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Measles infections pose far more risks than most realize, including a fatal neurological complication – NBC News

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Erica Finkelstein-Parker planned her daughter’s 8th birthday party with love.

Because Emmalee adored airplanes, Finkelstein-Parker chose the theme “Flying High with Emmalee.” Finkelstein-Parker filled nearly two dozen brightly colored goody bags for Emmalee’s friends — one for every child in her class, so no one would feel left out.

Months later, the treat bags remained unopened in Finkelstein-Parker’s bedroom, reminders of a birthday party that was never held.

Emmalee, who developed a rare complication of measles that can strike years after infection, spent her 8th birthday in hospice care at her family’s home. Her parents adopted Emmalee from an orphanage in India when she was 2 ½ years old. The orphanage staff didn’t tell them she had been infected with measles.

Emmalee Madeline Snehal Parker.
Emmalee Madeline Snehal Parker. Emmalee was otherwise healthy when she developed a devastating complication after apparently recovering from measles.Erica Finkelstein-Parker

“There are some things that a parent should never have to do,” said Finkelstein-Parker, of Littlestown, Pennsylvania. “I had to call the birthday venue and explain that we were canceling the party because our daughter was dying.”

Emmalee died on Jan. 2, 2011.

“People think these diseases are ancient history, but they’re still around,” said Finkelstein-Parker. “Measles is a stealth virus. It may look like it has cleared your body, but it can hide in your nervous system.”

The massive resurgence of measles around the world — attributed to pandemic-related declines in immunizations and rising rates of vaccine hesitancy among parents — raises the risk of more serious complications and deaths, said Dr. James Cherry, a professor of pediatrics and an infectious disease expert at the David Geffen School of Medicine at UCLA.

In the past two months, doctors in the U.S. have diagnosed dozens of measles cases related to unvaccinated travelers who arrived at international airports, then exposed others at hospitals and day care centers. State health departments have reported measles cases in California, Georgia, Missouri, New Jersey, Pennsylvania, Washington, Ohio, Maryland and Minnesota. The Centers for Disease Control and Prevention has issued a warning to health providers, warning them to be on alert for more cases.

“All it takes is one infected traveler to spark an outbreak,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. “It’s coming from people who are getting off airplanes.”

Measles is so contagious that even one case is considered an outbreak. Each measles patient infects an average of 12 to 18 people who lack immunity from vaccines or natural infection. In comparison, each Covid-19 patient infects about two other people, said Dr. Paul Offit, the director of the Vaccine Education Center at Children’s Hospital of Philadelphia.

“Measles is much, much more contagious than Covid or the flu,” Offit said.

Although two doses of the measles vaccine protect 97% of children, the airborne virus spreads so quickly that 95% of children in a community need to be vaccinated in order to stop outbreaks. About 93% of children were up to date on the measles vaccine in 2022-23, according to the CDC.

All states mandate vaccinations for children in public schools, but a growing number of families are taking advantage of exemptions for religious, philosophical or medical reasons. About 3% of students are now exempt from vaccine mandates. In 10 states, more than 5% of schoolchildren are exempt, a rate that makes it harder to contain outbreaks.

People who decline to vaccinate their children against measles are taking large and unnecessary risks, Dr. Peter Hotez, co-director of the Center for Vaccine Development at Texas Children’s Hospital, said. Measles vaccines have repeatedly been shown to be safe.

Long-term effects of measles

For every 10,000 children infected with measles, 2,000 will be hospitalized; 1,000 will develop ear infections with the potential for permanent hearing loss; 500 will develop pneumonia; and 10 to 30 will die, said Hotez, who is also dean of the National School of Tropical Medicine at Baylor College of Medicine.

Ariel Loop was shocked when her 4-month-old son, who had received all recommended vaccines, became sick with measles after visiting Disneyland in 2015. Babies are vulnerable to measles because they aren’t routinely vaccinated against the virus until age 12 to 15 months.

Loop took her son to the emergency room after he developed red spots, itchy eyes and a fever of 102 degrees that acetaminophen didn’t help. Loop, a nurse, was especially worried about her son because he was born prematurely and suffered a stroke while in utero.

Mobius was 4 months old when he became sick with measles after visiting Disneyland in 2015. Babies are vulnerable because they aren’t routinely vaccinated against the virus until 12 to 15 months.
Mobius was 4 months old when he became sick with measles after visiting Disneyland in 2015. Babies are vulnerable because they aren’t routinely vaccinated against the virus until 12 to 15 months.Ariel Loop

“He was my first baby, and I didn’t know how dangerous measles was,” said Loop, who lives in Pasadena, California.

Measles often leaves patients vulnerable to secondary bacterial infections, such as pneumonia, one of the most common causes of death in measles patients, said Patricia Stinchfield, president of the National Foundation for Infectious Diseases.

Measles also causes “immune amnesia,” in which the immune system loses its ability to fight infections that a patient was previously immune to, Cherry said. The virus wipes out 11% to 73% of a person’s antibodies — both those acquired through infection and vaccination — which can leave patients at increased risk from viruses such as the flu and bacteria that cause pneumonia and skin infections.

Early symptoms of measles

In addition to the well-known red spots on the skin, measles usually causes white spots in the mouth, which can make it painful for children to eat or drink, Stinchfield said. Many kids with measles become dehydrated and malnourished during their illness.

About 20% of measles patients are hospitalized, often because they need intravenous fluids, she said.

“These kids come in, slung over their parents’ shoulders, barely able to hold the head up,” Stinchfield said. “They’re like little rag dolls. They won’t even take a popsicle.”

In the days before children develop a red measles rash, symptoms include:

  • Cough
  • Lethargy
  • Runny nose
  • Pink eye
  • Fever  

Many become so sensitive to light that ordinary room lights hurt their eyes.

“It might look like the common cold except for the degree of misery they have,” Offit said.

People with measles can spread the virus for nine days — from four days before they develop spots until four days after, Stinchfield said.

Because the virus spreads through aerosols, it can infect people up to two hours after a sick person has left the room.

A fatal long-term complication

Although Emmalee was always tiny for her size — topping out at a weight of 39 pounds — she was otherwise healthy, Finkelstein-Parker said.

The first signs of serious illness occurred when Emmalee was 7 and began tripping over her feet, Finkelstein-Parker said. At first, her mother said she wondered if Emmalee’s new shoes were too big. The next day, Emmalee’s chin dropped onto her chest, as if she couldn’t hold up her head. While sitting in a chair, Emmalee listed to one side, without enough muscle control to remain upright.

A pediatrician at Children’s Hospital of Philadelphia who was trained in India quickly recognized the early signs of a devastating long-term complication of measles called subacute sclerosing panencephalitis, which is more common in countries where the virus remains endemic. The fatal condition can cause memory loss, irritability, disturbances in movement, seizures and blindness, and can develop six to eight years after a child has apparently recovered from measles. Although anti-seizure drugs can sometimes ease symptoms, they don’t cure the disease.

Recent research shows the complication is more common than previously believed, striking about 1 in 600 infants with measles.

Emmalee began having uncontrollable seizures. After four months, Emmalee slipped into a coma while at home, Finkelstein-Parker said.

“My father couldn’t understand why she wouldn’t wake up,” Finkelstein-Parker said. “He tried everything, including playing music from her favorite music box.”

Emmalee spent five weeks in home hospice, passing away five months after symptoms began, Finkelstein-Parker said.

After Emmalee died, Finkelstein-Parker took the goody bags to school as presents for her daughter’s classmates. The children, who were also grieving, shared their favorite stories about Emmalee, and made a hanging mobile decorated with drawings and notes.

“Their teacher said they needed closure,” Finkelstein-Parker said. “They handled that day a whole lot better than I did.”

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What’s the greatest holiday gift: lips, hair, skin? Give the gift of great skin this holiday season

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Give the gift of great skin this holiday season

Skinstitut Holiday Gift Kits take the stress out of gifting

Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.

In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.

“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.

There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.

Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.

Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.

In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.

 

Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

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Here is how to prepare your online accounts for when you die

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LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?

It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.

Here’s how you can prepare your digital life for your survivors:

Apple

The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.

For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.

You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.

Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.

Google

Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.

When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.

You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.

There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.

Facebook and Instagram

Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.

When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.

The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.

You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.

TikTok

The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.

Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.

X

It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.

Passwords

Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?

Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.

But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.

___

Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.

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Pediatric group says doctors should regularly screen kids for reading difficulties

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The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.

New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.

The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.

Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.

Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.

“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.

“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”

McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.

But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.

The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.

He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.

“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.

“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.

McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”

McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.

He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.

“Early identification of reading difficulty can truly change the trajectory of a child’s life.”

This report by The Canadian Press was first published Oct. 23, 2024.

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