Health

How the Measles Outbreak Endangers People Receiving Cancer Treatment

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The immune systems of people with cancer are weaker, so their risk for contracting measles is higher. Getty Images

People with cancer have many health concerns.

Among them is the fact that treatments can affect the immune system, increasing the risk of infections like measles.

“Getting measles at any time in your life is dangerous,” said Dr. Nicholas Rohs, assistant professor of hematology and oncology at the Tisch Cancer Institute at Mount Sinai Hospital in New York. “But it’s particularly dangerous in people who are getting active cancer therapy.”

The measles vaccine has been so effective that the disease was declared eliminated in the United States in 2000.

But in 2019, that’s no longer true.

The Centers for Disease Control and Prevention has confirmed 839 cases of measles in 23 states as of May 10. This number is preliminary and subject to change.

The MMR vaccine protects against measles, mumps, and rubella. It’s given in two doses: the first typically between 12 and 15 months of age and the second between 4 and 6 years of age.

Those too young for the vaccine or people with compromised immune systems must depend on a community’s “herd immunity” for protection.

For measles, that requires a vaccination rate Health Organization” rationale=”Highly respected international organization”>between 93 and 95 percent.

In the United States, vaccination coverage varies from state to state. In 2017, 11 states reported coverage levels under 90 percent.

Measles is still common in many parts of the world. That means travelers can bring the disease into the United States.

The virus is highly contagious. It survives up to two hours in the air after an infected person sneezes or coughs. It can spread from four days before to four days after you notice the measles rash.

If you have measles, up to 90 percent of people around you will get the disease if they’re not already immune.

Rohs says that when it comes to people with cancer, the greatest risk is to those who are undergoing active chemotherapy.

“Many kinds of chemotherapy can suppress the immune system, making it harder for the body to combat the virus,” he told Healthline. “However, other types of cancer therapy, including targeted pills and immunotherapy, can also suppress the immune system.”

Certain types of cancer, such as lymphoma, may increase the risk of infection even when a person isn’t being treated, Rohs adds.

“With the possible immunosuppressive effects of the therapy as well as the general demands on the body to heal and recuperate, a person is at higher risk of having more complications from the disease, including it spreading to the brain and lung, which can be life-threatening,” he said.

Dr. Istvan Redei is director of the Stem Cell Transplant and Cell Therapy Program at Cancer Treatment Centers of America in Illinois.

Redei told Healthline the danger is especially acute for people with certain hematologic diseases.

“Treatment options may include essentially rebooting the patient’s immune system through a stem cell transplant to help treat the primary illness,” he said.

“In these cases, patients don’t yet have the protection of vaccines, making population health through vaccination an important factor for their recovery after treatment to help limit complications through a secondary illness like the measles,” he explained.

Population health refers to the protective effect a high vaccination rate can have on supporting immunocompromised patients or others who are unable to get vaccines because of allergic reactions or other reasons.

Rohs says that everyone who comes into his cancer centers is screened for previous measles vaccinations and symptoms.

“This is really important, given how easily measles can spread,” he said.

Some people with cancer can get a measles vaccine, according to Rohs. However, those in active therapy or who have certain types of cancer shouldn’t get the MMR vaccine because it’s a live vaccine.

“This means that it works by introducing a very mild form of the disease to the body to allow it to learn to fight the disease. If the immune system is weakened, the body won’t be able to form the proper defenses and it can become a real infection,” he said.

Most people with cancer who’ve been previously vaccinated don’t need to be vaccinated again after treatment.

“This exception is for people who undergo bone marrow transplants. They have to receive all of their vaccines again after a transplant. The MMR vaccine is often recommended two years after completing a transplant,” Rohs said.

Talk to your doctor if you’re not sure of your vaccination status, Rohs advises. A blood test can determine whether you’re immune to measles.

“It’s important that all cancer patients and their caregivers and families, particularly those who had received [a] stem cell transplant, be aware of the heightened risk of contracting the measles virus and to take precautions to limit any exposure to the virus,” Redei said.

If they can’t be vaccinated, people with cancer should avoid areas where outbreaks have been reported.

“This is difficult, because you can’t tell if someone with measles has been in a certain area,” Rohs said.

“I would hesitate to tell anyone to quarantine themselves to their home to avoid exposure. Families can help by getting vaccinated, avoiding any exposure to high-risk areas, and not being around loved ones if they have any symptoms of measles,” he said.

The most common symptoms of measles are cough, runny nose, red and irritated eyes, sore throat, and fever, Rohs says.

Before the hallmark rash appears, there might be tiny white spots on the inside of the mouth.

Within a few days of the first symptoms, flat red spots appear on the face and hairline, then slowly spread down the body.

“Rarely, people who are immunocompromised, such as those undergoing cancer therapy, can either have no rash or a more severe rash,” he said.

“Once measles has been diagnosed, treatments are generally supportive, including controlling fevers, pain, and calming the skin rash,” he said.

“So far, I haven’t met a person with cancer who had measles, and I hope I never do,” Rohs said.

He urges people who haven’t been immunized to get the MMR vaccine.

“You’ll not only be helping to protect yourself from a real and dangerous disease, but you’ll also be protecting vulnerable populations, such as infants and people with cancer, who aren’t able to be vaccinated yet,” he said.


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