Measles outbreak puts cancer patients at risk

In the year 2000, measles was declared eliminated in the U.S., thanks to the effective development and implementation of the MMR (measles, mumps and rubella) vaccine. Despite this sweeping success, measles has reemerged with a vengeance. So far this year, there have been more than 839 new cases of measles — a sharp increase from the 372 cases reported in 2018.

“The resurgence of measles is deeply disappointing,” said City of Hope's Jana Dickter, M.D., an associate clinical professor in the Department of Medicine, Division of Infectious Diseases.

“I see so many patients who have aggressive, sometimes terminal cancer. Cancer is a disease that can strike without warning. Measles, on the other hand, is so preventable. Vaccines are widely available, easy to access and affordable. Community clinics offer them at low or no cost to patients. And they are also safe.”

Measles is a highly contagious viral infection that lives in the nose and throat mucous of those who have contracted the illness. An infected person coughing, sneezing or even talking can lead to others breathing in contaminated particles and possibly contracting the illness themselves. Measles can also live in the air for up to two hours, and surfaces can easily become infected as well.

Symptoms include a fever, cough, red eyes, runny nose, sore throat, small white bumps known as Koplick’s spots in the mouth and, finally, a rash on the forehead that eventually spreads downward. Measles can cause further complications, like pneumonia, encephalitis, seizures and respiratory failure, all of which can be fatal.

Twenty-three states have reported new cases of measles, and outbreaks are currently happening in 10 jurisdictions across the country. These numbers are startling, especially for those who have compromised immune systems, putting them at a higher risk of contracting measles. One such high-risk group is cancer patients.

Chemotherapy, immunotherapy and stem cell transplants are often the best treatment options for cancer patients, but despite their efficacy, they can also present dangerous side effects, one being their impact on the immune system. Unfortunately, some of these treatments wipe out patients’ immune systems, leaving them more vulnerable to viral and bacterial infections.

Even if patients have been vaccinated before, certain cancer treatments may render those vaccines ineffective, and getting vaccinated while still undergoing treatment, or even too soon after, is not advised.

“Cancer patients should be off chemotherapy for at least three months with no ongoing immunodeficiency before getting the MMR vaccine. Bone marrow transplant recipients must be safely two years post-transplant, and can’t be on any immunosuppressant drugs,” Dickter said.

How can cancer patients protect themselves from measles?

“The best way for cancer patients to protect themselves against the measles is to surround themselves with people who are immune. I would encourage people to talk to their family members, particularly those living in the same household, and make sure everyone is vaccinated. That’s really the best way to avoid contracting the virus,” said Dickter.

Despite the fact that vaccines are thoroughly tested to make sure they’re safe and monitored closely through public health surveillance, misinformation about vaccine safety has spread like wildfire through social media and the internet. A 1998 study led by discredited former doctor Andrew Wakefield claimed that the MMR vaccine caused autism, and while this study has since been debunked, some parents are still hesitant about vaccinating their children.

“I’m a mother, so I understand the concerns of parents who have to vaccinate their children. It can be overwhelming to take your child to the doctor to get shots with vaccine bundles. I remember those days, and my children’s discomfort, but it’s also necessary to protect not only your children, but others who can’t get vaccinated,” Dickter explained.

“In the medical community, I think we need to do a better job of educating parents and children about vaccines. We haven’t done enough to address their fears, validate their concerns and give them accurate, science-backed information about the safety of vaccines.”

Visit the Centers for Disease Control and Prevention website for more information on the measles vaccine to make sure you and your family are protected.