The U.S. is experiencing the largest outbreak of measles in the last 25 years. It had been believed that any form of measles outbreak was eliminated due to the measles, mumples, and rubella (MMR) vaccination. In recent years, this is not the case. Some parents have been skeptical of getting their children vaccinated. However, we’re seeing more outbreaks now in the states. In combination with those that enter the country unvaccinated, there’s been a higher number contracting and spreading measles. In fact, there have been more than 1022 cases of measles reported in 2019 as of June 6, 2019. 13 cases reported in 3 NJ counties and 11 cases in Ocean County, NJ.

The Centers for Disease Control and Prevention have found the following:

1: 25% of people that get measles in the United States will be hospitalized.

2: 1 out of 1,000 people that have measles will experience brain swelling, which could further lead to brain damage.

3; A woman that has measles during her pregnancy could spread this to her unborn child, which may result in serious birth defects or spontaneous abortion.

Measles is highly contagious. Just one person with measles in a room will expose everyone to it. Additionally, it can linger in the air for up to 2 hours even after the patient leaves. It doesn’t matter if it’s in a dorm, school, church or waiting room, it can still spread quickly. That’s why it’s public health policy to get them quarantined until they can get properly vaccinated. According to Dr. Rudy Liddell, Council on Dental Practice vice chair, “Transmission can happen in any setting, including health care facilities. The council is very concerned about the health and well-being of patients and dental professionals during this rise of measles. We’ve responded by developing resources that answer frequently asked questions and provide direct links to credible resources.” People have been seeing this in popular vacation spots where the population is high.

How does this affect dental practitioners? When it comes to medical outbreaks, such as a rash or fever, they’re not held in a regular room, but in an isolated area. Also, measles can affect both adults and children. Good infection control still isn’t powerful enough to spot a virus from spreading. To combat this, here are some guidelines to help out.

First, if you aren’t in an infected area, you should still follow the same procedures as if you were there. It’s important to see the warning signs on patients that may be a precursor to them getting measles. Lookout for symptoms like a runny nose, coughing, and even rashes on exposed areas of the skin. Another thing to check for is Kopliks spots, because often these are the precursor to full blown measles. In this case, stop treatment and discuss the options with your patients. You can tell when it’s really taken effect when the measles have gone from the head to the lower parts of the body. It’s also necessary to do a follow up with your local health department.

Secondly, ask your health department for any precautionary methods that can be taken.

A few questions to ask include:

1: Is measles in your area?

2: Who should you contact in case there’s an outbreak?

3: Where should you send a patient that has contracted measles?

Lastly, if your practice is in a measles area, it’s important to let your patients that show symptoms of rash and fever, know that they need to reschedule. This is an important method to take. If you’re suspected of a case, then your practice is at risk. Also, the status of your practice may be under review from your local public health department. This is a potential liability that shouldn’t be ignored.

Dr. Lidell states, “The CDC recommends that health care providers ask patients to confirm their vaccination status by providing written documentation.” If any patients are found with it, you need to isolate them completely from all the other patients and staff. Make sure that the staff uses respiratory protection, like an N95 respirator or something that’s good in preventing airborne transmission.

The CDC reports that one dose of the MMR vaccine is 93% effective while the two dose method is 97% effective. There’s a specific age recommendation as far as getting the vaccine. Children should receive their first dosage of the MMR vaccine at the age of 1. The second dose should be when they’re around 4-6. Also, students who are going to a post high-school institution should receive two doses of the vaccine. If you were born on or around 1957 and have no evidence of getting vaccinated, you should receive at least a single dose. There are also different measures to take for those that travel internationally on a frequent basis.

At the end of the day, it’s all about being safe than sorry. Different practices should take the proper measures to help ensure patients’ safety and others.

Sources:

https://www.dentistrytoday.com/news/todays-dental-news/item/4772-dentistry-and-the-measles-epidem ic?fbclid=IwAR3m4oO9g9wlj19Y1xtpjVacDrVQnzIrUrr9CL0Ydw0R_EuLl3dFZqIQ9Hs

https://www.ada.org/en/publications/ada-news/2019-archive/may/council-on-dental-practice-provides- guidance-during-measles-outbreak

https://success.ada.org/en/practice-management/patients/infectious-diseases-measles

https://www.cdc.gov/measles/cases-outbreaks.html