As measles extend throughout the country, sick children and adults are exposing other patients, including newborn babies, when they look for attention in hospitals, pediatric offices and urgent care centers.
To help control measles spread, one of the most contagious viruses in the world, medical experts say that people with suspicious cases should take precautions before visiting the office of a doctor or the emergency room.
“I never want to dissuade anyone to seek attention,” said Dr. Alison Haddock, president of the American Emergency Medical College. But “measles is very contagious and it is dangerous to expose others.”
Entering a crowded clinic or emergency department, especially without a mask, can infect others in the waiting room, including pregnant, medically vulnerable or immunocompromised patients, said Dr. Ari Brown, a pediatrician in Austin, Texas and spokesperson for the American Academy of Pediatrics. A boy not vaccinated with measles, who had been infected while traveling abroad, caused an outbreak in San Diego in 2008 that included children in the waiting room of the office of a pediatrician.
“If you have any concerns” about being infected with measles, “not only present in the pediatrician’s office. Not only does it appear in the emergency room,” Brown said. “Call first to be prepared.”
Until Friday, the United States has seen more than 500 measles cases in at least 20 states and Washington, DC since the beginning of the year. Most are found in Texas, where an outbreak on the western edge of the state has grown to 400 cases and has shed New Mexico and Oklahoma. Two people have died, including a 6 -year -old girl.
While any person who is not vaccinated can be infected with measles, patients in hospitals and clinics can be especially vulnerable to complications, especially if they are pregnant, immunocompromised or fragile health, Brown said. The measles virus can survive in the air for two hours after an infected person leaves the room, according to the centers for disease control and prevention.
Dr. William Schaffner, an expert in infectious diseases at the Medical Center of the University of Vanderbilt, suggested to alert ER staff that someone with measles is on their way.
Schaffner also advised people to bring a second adult to the emergency room together with the patient. While an adult waiting outside the building with the patient, the second adult should enter, notify the emergency room and discover what precautions take before bringing a potentially infected patient inside.
ER personnel may need time to prepare an isolation room for someone with measles. These rooms have specialized air flow and filtration systems to prevent viruses in the air from deviating in public areas, Haddock said.
However, given the overcrowding in most ER, “staff may need to reorganize patients so that this room is available to you,” said Haddock.
Measles patients and family members or caregivers should wear masks when they are in any medical care center, Haddock said. ER staff can ask people with measles to enter through a special door, such as Ambulance Bay, to reduce the risk of exposing other patients.
Few primary care practices have insulation rooms, also known as negative air pressure rooms, Brown said.
Doctors may prefer to see people with suspicious cases of measles by Telesalud. Other doctors can choose to see patients in parking, a common practice during Covid pandemic, Brown said. Alternatively, doctors can see patients with suspicions of measles infections at the end of the day, after other patients have abandoned the clinic.
Even mild measles cases can make people feel miserable.
“It’s not just a normal fever and an eruption,” said Dr. Paul Offit, director of the Vaccine Education Center of the Children’s Hospital in Philadelphia. “These children are sick.”
About 20% of people who obtain measles are hospitalized. In children, the most common causes of hospitalization are pneumonia or dehydration, caused by diarrhea, said Offit.
There is no specific measles treatment, according to Offit, apart from support care, such as fluids and medications for fever reduction. Antibiotics do not help a measles infection because it is caused by a virus, although doctors can prescribe antibiotics for children who develop secondary bacterial infections. Doctors recommend that children rest a lot. Children can feel better in a dark room, because measles can make them sensitive to light.
Although many children with measles can be treated safely at home, parents should call a doctor if their child seems breath or dehydrated, said Offit. It is easy for children with fevers to dehydrate, especially if they have diarrhea and cannot drink enough liquids.
Offit, who has treated many measles patients, said it has diagnosed the disease based on symptoms, which include fever, cough, nose that are, pink eye, sensitivity to light and white spots inside the mouth. However, many younger doctors have never seen measles and can lose diagnosis. Doctors can make a definitive diagnosis with a blood analysis or when hitting the nose or throat of patients. You can take several days to recover the results of a public health hospital or laboratory.
Brown points out that many people do not realize that they have measles and can believe that they have a bad flu case. That is because the characteristic eruption of red measles does not appear for four days after the symptoms begin. The eruption follows a pattern, which begins in the face in the hair line and gradually extends through the body. People are contagious for four days before the eruption appears and four days later; Patients should stay at home during this time to avoid infecting others.
Because measles has a long time incubation, uncompassed people can reduce their measles risk by obtaining a vaccine within 72 hours after exposure, Offit said. Measles vaccines are extremely effective, with two doses that prevent 97% of infections.
