Physician associations urge vaccination, preparation against measles outbreak

In response to the 102 cases of measles reported across 14 states as of Jan. 30 — largely stemming from the outbreak in Disneyland resort theme parks in December — the American College of Physicians and the American College of Emergency Physicians have released statements emphasizing the importance of vaccination and measles prevention strategies.

In particular, boosting immunization compliance among vaccine-hesitant populations represents a significant challenge for public health officials as vaccine refusal and delay have been associated with increased risk for measles and pertussis outbreaks, as well as higher individual risks for measles, pertussis, varicella and pneumococcal infections.

“The American College of Physicians expresses its full support for the evidence-based recommendations of the Advisory Committee on Immunization Practices and the Centers for Disease Control and Prevention regarding immunization against measles, rubella and mumps (MMR),” David A. Fleming, MD, MS, president of the ACP, said in a press release. “The scientific evidence clearly supports the benefit of the MMR vaccine and the lack of any association with autism.”

David A. Fleming

In 2014, the United States experienced a record number of 644 measles cases across 27 states, according to the CDC’s National Center for Immunization and Respiratory Diseases — the highest incidence of cases since endemic measles was eliminated in the US in 2000.

The CDC said the ongoing multistate outbreak also highlights the importance of health care providers in response to measles cases and outbreaks, especially less experienced physicians who have never witnessed a case of measles and may not initially consider the diagnosis in a clinically compatible case.

“ACEP has notified all of its members to be on alert to identify measles cases,” Michael Gerardi, MD, president of ACEP, said in a press release. “As is typical in the winter, we see many patients with fevers — some have flu and this year, some will have measles. We are equipped to identify, isolate and treat measles patients and provide valuable information to the relevant health agencies.”

The CDC has advised all health care professionals to consider measles when evaluating patients with fever, rash and other measles-related symptoms, especially among patients who may not be eligible for MMR vaccination due to immunosuppression or age. Parents are encouraged to consider these children in addition to their own when making vaccination decisions.

“Physicians have a duty to provide the best care for their patients, as well as to protect the public health,” Fleming said. “At the same time, the profession has a duty to advocate based on accurate scientific data. Patient/parent autonomy is not absolute when it has the potential to compromise both individual and public health. Thus, we urge all Americans to embrace the sound preventive medicine practice of both routine pediatric and adult immunizations.”