Falling vaccination rates
疫苗接種率下降
Vaccination rates in the US also remain low, particularly among children, according to American Academy of Pediatrics spokesperson Dr. Christina Johns, a Maryland-based pediatric emergency physician at a PM Pediatric Care urgent care.
About 92% of US children have been vaccinated against measles, mumps and rubella (called the MMR vaccine) by age 2, according to a 2023 report from the CDC – below the federal target of 95%.
據美國兒科學會發言人博士稱，美國的疫苗接種率仍然很低，特別是在兒童中。 克里斯蒂娜·約翰斯，位於馬裡蘭州的兒科急診醫生，在PM兒科護理緊急護理。
根據疾控中心2023年的一份報告，大約92%的美國兒童在2歲時接種了麻疹、腮腺炎和風疹疫苗(稱為MMR疫苗)——低於95%的聯邦目標。
The percentage of kindergartners who got their state-required vaccines for measles also remained below the federal target for the 2022-23 school year, according to CDC data. And the rate of vaccine exemptions for children has reached the highest level ever reported in the US.
Children should get two doses of the MMR vaccine, according to the CDC: the first dose at 12 to 15 months of age and the second at 4 to 6 years of age.
Before the nation’s measles vaccination program, about 3 million to 4 million people got the virus every year, and about 400 to 500 died.
根據疾控中心的資料，接種國家要求的麻疹疫苗的幼兒園比例也低於2022-23學年的聯邦目標。 兒童疫苗豁免率已達到美國有史以來的最高水準。
據疾控中心稱，兒童應接種兩劑MMR疫苗：第一劑在12至15個月大時接種，第二劑在4至6歲。
在國家麻疹疫苗接種計劃之前，每年約有300萬至400萬人感染病毒，約400至500人死亡。
The last significant measles outbreak in the US was in 2018-19 in Rockland County, New York, focused among unvaccinated children in Orthodox Jewish communities.
Although the CDC reported only 56 measles cases in 2023, Johns says that is too many when a highly effective vaccine exists.
“Most people haven’t seen a case of measles,” she stressed. “They don’t really have an appreciation for the severity of the illness.”
美國最後一次嚴重的麻疹疫情是在2018-19年，在紐約州羅克蘭縣爆發，集中在東正教猶太社群的未接種疫苗的兒童中。
儘管疾控中心在2023年只報告了56例麻疹病例，但約翰斯表示，當存在高效疫苗時，這太多了。
她強調說：「大多數人沒有見過麻疹病例。」「他們並不真正瞭解疾病的嚴重性。」
Measles spread and symptoms
麻疹傳播和症狀
The measles virus can spread when an infected person coughs or sneezes, lingering in the air for up to two hours after they leave a room, according to Murray. The virus can also live on surfaces such as doorknobs for about the same amount of time.
據Murray說，當感染者咳嗽或打噴嚏時，麻疹病毒會傳播，離開房間後在空氣中徘徊長達兩個小時。 病毒也可以在門把手等表面上存活大約相同的時間。
When symptoms begin, they’re similar to those of many respiratory illnesses – high fever, cough, red eyes, runny nose and congestion – followed by a “fairly characteristic” rash, Murray said.
“You get flat red lesions, flat red spots that typically start on your face and move down across the body across the chest and trunk and extremities,” he said. “It can be a total body rash, and it’s pretty severe.”
The incubation period for measles is very long, Murray adds. It takes about 10 to 12 days for initial symptoms to appear after exposure.
Murray說，當症狀開始時，它們與許多呼吸道疾病相似——高燒、咳嗽、眼睛發紅、流鼻涕和充血——然後是「相當典型的」皮疹。
他說：「你會得到扁平的紅色病變，扁平的紅色斑點，通常從你的臉上開始，穿過胸部、軀幹和四肢，穿過身體向下移動。」 「這可能是一種全身皮疹，而且非常嚴重。」
Murray補充說，麻疹的潛伏期非常長。 接觸後，初始症狀大約需要10到12天才能出現。
Because of this, most infected people assume their respiratory symptoms are nothing but a cold until the rash appears three to five days after the initial illness begins, according to Murray. Even then, most people – including some doctors – will not recognize a measles rash.
據Murray說，正因為如此，大多數感染者認為他們的呼吸道症狀只不過是感冒，直到最初疾病開始後三到五天出現皮疹。 即便如此，大多數人——包括一些醫生——也不會認出麻疹疹。
“The younger the health care provider, the less likely they are to have seen a case,” Murray said. “But certainly, when it’s circulating, we do everything we can to get the word out on what to look for.”
據Murray說，正因為如此，大多數感染者認為他們的呼吸道症狀只不過是感冒，直到最初疾病開始後三到五天出現皮疹。 即便如此，大多數人——包括一些醫生——也不會認出麻疹疹。
Murray說：「醫療保健提供者越年輕，他們出現病例的可能性就越小。」「但當然，當它流通時，我們會竭盡全力宣傳該尋找什麼。」
Measles health risks
麻疹健康風險
Lower MMR vaccination rates can put unvaccinated and undervaccinated individuals at risk, Johns says, especially children and those with immune system problems.
Johns說，MMR疫苗接種率較低會使未接種疫苗和未接種疫苗的人面臨風險，特別是兒童和有免疫系統問題的人。
Measles can lead to serious complications, especially in children under 2, such as blindness, encephalitis or inflammation of the brain, and severe pneumonia, according to Murray.
據Murray說，麻疹會導致嚴重的併發症，特別是在2歲以下的兒童中，如失明、腦炎或腦炎以及嚴重肺炎。
“Measles is also a virus that knocks down parts of the immune system,” he said. “There’s recent evidence that having measles increases your susceptibility to other infections.”
他說：「麻疹也是一種可以摧毀部分免疫系統的病毒。」「最近有證據表明，麻疹會增加你對其他感染的易感性。」
A rare complication called subacute sclerosing panencephalitis can also happen seven to 10 years after infection and may result in seizures as well as behavioral and mental deterioration.
一種罕見的併發症稱為亞急性硬化性全腦炎，也可以在感染後7到10年發生，並可能導致癲癇發作以及行為和精神惡化。
Additionally, someone who doesn’t get the MMR vaccine is at risk of contracting mumps and rubella, which are rare but still in circulation in the US due to international travel.
此外，沒有接種MMR疫苗的人有感染流行性腮腺炎和風疹的風險，由於國際旅行，這些流行性腮腺炎和風疹在美國很罕見，但仍在流通。
In 2023, 436 mumps cases were reported by 42 jurisdictions, according to CDC data. Rubella is less common, with fewer than 10 people in the US getting the virus each year.
根據疾控中心的資料，2023年，42個司法管轄區報告了436例腮腺炎病例。 風疹不太常見，美國每年感染病毒的人不到10人。
What to do if you were exposed to measles
如果你接觸過麻疹該怎麼辦
If you’re fully vaccinated against measles, your chance of infection after exposure is very low because the two childhood doses typically confer lifelong immunity, experts say.
專家表示，如果您完全接種了麻疹疫苗，接觸麻疹後感染的機率非常低，因為兩種兒童劑量通常具有終身免疫力。
“It’s not impossible, but it’s very, very low,” Murray notes.
Murray指出：「這並非不可能，但它非常非常低。」
But for people who aren’t unvaccinated or who have weak immune systems, the risk increases – “especially if they know they’re in an area where measles has been circulating,” he said. “In that case, what you would do is, you would call your health care provider and work with [them] to determine next steps.”
但對於沒有接種疫苗或免疫系統虛弱的人來說，風險會增加——「特別是如果他們知道自己在麻疹一直在傳播的地區，」他說。 「在這種情況下，你會做的是，你會打電話給你的醫療保健提供者，並與「他們」合作，以確定後續步驟。」
If you think you might have been exposed to measles, stay home until a plan is in place, Murray advises.
Murray建議，如果你認為你可能接觸過麻疹，請待在家裡，直到計劃到位。
“Call ahead before you go to any health care facility, because that health care facility can anticipate your arrival and make sure you are placed in the appropriate isolation rooms,” Murray said. “The last thing we want to do is have someone with measles sitting in the emergency room waiting room.”
Murray說：「在你去任何醫療保健機構之前，請提前打電話，因為該醫療保健機構可以預料到您的到來，並確保您被安置在適當的隔離室。” “我們最不想做的就是讓麻疹患者坐在急診室候診室裡。」
Unvaccinated people who know when they were exposed can get the MMR vaccine within 72 hours of exposure to prevent the disease altogether or lessen the severity of the illness, Murray adds.
Murray補充說，未接種疫苗的人可以在接觸後72小時內接種MMR疫苗，以完全預防疾病或減輕疾病的嚴重性。
As for treatment, the virus simply has to run its course, he says. There is no specific antiviral treatment, and medical care is mainly supportive: staying home from school or work to rest and drink plenty of fluids.
他說，至於治療，病毒只需要進行。 沒有特定的抗病毒治療，醫療護理主要是支援性的：從學校或工作回家休息和喝大量的液體。
If a person infected with measles is showing symptoms of encephalitis, such as a headache, high fever or seizures, they should be taken to a hospital immediately.
如果麻疹感染者出現腦炎症狀，如頭痛、高燒或癲癇發作，應立即送往醫院。
“Typically, hospitalization for measles occurs when children are in respiratory distress from lung involvement like pneumonia or are dehydrated and need IV fluids,” Johns said.
Johns說：「通常情況下，當兒童因肺炎等肺部受累而出現呼吸窘迫或脫水需要靜脈輸液時，就會因麻疹住院。」
Severe measles cases among children can also be treated with vitamin A, according to the CDC, to support the immune system.
據疾控中心稱，兒童嚴重麻疹病例也可以用維生素A治療，以支援免疫系統。
“Vitamin A should be administered immediately on diagnosis and repeated the next day,” the agency said.
該機構表示：「維生素A應在診斷後立即服用，並在第二天重複服用。」
Correction: A previous version of this story misstated the year measles was eliminated from the United States.
更正：這個故事的前一個版本錯誤地說了麻疹從美國消滅的年份。
Source from CNN
https://edition.cnn.com/2024/01/23/health/measles-cases-xpn-wellness/index.html
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