DOH: Be on alert for measles

COURTESY PHOTO Hawaii Department of Health State Epidemiologist Dr. Sarah Kemble.

The state Department of Health is advising travelers and residents to be on alert for measles.

International and continental U.S. outbreaks continue to increase and currently are affecting 16 U.S. states as of Feb.29, according to the DOH.


The DOH sent an advisory to physicians on Jan. 26 reminding health care providers to be vigilant.

“Hawaii has not experienced any recent outbreaks or spread of measles within the state, but infection can be just a plane ride away,” State Epidemiologist Sarah Kemble said in a statement. “Current outbreaks in the U.S. and abroad are a serious concern because of our popularity as an international and domestic travel destination and our frequent traveler resident population. Both groups have the potential to introduce and spread measles.”

The best way to prevent measles is to get vaccinated with the measles-mumps-rubella (MMR) vaccine.

The DOH encourages everyone to check their records and contact their health care provider if they need to be immunized. Before international travel or travel to areas experiencing a measles outbreak, infants ages 6 through 11 months should receive one dose of MMR vaccine. Children ages 12 months and older, as well as teenagers and adults without evidence of immunity, should receive two doses of MMR vaccine separated by at least 28 days.

MMR vaccination rates have dropped among children globally, nationally and in Hawaii since prepandemic years.

Based on recent data from the U.S. Centers for Disease Control and Prevention, Hawaii’s 2022-2023 kindergarten coverage rate is estimated to be 86.4%, which is nearly 10% lower than the 95% coverage level recommended for community protection.

Hawaii had the largest increase in nonmedical kindergarten vaccine exemptions nationally from 2021-2022 to 2022-2023.

“The decline in routine childhood vaccination rates is concerning for a potential measles outbreak in Hawaii,” said Kenneth Fink, director of health, in a statement. “Whereas unvaccinated and immunocompromised individuals can be protected by community immunity, we’re now below that threshold for measles putting this group at risk.”

Measles was declared eliminated in the United States in 2000, but remains a very contagious disease that is caused by a virus and can be serious. It spreads through the air when an infected person coughs or sneezes.

Measles starts with fever, followed by cough, runny nose and redness in the white parts of the eyes. Then a rash of tiny, red spots breaks out. It starts at the head and spreads to the rest of the body.

Measles can cause serious health complications, especially in children less than 1 year old, pregnant individuals and people who have a weakened immune system.

According to the CDC, one out of every 20 children with measles gets pneumonia, and one out of 1,000 develops encephalitis (swelling of the brain). Nearly one to three out of 1,000 children who become infected with measles will die from respiratory and neurologic complications.

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