Over a 99 % reduction in deaths was seen from the pre-vaccine era to 1981. Perhaps, the best way to evaluate the efficacy of measles vaccinations is the dramatic decrease in the number of cases since vaccine initiation and approval. Similar antibody and immunity response is seen in ProQuad ®. It is thought that most individuals experience permanent immunity to each virus. In addition, immunity occurs within 10 days and persists for at least 15 years. EfficacyĪfter administration of the measles vaccination via M-M-R ® II, antibodies are detectable in 95 % of patients in about 12 days. In 1971, the combined measles-mumps-rubella vaccine was licensed, with the combined measles-mumps-rubella-varicella vaccine following in 2005. The Edmonston–Enders strain provides a more attenuated strain that results in significantly fewer reactions than other strains. Multiple live attenuated strains of the vaccine have been licensed however, only the Edmonston–Enders strain remains available. While both the live attenuated vaccine and inactivated vaccines were available originally, the inactivated vaccine was withdrawn due lack of efficacy and the appearance of atypical measles in some recipients. The first measles vaccine was licensed in the US in 1963. M-M-R ® II is indicated for individuals 12 months or older, whereas ProQuad ® is indicated only for children 12 months through 12 years of age. Vaccination against measles is available in two commercially available vaccines, M-M-R ® II (Measles, Mumps, and Rubella Virus Vaccine Live) and ProQuad ® (Measles, Mumps, Rubella, and Varicella Virus Vaccine Live), both of which are manufactured by Merck & Co, Inc. The purpose of this paper is to describe the religious objections as they specifically relate to the measles vaccination. When the measles virus infects an individual in one of these unvaccinated communities it is highly transmissible and often spreads to all members. Many communities have made themselves particularly vulnerable to outbreak by choosing not to vaccinate for a myriad of reasons, most notably religious and philosophical. This high level of transmissibility underscores the need for continued vaccinations, especially among travelers entering parts of the world where measles remains endemic. The R 0 (basic reproductive number) has been reported to range from 11 to 18. The virus is highly contagious nearly anyone exposed to the virus without immunity will contract measles. Transmission of the virus occurs through the air via aerosolized droplets from breathing, sneezing or coughing. Infected individuals are considered contagious 4 days prior to the presentation of rash and continue to shed virus for 4 days following presentation of the rash. The incubation period is approximately 7–21 days long. In 2012, the infection was responsible for an estimated 1,22,000 deaths worldwide. Serious complications associated with measles occur more frequently in pediatric and elderly populations. Secondary complications include ear infections, pneumonia, encephalitis and in the most severe cases death. The characteristic measles rash usually appears 14 days after the individual is exposed to the virus. Symptoms of the infection include fever, cough, runny nose and conjunctivitis which are then followed by a rash that can appear over the entire body. There are several immunoglobulins that can be tested for in the blood to confirm a measles case. The virus is a single stranded RNA virus whose only natural host are humans it is a member of the genus Morbillivirus which is part of the Paramyxoviridae family. Measles, or rubeola, is an extremely contagious acute respiratory disease that is caused by the measles virus. Individuals traveling from endemic regions of the world import the virus while they are still contagious and introduce it to others. A majority of the US outbreaks occurring in 2014 were imported from the Philippines where the disease is still endemic. In 2014, the US has experienced the largest amount of measles activity since the elimination of the virus with 18 different outbreaks and 592 cases officially reported as of Aug. However, due to international travel and the global economy the measles virus has been imported to the US from endemic areas of the world, leading to sporadic outbreaks especially among unvaccinated populations. Due to aggressive vaccination programs measles has not been an endemic disease in the United States (US) since 2000.
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