So You Think It’s Measles…

General Information on Measles
Measles is a highly contagious virus, especially for children five years old or younger.

Measles Signs and Symptoms
The symptoms of measles (Rubeola) appear approximately 7 to 14 days after the person becomes infected. Measles usually starts with a high fever, cough, runny nose, and red, watery eyes (conjunctivitis). Two or three day after the person develops these symptoms, tiny white spots called Koplik spots may show up inside the mouth. Three to five days after onset of symptoms, a person can breakout in a rash. The rash usually begins as a flat, red spot. This rash shows up on the face at the hairline and it can spread downward to the neck, arms, legs, and feet. Small raised bumps can also appear on top of the red spot. Along with the rash, a person’s temperature can spike up to 104° Fahrenheit. The rash fades and the fever lowers after a few days. Most people completely recover, but complications can occur, such as pneumonia, an ear infection, encephalitis (swelling of the brain), or even death. Complications are more common in adults and very young children.

Transmission
Measles is a highly contagious virus. If one person is infected with the virus, 90% of those who are in close proximity to the infected person, and are susceptible, will become infected. The virus is in the nose and throat mucus of the infected person, so it spreads to others by a person coughing or sneezing. The virus can live for up to two hours on a surface where the person coughed or sneezed. A person can become infected when he breathes the contaminated air or touches the infected surface then he touches his eyes, nose, or mouth.

Infected people can spread the virus to others from four day before to four days after the rash appears.
The measles virus is not spread by animals.

Treatment and Vaccination
Currently, there are not any treatments that can get rid of the virus, but there are treatments that can make a person feel more comfortable. The best step to take is to get immunized and this could be done by getting the measles vaccine, which is part of the Measles, Mumps, and Rubella Vaccine (MMR). The vaccine is safe and effective. Children have the highest risk for developing the virus; they are the most vulnerable population. So, it is very important that parents get their children vaccinated against measles.

Two doses are recommended for people 12 months or older. The child should receive the second dose 28 days after the first dose. Infants between 6 and 12 months could be given the vaccine before their parents travel to areas of the world where the virus is common. Adults should make sure they are fully immunized.

Reporting Requirements of Measles for Ohio
If there is a case of measles, suspected case of measles, or a positive lab result, one must report the case to the local health department of where the patient resides right away via telephone.

If the patient’s place of residence is unknown, immediately call the local health department where the reporting health care provider or laboratory is. Local health departments are required to report the case to the Ohio Department of Health immediately.

Case Definition of Measles for the State of Ohio
The clinical case definition is an illness that has the following:
1. A generalized rash lasting for 3 or more days
2. Temperature of 101° F or more
3. Cough, Coryza (inflammation or irritation of the nose mucus),or conjunctivitis (red, watery eyes)

2015 Outbreak at Disneyland (California)
This January, 102 cases of measles in 14 states were reported. Most of these cases are part of the multistate outbreak associated with Disneyland in California. This one outbreak represents 92% of the measles cases that have been reported this year (2015). 42 cases were linked to an initial exposure at Disneyland, or Disney California Adventure Park in Anaheim, California, in December. These included five Disney employees.

Most of the people who contracted measles have been unvaccinated, or had not know if they were vaccinated.
Ohio is not one of the 14 states with a confirmed case of measles. However, Michigan has had a reported case of measles.
There were more adults in this outbreak then there had been in a typical outbreak.
17 states had less than 90% of children who had received at least one dose of the vaccine.

Resources:
CDC.gov/measles

Click to access measles.pdf

http://www.childrenshospital.org/conditions-and-treatments/conditions/measles-rubeola

Potassium Iodide (KI): What You Need to Know

Today, a press release was sent out from our department highlighting upcoming plans for distribution of Potassium Iodide (KI) in Jerusalem Township.  There have been many questions as to why we are distributing KI and if there is any need for concern– the answer is that we are required to provide individuals within the 10-mile Emergency Planning Zone with KI in the event of an off-site release of radioactive iodine from the nuclear power plant. The supply that was previously provided to those individuals has since expired and a new supply is required to be distributed. There is no need for concern. This is a routine event that we manage every 4-5 years.

We would like to take a few minutes to provide you with some general information about KI.

What is KI (potassium iodide)?

KI (potassium iodide) is a salt of stable (not radioactive) iodine that can help block radioactive iodine from being absorbed by the thyroid gland. This protects the thyroid gland from radiation injury. The thyroid gland is the part of the body that is most sensitive to radioactive iodine.

Individuals should take KI (potassium iodide) only on the advice of public health or emergency management officials.

KI does not keep radioactive iodine from entering the body and cannot reverse the health effects caused by radioactive iodine once the thyroid is damaged.

KI only protects the thyroid, not other parts of the body, from radioactive iodine. KI cannot protect the body from radioactive elements other than radioactive iodine—if radioactive iodine is not present, taking KI is not protective and could cause harm.

Table salt and foods rich in iodine do not contain enough iodine to block radioactive iodine from getting into your thyroid gland. Do not use table salt or food as a substitute for KI.

Do not use dietary supplements that contain iodine in the place of KI. Only use products that have been approved by the U.S. Food and Drug Administration (FDA).

How does KI (potassium iodide) work?
The thyroid gland cannot tell the difference between stable and radioactive iodine.

KI (potassium iodide) blocks radioactive iodine from entering the thyroid. When a person takes KI, the stable iodine in the medicine gets absorbed by the thyroid. Because KI contains so much stable iodine, the thyroid gland becomes “full” and cannot absorb any more iodine—either stable or radioactive—for the next 24 hours.

KI may not give a person 100% protection against radioactive iodine. Protection will increase depending on three factors.
• Time after contamination: The sooner a person takes KI, the more time the thyroid will have to “fill up” with stable iodine.
• Absorption: The amount of stable iodine that gets to the thyroid depends on how fast KI is absorbed into the blood.
• Dose of radioactive iodine: Minimizing the total amount of radioactive iodine a person is exposed to will lower the amount of harmful radioactive iodine the thyroid can absorb.

Who can take KI (potassium iodide)?
The thyroid glands of a fetus and of an infant are most at risk of injury from radioactive iodine. Young children and people with low amounts of iodine in their thyroid are also at risk of thyroid injury.

Infants (including breast-fed infants)
Infants have the highest risk of getting thyroid cancer after being exposed to radioactive iodine. All infants, including breast-fed infants, need to be given the dosage of KI recommended for infants.
• Infants (particularly newborns) should receive a single dose of KI. More than a single dose may lead to later problems with normal development. Other protective measures should be used.
• In cases where more than one dose is necessary, medical follow up may be necessary.

Children
The U.S. Food and Drug Administration (FDA) recommends that all children internally contaminated with (or likely to be internally contaminated with) radioactive iodine take KI unless they have known allergies to iodine.

Young Adults
The FDA recommends that young adults (between the ages of 18 and 40 years) internally contaminated with (or likely to be internally contaminated with) radioactive iodine take the recommended dose of KI. Young adults are less sensitive to the effects of radioactive iodine than are children.

Pregnant Women
Because all forms of iodine cross the placenta, pregnant women should take KI (potassium iodide) to protect the growing fetus. Pregnant women should take only one dose of KI following internal contamination with (or likely internal contamination with) radioactive iodine.

Breastfeeding Women
Women who are breastfeeding should take only one dose of KI if they have been internally contaminated with (or are likely to be internally contaminated with) radioactive iodine.

Adults
Adults older than 40 years should not take KI unless public health or emergency management officials say that contamination with a very large dose of radioactive iodine is expected.
• Adults older than 40 years have the lowest chance of developing thyroid cancer or thyroid injury after contamination with radioactive iodine.
• Adults older than 40 are more likely to have allergic reactions to or adverse effects from KI.

How is KI (potassium iodide) given?
The FDA has approved KI (potassium iodide) tablets that people can take by mouth after a radiation emergency involving radioactive iodine.
Tablets come in two strengths, 130 milligram (mg) and 65 mg. The tablets have lines on them so that they may be cut into smaller pieces for lower doses.

Taking a stronger dose of KI (potassium iodide), or taking KI more often than recommended, does not offer more protection and can cause severe illness or death.
It is important to consider the following:
• Children who are adult size (greater than or equal to 150 pounds) should take the full adult dose, regardless of their age.
• Adults should take 130 mg (one 130 mg tablet OR two 65 mg tablets).
• Women who are breastfeeding should take the adult dose of 130 mg.
• Tablets should be stored in a 59°F-86°F environment.

How often should KI (potassium iodide) be taken?
A single dose of KI (potassium iodide) protects the thyroid gland for 24 hours. A one-time dose at recommended levels is usually all that is needed to protect the thyroid gland.

In some cases, people can be exposed to radioactive iodine for more than 24 hours. If that happens, public health or emergency management officials may tell you to take one dose of KI (potassium iodide) every 24 hours for a few days.
Avoid repeat dosing with KI (potassium iodide) for pregnant and breastfeeding women and newborn infants.

Taking a stronger dose of KI (potassium iodide), or taking KI more often than recommended, does not offer more protection and can cause severe illness or death.

What are the side effects of KI (potassium iodide)?
Side effects of KI (potassium iodide) may include stomach or gastro-intestinal upset, allergic reactions, rashes, and inflammation of the salivary glands.

When taken as recommended, KI (potassium iodide) can cause rare adverse health effects related to the thyroid gland.

These rare adverse effects are more likely if a person:
• Takes a higher than recommended dose of KI
• Takes the drug for several days
• Has a pre-existing thyroid disease.
Newborn infants (less than 1 month old) who receive more than one dose of KI (potassium iodide) are at risk for developing a condition known as hypothyroidism (thyroid hormone levels that are too low). If not treated, hypothyroidism can cause brain damage.
• Infants who receive more than a single dose of KI should have their thyroid hormone levels checked and monitored by a doctor.
• Avoid repeat dosing of KI to newborns.

Be Informed!
During an emergency, stay tuned to local television and radio stations for the latest information.
Stay connected to the Toledo-Lucas County Health Department through social media and contact us.