The increase in measles in Israel began in March, but three months ago it seemed that the numbers were slightly higher than usual. Now the local health center believes that the country is experiencing a serious epidemic of one of the world's most contagious diseases – the one that led to the death of an 18-month-old child last week.
The local situation is associated with a simultaneous, sharp increase in the incidence of measles in Europe, but here the disease can take over the "pockets" of unvaccinated people in some cities and surrounding areas.
What is measles?
Measles is caused by the virus from Morbillivirus family, and concerns only humans, not animals, unlike many other infectious diseases. Although an effective vaccine against it exists from the 1960s, the Oder is still common and is one of the most contagious diseases among all, with a 90% risk of infection among unvaccinated people. The virus is highly contagious because it can survive for a long time outdoors: when someone coughs, sneezes or speaks with this disease, infected droplets are sprayed in the air, which are then inhaled by other people. After infection, the virus attacks the immune system; They are usually incubated for 8 to 12 days before the onset of symptoms.
What are the symptoms?
Symptoms include high fever, runny nose, cough, red eyes and sensitivity to light. Four or five days after the appearance of these symptoms (which are common in many states), a dark red rash appears on the skin. It usually starts on the neck and spreads on the face, body and limbs.
The rash begins as single points, but often coincides with a rash covering large areas of the body. On the third day after the appearance of the rash begins to fade and begins to look like small, dense flowers squill plants – hatzav in Hebrew, that's why the Hebrew name for this disease is hatzevet. At this point the patient will generally start to feel better, although the progression of the disease changes in some cases.
What are the complications and risks?
In addition to being extremely contagious, measles are dangerous because there is no cure for it. The disease can damage the respiratory and nervous systems. One third of people with middle ear infections, diarrhea or keratitis. A rare complication that may occur up to 10 years after infection is a degenerative condition of the brain that causes serious and irreversible damage to the central nervous system, including mental deterioration and convulsions. One in 1,000 cases of measles is deadly.
Why is the epidemic now?
Measles are transmitted only among people, and because there is an effective vaccine to prevent this, the epidemic is solely human. However, if the vaccination rate in the population decreases, the collective immunity provided to unvaccinated individuals by all vaccinated individuals – known as "herd resistance" – decreases. Larger parts of the population are then exposed to this disease and the risk of exacerbating the disease increases.
The source of the current outbreak of the epidemic in Israel are outbreaks of last year in various European countries, in which there was also a decrease in the frequency of inoculations – countries that often visit Israelis, such as Italy, England, Ukraine and Romania. Since then, the number of cases in Europe has increased to 40,000, and more than 40 people have died.
But the situation did not come here because an unvaccinated person was infected abroad and brought home sickness. The overall measles invasion rate in Israel exceeds 95 percent – but there are a few densely populated communities and districts with significantly lower rates of vaccination. According to the Ministry of Health, in some districts 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 across the country: from 40 cases throughout 2017 to 1,334 cases this year.
Is this the first time Israel has faced such an increase in measles?
In the 1950s, before the vaccine appeared, thousands of cases were reported annually. Since 1967, When vaccination became part of the Ministry of Health's protocol, the number of cases decreased systematically to several dozen annually. There were still other epidemics. For example, in 2003, 60 Israeli youths contracted measles in two weeks, and one of them died. The last major explosion occurred in 2008, when in a few months there were 1,452 cases among unvaccinated people, mostly in the Jerusalem area.
How effective is the measles vaccine?
Like other vaccines, the measles shot has two objectives – to protect the person against infection and to prevent the spread of the disease and to protect endangered populations that can not be vaccinated for medical reasons. Two doses of the vaccine, which are part of the protocol, offer 97 percent protection against the disease. The shot is given at the age of one year and again at the age of 6, as part of a fourfold vaccine that includes rubella (German measles), mumps and chickenpox.
What does the Ministry of Health do when a case of measles is detected?
In recent months, the healthcare facility has monitored every case of infection, regardless of whether the patient was detected during a flight, in a hospital, at school or elsewhere. When symptoms appear and a case of disease is suspected, a patient's blood sample is sent to the laboratory to determine if measles are actually present; At the same time, medical teams are trying to locate everyone who has contact with this person and determine if he has been immunized and what is the state of his immune system. In many cases, the ministry of health or hospital doctors will call people exposed to preventative treatment, ie Vaccinated.
The race to identify each case became more intense as the disease spread. Doctors in Jerusalem, where there have been so many cases of measles, have difficulty keeping pace with the identification and treatment of patients. The Ministry of Health is concentrating its efforts on increasing the immunization rate in ultra-orthodox districts, extending the admission hours in the infant clinics at Tipat Halav. Natali's car was also handled to allow easier access to vaccination.
What other steps are taken?
The Ministry of Health has banned unvaccinated people from hospital wards considered to be particularly sensitive, such as neonatal units, intensive therapy, oncology, hemato-oncology, etc. In addition, the ministry is considering banning unvaccinated children from school and checks whether vaccines currently given to children under one year can be routinely administered after 9 months.
If someone who is not vaccinated is exposed to measles, can anything be done to reduce his intensity?
Yes, but you have to act immediately. Prophylaxis of first contact involves administering a live virus vaccine within 72 hours after exposure, but a person who can not get an active vaccine can get a passive vaccine that will produce antibodies against that disease within six days.
When should you vaccinate or update your vaccinations?
The Ministry of Health calls on adults who have never had measles and have never received two shots of a vaccine to get vaccinated. The vaccine should be given in two doses separated by at least four weeks. This recommendation does not apply to people born before 1956.
The ministry also advises parents who have received their first injection so that they do not wait for the second dose until they reach school age, but that the child will be vaccinated immediately, as long as four weeks have passed since the first dose. The Ministry also informs that people traveling abroad who have doubts about their immunity are vaccinated before leaving Israel, even though full implementation of the vaccine takes two weeks. If you are traveling with a child between the ages of 6 and 11 months, the child should receive the first photo before leaving.
People born in Israel in the years 1957-1977 are considered to be unvaccinated or only partially vaccinated, because during these years only one vaccination was given and not all of them were received. Such people should now be vaccinated.
Who should not be vaccinated?
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 the previous vaccine; someone who is sensitive to one of the components of the vaccine; and people whose immune systems are at serious risk.