First, Vanilla Ice and more than 500 other people were quarantined on a flu-infected plane at JFK. Now, health officials say that, in late August, a whole bunch of Southwest Airlines passengers may have been exposed to the notoriously contagious measles virus.
"Our Safety & Security groups worked with the CDC to support the agency’s work in reaching our Customers who traveled onboard four intra-Texas flights […] with a passenger later diagnosed with Measles," Southwest Airlines said in a statement emailed to SELF. "We’ve shared awareness of the situation and protocols with our Employees who also were onboard these aircraft."
The first flight, on Tuesday, August 21, was from Love Field Airport in Dallas to William P. Hobby International Airport in Houston. There, the passenger disembarked and boarded a connecting flight to Valley International Airport in Harlingen, Texas. The next day, August 22, the passenger returned, taking the same route in reverse: Harlingen to Houston, and then Houston to Dallas.
The airline has been collaborating with the Centers for Disease Control and Prevention (CDC) and local Texas health departments to investigate the event and get in touch with anyone who might be at risk. "CDC is aware of a reported case of measles in a traveler on [four] Southwest Airline flights in late August," CDC spokesperson Benjamin Haynes told SELF in a statement. "We are working with local officials to investigate and contact passengers who might have been exposed […] If you have any of these symptoms and traveled on one or more of these flights, please contact your healthcare provider."
The measles is a respiratory infection caused by the Rubeola virus, and it's spread via coughing and sneezing.
"Measles is probably the most contagious infectious disease that we know of," Amesh Adalja, M.D., a Senior Scholar at the Johns Hopkins University Center for Health Security, tells SELF.
Infectious mucus droplets can contaminate surfaces—like an airplane armrest or bathroom door—as well as the surrounding air, where it can linger up to two hours, the CDC says. (Southwest included in their statement that they thoroughly clean their planes and filter the cabin air: "Our entire fleet is subject to rigorous and regular cleaning programs and every aircraft utilizes hospital-quality HEPA filtration that improves overall quality of the air in the passenger cabin.")
Symptoms of the measles usually show up a week or two after you're exposed to the virus. They begin with a high fever, cough, runny nose, and red and watery eyes, according to the CDC. Two to three days after that, little white spots (called Koplik spots) may start appearing in the mouth. Then, three to five days after the first symptoms, the infection's signature rash breaks out and the fever shoots up to 104 degrees Fahrenheit or higher, the CDC says.
The most common complications are relatively minor and include ear infections and diarrhea. But more rare and serious complications may occur, such as pneumonia and encephalitis (a potentially life-threatening swelling of the brain), according to the CDC. One or two children out of every 1,000 who contract the measles will die from it, most often as a result of the pneumonia.
Fortunately, the MMR vaccine, which protects against measles, mumps, and rubella, gives immunity to the vast majority of people.
According to the CDC, a single dose of the vaccine (typically given at 12-15 months) is approximately 93 percent effective, while a second dose (around age four to six) ups the efficacy to 97 percent. (Experts aren't sure why the other 3 percent of people don't become resilient to the virus, though they suspect it has to do with an abnormal immune response to the vaccine. However, if a vaccinated person does still contract the measles, it will probably be much less severe.)
The vaccine works so well that in 2000, the U.S. declared that it had eradicated endemic measles—i.e. infections caused by strains originating in the country—thanks to high vaccination rates in the population, according to the CDC. And in 2016, the Americas was also pronounced to have eradicated endemic measles.
However, the disease still kills tens of thousands of people worldwide every year. And several areas around the world are currently experiencing outbreaks, including some countries in Europe like Italy, Greece, the Ukraine, and France. Over 41,000 people in the WHO European region were infected in the first six months of 2018 alone, including 37 deaths, according to WHO. This is far higher than the total for any year in the past decade, according to WHO. (For instance, there were only 5,273 cases in 2016.)
People who haven't been vaccinated are extremely vulnerable to the disease if exposed.
"Because of the contagiousness level of this virus, whenever it’s around unvaccinated people, it invariably finds them," Dr. Adalja says. In fact, nine out of 10 people who are without immunity to the measles virus will contract it if exposed, the CDC reports. "That’s why it's so important to keep vaccination rates against measles as high as possible," Dr. Adalja says.
Most cases of measles in the U.S. occur when people who don't have the vaccine pick up strains of the measles virus overseas and bring it back to the U.S., the CDC says. It is "more than likely" that that's how this particular passenger was exposed, according to Dr. Adalja. "Especially when you’re talking about an airplane, you’ve got people from all over the world on that plane that are going to go on to their destination," Dr. Adalja says. Dr. Adalja notes that many cases imported to North America are from Europe because of the sheer amount of air travel between the two continents. "These outbreaks are going to continually reintroduce this virus into the U.S."
If exposure occurs in an area where many people aren't vaccinated, an outbreak can occur.
"We’ve seen the anti-vaccine movement make very big in-roads in certain parts of the country," Dr. Adalja. says. "There are pockets of this country where vaccination rates dip low enough that we can see small outbreaks occurring." (The CDC defines an outbreak as three or more linked cases.) One example is the outbreak that struck 145 people in Disneyland in 2015.
In the first eight months of 2018, there have been 124 confirmed cases of measles in 22 states and the District of Columbia, including nine outbreaks. "These exposures need to be treated seriously, and they need to be prevented by increasing the vaccination rate," Dr. Adalja says. "The only way to protect ourselves against it is to be as vaccinated a population as possible."