Measles Outbreak Shows Even Vaccinated at Risk

A measles outbreak in Boston is showing how the global economy opens opportunities for one of the world's most contagious viruses. Disease detectives say a computer programmer from India brought the virus to Boston's tallest office tower. The outbreak reveals that millions of Americans in their 30s and 40s are vulnerable to measles, even though they were vaccinated years ago.

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LINDA WERTHEIMER, host:

This is MORNING EDITION from NPR News. I'm Linda Wertheimer.

STEVE INSKEEP, host:

And I'm Steve Inskeep. Good morning.

Next, we will report on a disease that is supposed to be, almost wiped out, in the United States. But worldwide, 30 million people come down with measles every year, and half a million people die of it. U.S. Public Health officials know that millions of Americans are still susceptible to measles, despite mandatory vaccinations. As NPR's Richard Knox reports, Boston is struggling to control an unusual outbreak.

RICHARD KNOX reporting:

Boston's run of cases, 14 so for, was touched off by a virus imported from India. It hitched a ride with a computer programmer in his early 30s who came to work at Investors Bank and Trust.

Dr. ANITA BARRY (Physician, Boston Pubic Health Commission): The person hadn't been feeling well, had had fever and some other symptoms; developed a rash.

KNOX: Dr. Anita Barry of Boston's Public Health Commission says the man went to a local hospital.

Dr. BARRY: Where a very astute nurse looked at the person and said, I think that's measles; and indeed it was.

KNOX: When Barry learned where the man worked, in the city's tallest building, the Hancock Tower, she was worried. Five thousand people work there. The Health Commission used the Internet and Podcasts to warn the workers.

Unidentified Man: This Podcast is being produced for employees and tenants of the John Hancock Tower to update them on the measles cases here in the City of Boston.

KNOX: The City set up a vaccination clinic at the building.

Dr. BARRY: Only about 30 people showed up at that initial clinic. And I wish there had been a lot more people show up. And the company might too, given the subsequent events.

KNOX: Soon six other measles cases appeared within the bank. Barry and her staff worked to make people understand that measles isn't trivial.

Dr. BARRY: We worry about things like development of pneumonia or inflammation of the brain: encephalitis. And in pregnant women, we worry about increased risk of spontaneous abortion and low birth weight babies. Also it's a miserable disease to get.

KNOX: Soon the virus had hopped a few blocks down the street, to a man in his late 30s, who works at the headquarters of the Christian Science Church.

Dr. BARRY: The Christian Science Church, of course, emphasizes healing through prayer and faith, and many of their adherents don't get vaccinated. So, we knew it was a setting where there were likely to be a lot of susceptible people.

KNOX: Investigators haven't been able to find any link between the Hancock Tower employees and the Christian Science case. But case number nine, a man who clears tables at two restaurants nearby, shows that the virus was circulating downtown. Case number 10 was a construction worker working on the 56th floor of the Hancock, with no known contacts among people at the bank. He's in his early 40s and that fits a pattern. The measles virus is mostly seeking out people born in the 1960s.

Dr. BARRY: I think this outbreak has illustrated a problem in the immunity of people in the United States. People born in 1957 or later, through the late 1960s, may well be susceptible to measles.

KNOX: Measles vaccines used then were not as effective. So 10 million Americans may be vulnerable even though they were vaccinated. That's a big opportunity for the measles.

Dr. ALFRED DEMARIA (Chief Infectious Disease Official, Massachusetts): It's actually more contagious than smallpox.

KNOX: Dr. Alfred DeMaria is Massachusetts Chief Infectious Disease Official.

Dr. DEMARIA: If I had measles and I coughed the measles virus in the air, and those droplets dried out and floated in the air, I could be out of this room for two hours and somebody who is susceptible could come into this room, breathe the air and develop measles.

KNOX: To get ahead of it, officials had distributed thousands of vaccine doses. And they've told at least 1,000 people to stay home from work for 16 days if they can't provide proof of immunity. Even so, measles has popped up in another downtown tower and in a woman in East Boston who was unvaccinated because she was born abroad. Area hospitals are on alert for more measles.

Last week, a man showed up at Milton Hospital, just south of Boston, with a fever. The next evening he came back with a rash.

Dr. JOSEPH RADUAZZO (Milton Hospital): He presented to our triage nurse with a high fever. From what we had from the physician, it was a rather typical rash for measles. Dr. Joseph Raduazzo says the hospital closed its emergency room.

Dr. RADUAZZO: And all the patients within the emergency room are counseled, as to the situation.

KNOX: Were people alarmed about this?

Dr. RADUAZZO: Well, I think so. Yes. Certainly, measles is something that we all thought was pretty much eradicated.

KNOX: Officials are waiting for tests to see if that patient has measles. Anita Barry, of the Boston Public Health Commission, expects more alarms, and false alarms, throughout the summer.

Dr. BARRY: I'll feel safe after we've had two incubation periods after the last case. So that would be 42 days after the last case.

KNOX: Meanwhile, officials advise Americans going abroad this summer to get measles shots if they aren't sure they're immune, especially if they're going to Germany to see some World Cup soccer. Lately, measles has struck more than 1,100 Germans.

Richard Knox, NPR News, Boston.

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