Forty-four percent of pediatricians in the U.S. have entered the workforce since measles was officially eliminated in 2000, and many more began practicing in the years since measles was technically common, according to philly.com.
With 644 measles cases in 2014 and the recent Disneyland outbreak, pediatricians and primary care doctors need to be prepared diagnose infections quickly so other people aren’t put at risk, especially infants who are still too young to be vaccinated.
“I only have read about it in textbooks. That’s very different from seeing something on a daily basis,” said Jennifer Coren, a pediatrician for 15 years. An emergency staff meeting was recently held at her small practice in Hatboro, Pa. to review policies and symptoms. “I can tell you pretty quickly and with pretty good accuracy whether you have flu or strep,” she said. “I can’t do that for measles.”
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Some practices are creating new policies to compensate for a lack of experience with measles, like that of pediatrician Sharon Sowinski-Mueller, who completed her residency in 2003.
“Anyone who is calling in with fever and conjunctivitis, we are asking the parents to drive them over and call us when they are there so we can go out and look at them,” Sowinski-Mueller said. If enough of the symptoms match that of measles, a child will be sent home for isolation and the county health department will be notified.
“I’m confident that I could make a diagnosis, but I have that small bit of worry in the back of my head that it might be later in the process compared with someone who had experience seeing it before,” she said.
Despite proper training, it can be difficult to diagnose measles in the early stages. Having knowledge of vaccination history and any recent travel is helpful, but one way doctors not very familiar with the infection can potentially make an early diagnosis is by checking inside of the cheek for Koplik spots – little dots that look like grains of sand and appear before the rash.
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“There is nothing else besides measles that gives you those spots,” said Meg Fisher, medical director of Unterberg Children’s Hospital at Monmouth Medical Center.
There must continue to be more attention put on training physicians to be aware of and prepared for measles cases, especially considering many anti-vaxxers aren’t budging. But overall, it makes sense for some practices to be overly cautious if symptoms match. Better safe than sorry.
Caroline Johnson, disease-control director at the Philadelphia Department of Public Health, said physicians contact her several times a month and say, “‘I don’t really think this is measles, but I want to run it by you,’ and we are very happy to get those calls.”
[Photo from Flickr user Myfuture.com]
