen water erosion. Stay away from river bends where the banks tend to become eroded.
Jeff reminds us that “any time you, your children, or your pets are recreating near a body of water, make sure you are wearing a personal flotation device such as a life jacket. Having a throw flotation device and a throw rope handy is also a good idea.”
If someone witnesses another getting swept away, do not jump in, unless you are well-equipped and professionally trained in water rescue. Look for something to reach out to the victim and call 9-1-1.
As you educate your community, remind them to “Stay Back, Stay Alive” and “Turn Around Don’t Drown.”
I hope you can enjoy the upcoming warm weather. Thank you for all you do in taking care of Utah’s children. Be prepared and be safe!
Pediatric Education and Trauma Outreach Series (Petos)
Monday, June 10th, 2-3pm
475 300 East
Salt Lake City, UT
Pediatric Respiratory Emergencies
presented by Zack Drapkin, MD, PCH Emergency Attending Physician
Pediatric lectures for EMS. Face time with PCH attending physicians. These lectures occur monthly on the 2nd Monday from 2-3 p.m. You may attend in person or watch the webinar. It will qualify for pediatric CME from the Utah Bureau of EMS and Preparedness. Access at https://intermountainhealthcare.org/locations/primary-childrens-hospital/classes-events/petos/
Essentials for Childhood Institute - Free Seminar
Wednesday, June 19th, 8:30am
500 Main Street
Salt Lake City, UT
Safe, stable, nurturing relationships and environments are essential to prevent child maltreatment and to assure children reach their full potential. Essentials for Childhood proposes strategies communities can consider to promote the types of relationships and environments that help children grow up to be healthy and productive citizens so they, in turn, can build stronger and safer families and communities for their children.
Essentials for Childhood is intended for anyone committed to the positive development of children and families, and specifically to the prevention of all forms of child abuse and neglect. Essentials for Childhood focuses on four goals and related activities. They are:
- Raise awareness and commitment to promote safe, stable, nurturing relationships and environments and prevent child maltreatment
- Use data to inform actions
- Create the context for healthy children and families through norms change and programs
- Create the context for healthy children and families through policies
Register at http://bit.ly/EfCInstitute
Looking for a PEPP Class?
EMSC Pediatric Education for Prehospital Providers
Register online at peppsite.org. Look up classes in Utah and find the one that works for you. Once you find the class, go to jblearning.com, and look up pepp als in the search tool. Purchase the number ($18.95). Return to peppsite.org to register for the class and follow the prompts.
If you have any questions, please email Erik Andersen at email@example.com or text/call 435-597-7098. Continue to watch the website for additional classes.
Emergency Medical Services for Children, Utah Bureau of EMS and Preparedness
The Emergency Medical Services for Children (EMSC) Program aims to ensure that emergency medical care for the ill and injured child or adolescent is well integrated into an emergency medical service system. We work to ensure that the system is backed by optimal resources and that the entire spectrum of emergency services (prevention, acute care, and rehabilitation) is provided to children and adolescents, no matter where they live, attend school, or travel.