Every parent wants their child to be in the best health they can be, so headlines about infectious diseases can understandably make moms and dads a little nervous.
In recent days there has been a lot of news coverage about measles, a disease declared eliminated from America in 2000. It's true that there is an outbreak of measles in New York state's Rockland County right now, but there's a lot to unpack behind the headlines and parents shouldn't panic.
Here are six things you need to know:
1. There are outbreaks, and a state of emergency, but not a national one
There is no national outbreak of measles in the United States right now, but there are outbreaks on both the east and west coasts. As of March 26, 2019, there are 153 confirmed reported cases of measles in Rockland County, New York.
Rockland County declared a state of emergency this week and banned unvaccinated kids from public places like schools, churches, restaurants, civic centers and shopping malls.
At a news conference on Tuesday, Rockland County Executive Ed Day explained why the county has taken this extreme measure.
"We believe this to be the first such effort of this kind nationally and the circumstances we face here clearly call for that," said Day. "Rockland will lead the way in service and safety to the people here."
The emergency declaration in Rockland County follows another outbreak in Clark County, Washington, near the Oregon border.
In Clark County, public health officials have identified 73 confirmed cases of measles since January 1, and 63 people who got sick are under 18. According to officials, 63 of the sick people were confirmed as unvaccinated. The vaccination history of 7 individuals hasn't been verified, and three people had one dose of the MMR (measles, mumps, & rubella) vaccine.
The last confirmed case of measles in Clark County was reported on March 18.
This is certainly cause for concern for public health officials, but it also isn't an unprecedented explosion of infected people.
According to the CDC, last year 349 people got measles in 26 states and the District of Columbia. "This is the second-greatest number of annual cases reported since measles was eliminated in the U.S. in 2000", the CDC notes.
In 2017, 118 individuals from 15 states got measles. In 2016 it was 86 people, and in 2015 it was 188. The greatest number of cases since measles was eliminated from America happened in 2014, when 667 people from 27 states caught it.
2. Eliminated doesn't mean immune
In 2000, measles were declared eliminated from America, "thanks to a highly effective vaccination program in the United States," according to the CDC.
To be considered eliminated, there needs to be "the absence of continuous disease transmission for 12 months or more in a specific geographic area".
Measles is no longer the constant threat that it was in the 1960s, when millions of people got measles each year and hundreds died, but while the disease has been eliminated in America, travelers bring it into the United States from countries that are still dealing with continuous transmission.
Measles is super contagious and can live for up two hours on surfaces, so if an infected person hangs out in an airport or another public place, unvaccinated individuals in the same space are likely to contract the illness.
3. Vaccination is recommended before travel
That is why the CDC recommends families get vaccinated against measles before doing any international travel.
Babies between 6 and 11 months old can get one dose of the vaccine if their family will be traveling. Breastfeeding moms can be vaccinated against measles, but pregnant women can't. The CDC recommends getting vaccinated before trying to get pregnant.
Kids over a year old who are going to be traveling internationally should get vaccinated, say the CDC and the World Health Organization.
4 . Vaccination is recommended even if you don't travel
Even if you're not planning on traveling any time soon, you never know when someone who has traveled might walk into your local shopping centre, airport or school and expose your community to measles.
That's why the American Academy of Pediatrics and the World Health Organization are urging parents to consider vaccinating kids. The WHO recently declared vaccine hesitancy ("the reluctance or refusal to vaccinate despite the availability of vaccines") as a threat to global health.
The 1998 research of former doctor Andrew Wakefield linking vaccines to Autism is often cited as the epicentre of vaccine hesitancy but has been debunked repeatedly.
Still, many parents just aren't sure if they want to vaccinate. It's totally normal to want to make sure that a vaccine is safe for your child, and to know the risks and benefits. That's why experts suggest concerned parents talk to their pediatricians about vaccination.
According to the American Academy of Pediatrics, "before the measles vaccine was available, every year an average of 450 people died from measles; most of them were healthy children."
The AAP states the measles, mumps and rubella (MMR) vaccine is very safe.
"Like any medicine, [the MMR vaccine] is capable of causing side effects but usually these are mild, such as pain or swelling at the injection site and a fever that lasts a day or two. The risk of the measles vaccine causing serious harm is extremely small. Getting the measles vaccine is much safer than getting the measles infection," the AAP notes.
5. Some communities are more at risk for measles
In Clark County the vaccination rate for measles is 84.5%, KATU News reports. According to infectious disease experts, that's just too low for so-called herd immunity to exist.
"To prevent outbreaks, we like to see immunization coverage rates above 90 per cent, and actually for measles, above 95 percent to really be able to stop transmission," Julie Bettinger, a professor at the Vaccine Evaluation Center of the University of British Columbia told Global News.
As the Washington Post reports, experts are worried that dipping immunization rates in some communities (like Clark County) are creating geographic pockets where the population is particularly at risk for measles and other contagious diseases.
According to a 2018 study in the journal PLOS, of the 18 states that permit non-medical vaccine exemptions for school children due to philosophical beliefs, 12 have seen an increase in unvaccinated kindergarteners in recent years. The study's authors also highlighted 15 metropolitan "hot spots" where more than 5% of kindergarteners are not vaccinated. Portland, which is very close to Clark County, is one of them.
6. Don't rush to the doctor
There are a lot of potential exposure sites related to the Clark County outbreak, mostly in Portland and Vancouver.
According to the CDC, measles typically begins with a cough, high fever, runny nose and red eyes, and a quarter of the people who get it need to be hospitalized.
If your family has been exposed to measles, don't rush to your doctor's office—call first so that your doctor can make special arrangements for you to be evaluated without spreading measles in the waiting room. Your doctor might be able to tell you over the phone whether your family is likely to be "immune to measles based on your vaccination record, age, or laboratory evidence," notes the CDC.
The bottom line is this: Parents shouldn't panic about measles outbreaks, but the WHO and the AAP do want to see more kids protected through vaccination.
[A previous version of this post was published August 21, 2018. The story has been updated.]