The increase in the number of measles cases in Israel began in March, but until three months ago it seemed that the figures were a little higher than usual. Now, the local health establishment believes that the country is suffering a serious epidemic of one of the most infectious diseases in the world, one that led to the death of an 18-month-old boy last week.
The local situation is related to a concurrent and abrupt increase in the incidence of measles in Europe, but here the disease can take hold in the "pockets" of people not vaccinated in certain cities and neighborhoods.
What is the measles
The measles is caused by a virus morbillivirus Family and affects only humans and not animals, unlike many other infectious diseases. Although there has been an effective vaccine against it since the 1960s, measles is still common and is one of the most contagious diseases of all, with a 90 percent risk of infection among non-vaccinated people. The virus is highly infectious because it can survive a long time in the open air: when someone with the cough disease, sneezing or speaking, the infected droplets are sprayed into the air, which are then inhaled by others. After the infection, the virus attacks the immune system; It is usually incubated for a period of between eight and 12 days before the symptoms occur.
What are the symptoms?
Signs and symptoms include high fever, nose, cough, red eyes and light sensitivity. Four or five days after the appearance of these symptoms (which are common to many conditions), a dark red rash appears on the skin. It usually starts on the neck and stretches face to face, body and limbs.
The eruption begins as individual spots, but these usually converge in an eruption that encompasses large areas of the body. The third day after it appears, the eruption begins to disappear and begins to resemble the small and dense flowers of the squire plant. hatzav In Hebrew, that is why the Hebrew name of the disease is Hatzevet. At this point the patient will usually begin to feel better, although the progress of the disease varies in certain cases.
What are the complications and risks?
In addition to being extremely contagious, measles is dangerous because there is no remedy for it. The disease can harm respiratory and nervous systems. A third of the patients will develop middle ear infections, diarrhea or cornea inflammation. A rare complication, which can emerge up to 10 years after infection, is a degenerative brain condition that causes serious and irreversible damage to the central nervous system, including mental deterioration and convulsions. One in every 1,000 cases of measles is deadly.
Why is there now an outbreak?
Measles is transformed only between humans and an effective vaccine to prevent it, the outbreak is exclusively artificial. If the immunization rate in a population falls, however, collective immunity provided to people not vaccinated by all people, vaccines, known as "flock immunity," is mined. The largest parts of the population are then exposed to the disease and increases the risk of a fire.
The source of the current outbreak in Israel is attributed to outbreaks last year in several European countries that also saw a drop in inoculation rates, countries that often visit Israelis, such as Italy, England, Ukraine and Romania. Since then, the number of European cases has slipped to 40,000 and more than 40 people were killed.
But the situation did not arise here because some non-vaccine person was infected abroad and led the disease back home. The overall measles inoculation rate in Israel exceeds 95 percent, but there are some densely populated communities and neighborhoods with much lower vaccination rates. According to the Ministry of Health, in some neighborhoods of Jerusalem, for example, the vaccination rate is only 55 percent. As a result, there has been an increase in the number of measles cases in the country as a whole: from 40 cases in 2017 to 1,334 cases in the coming year.
Is this the first time that Israel faces such a high increase in measles cases?
In the 1950s, before there was a vaccine, there were thousands of cases reported annually. Since 1967, when inoculation has become part of the Ministry of Health protocol, there has been a consistent drop in the number of cases to dozens per year. Even so, there were other outbreaks. In 2003, for example, 60 Israeli youth contracted measles within two weeks, and one of them died. The last big flare-up was in 2008, when in a few months there were 1,452 cases regarding unvaccinated people, most of them in the Jerusalem area.
How effective is a measles measles vaccine?
Like other vaccines, measles shot has two purposes: to protect the person from the infection and to prevent the spread of the disease and to protect populations at risk that can not be vaccinated for medical reasons. The two doses of the vaccine that are part of the protocol offer 97 percent protection against the disease. The shot is administered at the age of one year and again at age 6, as part of a quadruple vaccine that includes rubella (German measles), mumps and chicken pox.
What does the Ministry of Health do when a case of measles is discovered?
In recent months, the health establishment has controlled each case of infection, if the patient was discovered on a flight, in a hospital, at school or elsewhere. Once the symptoms are presented and a case of the disease is suspected, a sample of the patient's blood is sent to a laboratory to determine if the measles is actually present; At the same time, medical teams try to locate all those who came into contact with the person and determine if they were vaccinated and what is the condition of their immune system. In many cases, the Ministry of Health or the doctors of the hospital will summon the patients exposed to preventive treatment, that is to say, to be inoculated.
The race to identify each case has become more intense when the disease spreads. Doctors in Jerusalem, where so many cases of measles have been recorded, are having difficulty keeping pace with the identification and treatment of patients. The Ministry of Health focuses its efforts on elevating the immunization rate in the ultra-Orthodox neighborhoods by extending reception hours at the Tipat Halav baby welfare clinics. A vehicle belonging to the Natali healthcare service also conducted the rounds to allow easier access to vaccines.
What other measures are being taken?
The Ministry of Health has banned non-vaccinated people from the hospital departments that are considered particularly sensitive, such as neonatological units, intensive care, oncology, hemato-oncology, etc. In addition, the ministry is considering prohibiting non-vaccinated children from schools and verify that inoculation already given to children in one year can be routinely administered at 9 months.
If someone vaccinated is exposed to measles, can something be done to decrease their intensity?
Yes, but you have to act right away. Preventive care of the first remedy involves the administration of the vaccine against the virus alive within 72 hours of exposure, but someone who can not obtain the active vaccine can obtain a passive that will produce antibodies against the disease within six days.
When vaccinations should be vaccinated or updated?
The Ministry of Health is asking adults who never had measles and never got two shots from the vaccine to vaccinate. The vaccine should be administered in two doses of at least four weeks apart. This recommendation does not apply to those born before 1956.
The ministry is also advising parents who received the first shot so as not to wait for the second dose until they reach the school age, but for the child to be immediately inoculated, as long as they spend four weeks from the first dose. The ministry is also advising that people traveling abroad who are hesitated about their immunity are inoculated before they leave Israel, although it takes two weeks for the vaccine to take full effect. If you travel with a baby between 6 and 11 months of age, the child should receive the first shot before leaving.
People born in Israel between 1957 and 1977 are considered to be vaccinated or only partially vaccinated, since during those years only one vaccine was administered and not all were received. These people are advised to inoculate now.
Who should not vaccinate?
The Ministry of Health says that the following people should not be vaccinated: pregnant women; a person with high fever; a person who had an allergic reaction to a previous vaccine; someone who has a sensitivity to one of the components of the vaccine; and people whose immune systems are seriously compromised.