originally published on February 2, 2014 by the American Optometric Association
A recent measles outbreak—believed to have direct links to Disneyland and Disney California Adventure Park—has health officials and health care providers on high alert.
"The evidence is clear that vaccinations save lives and reduce suffering."
The disease outbreak, while concentrated in California, has affected 84 people in 14 states since January 1, 2015, according to the latest CDC data.
Preparing physicians for a measles outbreak
With measles cases on the rise, optometrists should know the signs and symptoms associated with the disease.
The most common ocular complication associated with measles is bilateral nonpurulent keratoconjunctivitis, according to David Ardaya, O.D., member of the California Optometric Association (COA).
Other early signs of measles include fever, buccal rash consisting of white spots, and the classic red, spotted rash that covers the body. Dr Ardaya adds that, in rare cases, ocular signs can extend to retinopathy including edema—both macular and nerve—as well as optic atrophy.
"Optometrists should look for measles-related systemic symptoms in viral conjunctivitis patients," says Dr. Ardaya, referring especially to ODs located in California.
The AOA has also created a toolkit that member ODs can use to educate their patients about conjunctivitis and the importance of good hygiene practices.
Emphasizing the importance of vaccinations
David Redman, O.D., COA Legislation-Regulation Committee chair, believes many people who choose not to vaccinate their children are misinformed. He encourages his patients to talk to him about immunizations, so he can dispel any misinformation they may have heard.
When speaking to parents and caregivers of children and young adults, Dr. Redman calls immunizations "the single most important health-promoting intervention we can perform as health care providers and they can perform as parents and caregivers."
The World Health Organization's strategy to eliminate measles includes a recommendation that all unvaccinated children receive the Measles Containing Vaccine (MCV) between 9 and 12 months of age as part of routine health services.
A second dose of MCV is suggested at 15 to 18 months of age or at school entry, because a single dose MCV will leave people unprotected and will not prevent large outbreaks.
As of January 21, 2015, the California Department of Public Health reported that vaccination status had been documented for 34 of the confirmed cases in the state—with 28 of the 34 being unvaccinated.
"As part of the overall health care team, optometrists should continue to advocate for parents and caregivers to have their children vaccinated," Dr. Redman says.
Dr. Ardaya agrees. "The best time to inquire about immunization status is during our case history. As a father of two young children, I realize this can be a touchy subject, but the evidence is clear that vaccinations save lives and reduce suffering."
In regards to the measles vaccination specifically, Dr. Ardaya suggests ODs educate patients on the importance of receiving two doses.
"Having two doses can reduce the chance of infection to one percent," he adds.
In addition, Dr. Redman noted that the COA would continue to support legislation that would give optometrists the authority to administer vaccines.