As of early August,  more than 1,300 confirmed measles cases have been reported across the country. And now, measles pathogens have been detected in local wastewater by the Southern Nevada Health District. The last outbreak in Southern Nevada occurred in 2015, with the last confirmed case in 2018.

Though an individual with measles hasn’t been identified locally, wastewater surveillance indicates that the virus may be present. And local health officials are stepping up monitoring efforts and have urged residents — especially families with school-age children — to make sure they are up to date on the most effective precaution available: the measles, mumps and rubella (MMR) vaccine.

Measles is one of the most contagious human diseases and can cause serious health complications in youngsters. Common symptoms include high fever, cough, runny nose, red watery eyes, and a rash. According to the Centers for Disease Control, if one person has it, up to 9 out of 10 people nearby can become infected if they are not vaccinated.

To better understand what the wastewater findings mean for Southern Nevada, we checked in with Brian Labus, an infectious disease epidemiologist and associate professor at the UNLV School of Public Health.

“The point of these kinds of surveillance systems is to tell medical and public health professionals that there's something going on that we need to look for a little more,” said Labus. “If you're a doctor and you know that there's measles circulating and a patient comes in with a fever and a rash, you might look at that differently than you would if there was nothing going on.” 

Wastewater surveillance is a public health practice that ramped up nationwide during the COVID-19 pandemic and provides information about what’s happening in the community. 

“Our system relies on people getting sick and going to the doctor, but for most diseases, people don’t seek medical care,” said Labus. “So, we can look at the wastewater because everybody has to use the bathroom. But one thing wastewater can't tell us is who that person is.”

By definition, an outbreak means there is more disease in a community than would be expected. According to Labus, since Southern Nevada hasn't seen a case of measles in nearly a decade, even a single infected person represents a big change.

He says that even with the new information, the recommendations don’t change.

“The best way to protect yourself from measles is to get vaccinated,” Labus said. “The MMR vaccine is safe and over 99% effective in preventing measles. Now is the time to check your records to make sure you are up to date on your measles vaccination, and to get vaccinated if you are not. It's also something that's required to attend schools in Nevada.”

If the vaccine is effective, why are some people hesitant to get vaccinated?

“To recommend a vaccine, the risk of the disease has to be greater than the risk of any potential risk from getting the vaccine. And for measles, that’s definitely the case,” said Labus. “The disease can be deadly, and the vaccine is safe. People haven't seen measles in so long that they don't appreciate how dangerous the disease is. All they see is the minuscule risk that goes along with any vaccine. And so in their calculation, the vaccine is way less safe than the disease. The reality is just the opposite.”

According to Labus, these are some ways individuals can prepare for a measles outbreak:

• The measles vaccine is safe and effective. It rarely has side effects, and it doesn’t cause long-term problems. It’s the only thing that's going to keep you from getting measles, unless you’ve had it previously. 
• Measles used to be a common childhood disease. Now that we’ve vaccinated everybody, it’s not a childhood disease anymore. The high-risk people are those who are not immune because they’re unvaccinated or undervaccinated.
• An undervaccinated individual is someone who hasn’t received the recommended two doses of the MMR vaccine. If you don’t know if you received two doses, check with your healthcare provider. The two-dose recommendation began in 1989.