By now, everyone has heard about the measles outbreak that started at the Disneyland Resort during the holiday season. What started with news of less than ten individuals having come down with the virus has now skyrocketed to more than 40, with the news that among the infected are Cast Members. This news is alarming, especially for families with babies too young to be vaccinated. If you are planning a trip to Disneyland and you are confused or concerned about the threat of measles, here is what you need to know while considering whether or not a trip is right for you.

What is measles?
Measles is a highly contagious disease found in many parts of the world, including Europe, Asia, Africa and the Middle East, and according to the Centers for Disease Control (CDC), it is a disease often brought to the U.S. by foreign travelers. As of 2000, it is a disease that was eliminated from the U.S., meaning it was no longer an illness that was “native” to our country.

Measles is a serious respiratory disease. It starts with a very high fever and can include additional symptoms including a cough, runny nose, red eyes, diarrhea, ear infection and, most notably, a rash of tiny, red spots that starts at the head and spreads to the rest of the body.

Measles can be quite dangerous–especially for young children. The CDC reports that 28% of children under the age of 5 who come down with measles end up in the hospital.

How does measles spread?
The way measles spreads is scary. As parents, we tell our children that if they wash their hands, don’t touch their face and practice proper hygiene they will stay healthy, but measles has other plans for those who are not vaccinated–and even for some people who have been vaccinated. Measles spreads when an infected person breathes, coughs, or sneezes. That’s right: BREATHES. Moreover, it is possible to catch measles just by being in a room where a person with measles has been–even up to 2 hours after that person is gone. According to the CDC, people who may not even yet know they have measles (not yet have the rash) can still transmit the virus and because of its highly contagious manner, almost everyone who has not had the MMR shot will get measles if they are exposed to the virus.

How can I prevent my child from getting measles?
According to the CDC, the Orange County Health Care Agency and the California Department of Public Health (CDHP), the ONLY way to try to prevent getting measles is by getting the MMR vaccine. This is not a pro-vaccine statement, this is just the reality of this virus. There is no other way to protect against getting it if you or your children are exposed to a person who is presenting symptoms or is carrying the virus and doesn’t know they have it yet.

• The Orange County Health Care Agency advises that children should receive their first MMR vaccine at 12-15 months of age. The second dose of MMR is given at 4 to 6 years of age before going to school.
• If you are unsure of your vaccination status or if you just want to make sure that your two doses have provided you with the immunity to measles it should have, you can speak with your doctor to have a test done to see if you have measles immunity or if you need to receive a vaccination.
• According to Dr. Gil Chavez, State Epidemiologist and Deputy Director, Center for Infectious Diseases, California Department of Public Health, “CDPH is urging caution to individuals who are not vaccinated, especially infants under 12 months. Any place where large numbers of people congregate and there are a number of international visitors, like airports, shopping malls and tourist attractions, you may be more likely to find measles, which should be considered if you are not vaccinated. It is absolutely safe to visit these places, including the Disneyland Resort, if you are vaccinated. Therefore, CDPH recommends that anyone not already immunized against measles gets immunized at this time. Two doses of measles-containing vaccine (MMR vaccine) are more than 99 percent effective in preventing measles.”

Is the measles vaccine safe?
The CDC reports that most children do not have any side effects from the MMR vaccine, and that any side effects that do occur are usually very mild (fever or rash). More serious side effects are rare and typically impact about 1 out of every 3,000 people who get the shot. Those side effects may include high fever that could cause a seizure and temporary pain and stiffness in joints (mostly in teens and adults). Possible side effects of catching measles can include pneumonia (a serious lung infection), brain damage, deafness and even death. Measles is a very serious illness, and it is important for parents to weigh the risks of each when determining what is best for their child and the welfare of others in their family and their community as a whole.

I admit, that with my three children, I have felt like the vaccine schedule seemed like a bit much. So many shots at once! I will also admit that one of my children fell into the category of coming down with a mild rash and fever after receiving an immunization. (Although I’m pretty sure it was not the MMR vaccine, because he was not quite a year old yet when it happened.) That being said, I have not personally deterred from vaccinating my children. For me, I source most of my information on vaccine safety from the Centers from Disease Control. I recommend reading their pages on vaccines and the child’s immune system, possible side effects of vaccines offered in the United States and how vaccines prevent disease. I’m sure there are many more sources of information out there, but given my line of work, this is my go-to website and I personally trust its content.

And as mentioned above, no vaccine is a magic bullet, but it serves as a proven barrier and provides kids and adults with a much better chance at not getting virus.

Is measles on the rise?
The answer to this is yes. Immunization rates in California schools have dropped, which means when people travel to the U.S. with measles, these children can in turn contract the illness and spread it to those who may also not be immunized, not yet fully immunized or those for into the less than 1% for whom the vaccine may not be effective.

Measles outbreaks since “measles elimination” was documented in the U.S. in 2000. Measles elimination means that the disease was no longer “native” to the U.S. Image from the CDC website.

What is the Disneyland Resort doing about the measles outbreak?
The Disneyland Resort is taking the measles outbreak very seriously. The Resort is working to minimize any more exposure of sick Cast Members coming contact with other guests or one another. According to a Resort spokesperson, they are reaching out to all Cast Members whom they believe may have come into close contact with someone who has tested positive for measles and requesting their immunization history. If the Cast Members cannot verify their immunization history, they are taking the blood test mentioned previous to check their immunity status. “Cast Members who may have come into close contact with someone who has tested positive for measles will be required to take paid leave from work until we have confirmed their immunity status,” says the spokesperson. “If a Cast Member is not immune or does not want to be tested, we are offering vaccinations and requiring that they stay home through the incubation period.” He added that Cast Members who choose not to be immunized are not allowed to return to work  until the incubation period has ended and they are medically cleared to return to work. The Resort is working with their Cast Member community to help keep them safe, informed and provide them with access to the immunization and/or immunity verifications they may need.

The bottom line when it comes to Disneyland and measles, in my opinion, is that this is an issue that each family needs to consider on a personal level. Whether you are pro-vaccine or anti-vaccine, measles is real. Parents of my generation (let’s just say I am in my VERY LATE 30s) have never experienced the serious and scary childhood diseases our parents and grandparents endured. We’ve been sheltered from the horror of our children being gravely ill, and we have vaccines to thank for that blissful lack of knowledge.

For me, I vaccinate my children because I feel that the potential side effects of serious childhood disease far outweigh the side effects of vaccines. I also feel that we owe it to those in our society who are not old enough to vaccinate, cannot vaccinate or for those who may still contract a disease even though they are vaccinated. As a pediatric medical writer for a living, I spend my days writing about and seeing very ill children, and let me tell you something: seeing a very sick child covered in tubes in a hospital bed rips your heart out in a painful way that is difficult to fathom if you haven’t experienced it. I, for one, will do whatever it takes to give my kids better odds at not ending up being one of those kids. For me, that means vaccinating and for others, they feel not vaccinating is a means to that same end. I cannot judge their decision, any more than they should judge mine.

We took our son Connor to Disneyland when he was 7 weeks old back in 2010. If he were that little today, I may not make the same decision.

Whatever your belief system may be, it’s important to remember that illness can be and is everywhere. You can catch a cold from touching a shopping cart handle. You can catch lice from a movie theater seat. You can essentially catch measles and a number of many other infections diseases whenever you visit places heavily visited by travelers from abroad. It’s pretty much all about being in the right place at the wrong time. Weighing life’s risks and what we do and don’t expose our kids to is one of the hardest aspects of parenting. Do we hide in our homes from illness or enjoy and embrace life and travel in spite of the odds. I took my children to Disneyland at very young ages–when they were still infants. If this outbreak had happened back when they were tiny, I cannot say whether I would have made the same decisions or not, and I don’t envy the position this puts parents of infants in. Because my boys are all older now and all fully vaccinated, I feel comfortable taking them.

In the end, may we all respect one another’s decisions and may our kids live joyful, happy and healthy lives.