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Vincent Iannelli, M.D.

Measles Outbreak in NYC - Who do we blame?

By March 18, 2014

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A measles alert posted on a home of a child with measles by the health department. - Photo by Buyenlarge/Getty ImagesA new article in The New York Times, "Measles Outbreak May Have Spread in Medical Facilities, a City Official Says," seems to imply that doctors and hospitals were to blame for the outbreaks because they didn't diagnose people quickly enough.

The article starts by saying that "a rare outbreak of measles in New York City may have been spread by the failure of medical workers to recognize the disease quickly enough and to quarantine patients so they would not infect others, a city epidemiologist said this week."

The article also describes the outbreak as "rare," even though they acknowledge that there was a very large outbreak with 58 cases of measles in New York City just last year. An outbreak that was started "by an intentionally unvaccinated 17-year-old who had returned from London."

So who is really to blame for this outbreak and the other measles outbreaks across the country that have already led to at least 71 cases?

Is it the doctors and hospitals who may not immediately suspect that a child with a fever or a fever and a rash (both very common) might not have a vaccine preventable disease that was declared eliminated in the United States before some of those doctors even started medical school?

It is important to keep in mind that the symptoms of measles begin with a high fever, cough, and runny nose, etc. It is not until the rash begins two to four days later that you might suspect measles, instead of the flu or other viral infection. It is likely that most people with measles first go to the doctor or ER in the initial stages with just a fever and more non-specific symptoms and not the more classic measles rash. That they end up returning another two or three times has less to do with not getting a specific diagnosis, as it is not unusual to leave the ER with a diagnosis of a viral infection, but just how serious measles can be.

So should we blame doctors and hospitals instead of encouraging more people to vaccinate their kids so that they don't continue to fuel these outbreaks and put the rest of us at risk?

Should we blame doctors and hospitals instead of encouraging people who refuse to vaccinate their kids to take precautions before heading to a doctor's office or hospital when they might have measles or other vaccine preventable disease?

Improving vaccination rates, especially among the clusters of vaccine refusers, is an easy way to stop these outbreaks. Creating an environment where we blame doctors and hospitals for not diagnosing people with measles quickly enough will just create a system where more people will need to be put into isolation when they go to the emergency room and more people will need to be tested for measles.

Get Educated. Get Vaccinated. Stop the Outbreaks.

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