Minnesota officials remind parents that measles can cause seizures, comas, death

It didn't take long for measles to sicken Mahamed Tahir's two youngest kids. One day they were healthy toddlers enrolled in day care, and a few days later they were so weak and dehydrated they needed hospital care.

Racked with high fever and covered with a rash, Tahir's son and daughter suffered in ways he had never imagined.

"It was painful to see my kids gasp for air," Tahir said.

His children, aged 2 and 3, were among the early cases in an outbreak that so far has sickened 66, including 12 new infections in the past week.

They're also a reminder that measles — considered by many baby boomers to be a mild rite of passage and virtually unknown among younger generations — is a serious disease that can lead to severe complications and even death.

"Measles oftentimes is characterized as a benign illness, but it really is not," said Dr. Jennifer Halverson, a pediatrician at Children's Hospitals and Clinics of Minnesota who has cared for several children hospitalized in the current outbreak.

State health officials are underscoring the point as they reach out to parents who are skeptical of the measles vaccine. Some have accepted the discredited theory that the vaccine causes autism — and they reason that autism is serious while measles is not.

In fact, measles' impact on children, even after they recover, can last for years. Some are left more susceptible to other infectious diseases, and in rare cases the virus can hide within the nervous system and cause a fatal condition up to 10 years later.

Even with round-the-clock care, there is no medical treatment that can eradicate the infection once a patient falls ill.

"There is not a lot of magic unfortunately," said Dr. Andrea Singh, head of pediatrics at Park Nicollet. "We have to take a supportive approach because we can't just treat it and make it go away."

So far, 20 of the cases in the current outbreak have required hospitalization — exceeding the 16 that needed hospital care in the state's last outbreak, in 2011, when 26 became infected.

In Minnesota's last large outbreak, in 1990, the measles sickened 460 people, and complications led to the deaths of three children.

Michael Osterholm, who was Minnesota's state epidemiologist at the time, fears that could be repeated.

"What everybody is saying but nobody wants to talk about publicly is that we will have a child that will become severely ill and die," said Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. "And I don't want to have that happen."

Once measles takes hold, usually in children under age 5 or adults over age 20, its effects are unpredictable. With the body's immune system doing all it can to fight the measles virus, victims become susceptible to secondary infections, especially bacterial pneumonia. The virus can also pass into the brain, making it swell and setting the stage for seizures, a coma or permanent brain damage.

The most common problem is dehydration — the virus settles in the mouth and throat, making swallowing painful. In addition, the lungs can fill with mucus, making breathing difficult to the point where some patients need oxygen, and the skin becomes inflamed with a rash from head to toe.

"They are absolutely miserable, lethargic and weak," said Halverson. "When they cry, there are no tears coming out of their eyes because they are so dehydrated."

And yet doctors don't know why some patients are hit worse than others — even among otherwise healthy children.

"There is no way to predict which children with measles are going to develop complications," said Halverson. "That is what is scary about this disease."

Tahir's children became sick the same day he learned that others at their day care had developed measles.

"They had a really high fever," he said. "They had lost their appetite because they were coughing, vomiting and their eyes were red and inflamed. And later the rashes started to appear."

After a doctor visit, Tahir said, their condition worsened almost to the point where they had become unresponsive. That led to a trip to an emergency room, where they were tested for measles. After the results came back positive, he took them to Children's, where they were admitted and stayed two nights, receiving intravenous fluids and pain medication.

Tahir's four older children had all been vaccinated for the measles, but he resisted getting shots for the younger kids because friends and relatives advised him when he arrived in the United States three years ago not to get them vaccinated because of autism fears — a link that has been disproved by many scientific studies.

But the fear persists, and as long as there are pockets of unvaccinated children, the state could see more outbreaks, health officials say.

"If there are two children in a department store or a mall, one susceptible to measles and one infected, the bottom line is the virus will find that unprotected child," said Osterholm.

Most at risk are newborns — who are too young to get vaccinated — and those with compromised immune systems.

"It does make it more challenging if it is a little baby," said Singh. "They only have so many reserves to get through an illness."

Yet even when the children recover, Halverson said, the experience of living through a disease that is largely preventable takes a toll on everyone involved.

"It has been very emotional to take care of these kids," she said. "Every single parent I talk to regrets their decision not to vaccinate their kids."

Despite doctors reassuring Tahir that his kids will never get measles again, he moved to vaccinate them.

"I gave them the vaccine after they got better," he said. "I don't want to see my kids suffer again."

Glenn Howatt • 612-673-7192

Faiza Mahamud • faiza.mahamud@startribune.com