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In light of the measles outbreak in Lakewood, residents are concerned about their own wellbeing and that of their children. CHEMED has been inundated with calls from people seeking guidance on how to protect their families. The following are the most frequently asked questions. The guidance below has been approved for publication by Dr Jeffrey Kaminetzky, Director of Internal Medicine at CHEMED and Dr. Chaim Kaweblum, Director of Pediatrics at CHEMED.

What are the symptoms that most commonly indicate a potential case of measles?

Fever, cough, conjunctivitis (pink eye), and a rash which usually starts on the face and neck and spreads to the rest of the body - though not necessarily all of these symptoms are present in each patient.

If I have symptoms that may suggest measles, what should I do?

You must contact your provider - whether CHEMED or another practice - in advance before coming into the office, and tell them that you suspect a potential measles case. They will take precautions ahead of the visit to protect other patients from potential exposure. It is crucial that you see a doctor promptly, even if you were vaccinated.

How long is someone with measles contagious for?

As per the CDC "infected people can spread measles to others from four days before through four days after the rash appears"

Can one catch measles by coming in direct contact with a measles patient or their bodily fluid?

Yes. Measles can be transmitted through the air. The virus remains contagious up to two hours after the exposure, particularly if the area is indoors.

Is measles really that dangerous?

Approximately 30% of reported measles cases have one or more complications. Possible complications are Encephalitis (inflammation and swelling of brain), pneumonia or a subacute sclerosing panencephalitis (SSPE) a severe disease of the nervous system. Complications are most common among children under 5 years of age and adults 20 years and older. Measles illness during pregnancy results in a higher risk of premature labor, spontaneous abortion and low birthweight infants.

Is it safe for me to visit CHEMED?

Yes it is. We are working closely with the Department of Health and the CDC in order to implement protocols and procedures to minimize exposure of suspected cases. In addition CHEMED is taking steps to vaccinate as per the outbreak protocols of the New Jersey Department of Health and to administer vaccines to those who have not been adequately vaccinated.

Who needs to be vaccinated for measles?

Everyone born after 1957 requires vaccination in order to be protected from measles. The first MMR (Measles, Mumps, Rubella) shot is given at around 12 months, and the second MMR shot is given at around age 4. The first shot provides a 95% level of protection and the second shot raises it to 97%.

However during this current outbreak the Department of Health has modified the dosing schedule as follows:

Children 6 to 11 months of age should receive Dose #1 now, Dose #2 at 12 months of age at least 28 days after the first dose and Dose #3 at least 28 days after the second dose - there will be no dose needed at 4 years of age

Children 12 months of age and older who have not receive any doses of MMR should immediately receive a dose and receive Dose #2 at least 28 days after the first dose no dose will be needed at 4 years of age.

Children 12 months to 48 months who have had one dose of the MMR should receive should receive dose #2 immediately if it is at least 28 days after the first dose.

Teenagers and adults who do not have evidence of immunity against measles should get two doses of MMR vaccine separated by at least 28 days.

Who is most vulnerable to measles?

Obviously, anyone born after 1957 who was not vaccinated is at severe risk of exposure, especially when there are several cases in a particular community. Another vulnerable population are those whose immune systems are compromised either as a result of a disease, or due to immunosuppressant medications given to treat a disease. An immunocompromised individual has a higher risk, even if he/she has been vaccinated and should contact their primary care provider for further guidance during this outbreak.

I did not get vaccinated when I was supposed to. Can I be vaccinated now?

Yes, one can effectively receive the MMR vaccines at any age.

I was not vaccinated and am currently pregnant. What should I do?

Currently the CDC does not recommend that you receive the MMR vaccine while you are pregnant. Contact CHEMED's Women's Health Department or your OB/GYN immediately.

I do not know whether I was vaccinated.

Contact your childhood pediatrician. If that is not possible, or the physician does not have the necessary records, contact your primary care provider who will be able to order a blood test to see whether you are immune.

CHEMED is closely monitoring developments on the measles front in Lakewood and the surrounding areas. We are working closely with county, state and federal health authorities to take all appropriate action to protect our region's men, women and children. We will continually update the public in the event of any further developments.