Teenage girl's harrowing journey with measles highlights how serious the virus can be for the immunocompromised - ABC News

Makayla Skerva, 14, North Dakota, contracted measles in February after being exposed to the virus at school.

A teenage girl's harrowing experience with measles shows just how serious the virus can be for people who are immunocompromised.

Makayla Skirva, a 14-year-old girl from North Dakota, fell ill with measles in February.

When 14-year-old Makayla Skjerova came home from school last month complaining of pain in her neck, her parents didn't believe she had anything more than a mild illness.

However, this symptom soon turned into body aches, fever and a noticeable rash.Then came reports from the health department and Makayla's school that she might have contracted smallpox in the school gym.

Soon after, Makayla, of Cavalier, North Dakota, tested positive for measles and her health rapidly deteriorated.She was quickly hospitalized and had to be airlifted out of the country for care.

His fight against measles comes amid a resurgence of the virus in the United States. Last year, the country had the highest number of measles cases in 33 years, with 2,283 confirmed infections.This year, more than 1,000 people fell ill with measles in two months.

Her stepmother, Ashley Skjerwa, told ABC News that Makayla has been vaccinated against measles, but because she is immunocompromised, this puts her at high risk for infection and serious complications.

“Makayla is a fighter, but the fight is not over,” Ashley said."We're all trying to stay together and it's been really hard. I'm just glad he's still here. That's what I tell myself."

exposed to disease

Ashley said Makayla was diagnosed with autoimmune encephalitis, which occurs when the immune system mistakenly attacks brain cells and causes inflammation, at age 5.

Although autoimmune encephalitis does not directly cause a high incidence of infections, many patients often develop immunity due to the long-term immunosuppressive therapy required.

Ashley explained that Makayla has always been more prone to illness and has had trouble fighting infections in the past.

Ashley said Makayla is fully vaccinated against measles.The Centers for Disease Control and Prevention (CDC) currently recommends that people receive two doses of the measles, mumps, and rubella (MMR) vaccine; the first between 12 and 15 months of age, the second between 4 and 6 years of age.According to the CDC, one dose is 93% effective against measles and two doses are 97% effective.

Measles was declared eliminated from the United States in 2000, due in large part to a highly effective vaccination campaign.However, CDC data shows that vaccination rates have lagged in recent years, resulting in record levels of measles cases.

When more than 95 percent of people in a community are vaccinated.Most will be protected through herd immunity, according to the CDC. Doctors say herd immunity is important to protect everyone.This is especially true for people at high risk of serious illness, such as those with compromised immune systems.People too young to be vaccinatedor those who cannot be vaccinated for medical reasons.

"If you look at children who are immunocompromised, they're relying on the community to protect them not only from measles, but from other infections," said Dr. Alok Patel, a pediatrician at Stanford Children's Medical Center who did not treat Makayla.

It also does not mean that the MMR shot is not effective in a fully vaccinated individual.

"Why are we talking about reducing the risk? Nothing is 100% effective in life. Not car seats, not helmets, not antibiotics, but the risk of complications," said Patel.

However, "there is a reason that most children in this country who get measles are not vaccinated. Most of the complications we see from measles are in unvaccinated children."

North Dakota, where Makayla lives, has seen 24 cases of measles so far this year, according to the North Dakota Department of Health and Human Services.Last year, there were 36 cases of measles in North Dakota, the first in the state since 2011.

A new map from ABC News — a collaboration with researchers in New York and Massachusetts that allows people to type in their zip code and see the measles risk in their area — shows that 70% to 79% of young children in Macayla's hometown of Cavalier who receive at least one dose of MMR have moderate measles risk.

Ashley said Makayla first became ill on Tuesday, February 10. That Friday, her parents tried to take her to the emergency room, but medical staff said they could not see Makayla because her school had confirmed measles.Ashley said they recommend Tylenol and ibuprofen for pain, along with nebulizer therapy.

Makayla and her 1-year-old sister, Armani, who had not yet received her first gun, suffered seizures.Although Armani was a little sick, Makayla's illness was more severe.

"Makayla got the vaccine, but it doesn't do anything with a [weak] immune system," Ashley said."My little one got sick and she's doing great. She has the immune system to fight it off. Makayla doesn't."

Ashley said she brought Makayla and Armani to the clinic on Thursday, February 19, when the teenager was having trouble breathing.Her oxygen saturation level dropped to 62 percent, which is extremely low.

Clinic staff told Ashley that Makayla needed immediate medical attention and she immediately went to the hospital.Makayla's father, Derrick, picked up their youngest daughter and took her home while Ashley rode with Makayla in an ambulance about 100 miles south to Fargo.

"It was all downhill from there," Ashley said.

He was hospitalized and transported to Minneapolis

Makayla went to Sanford Children's Hospital in Fargo, where doctors diagnosed her with measles, pneumonia, COVID-19 and Haemophilus influenzae, which is contagious, according to Ashley.

According to the CDC, one in 20 children with measles will develop pneumonia.According to the Federal Health Office, measles is the most common cause of death in young children.

Research shows that patients with measles-related pneumonia are more likely to develop other infections.

Patel said one in five unvaccinated people will be hospitalized with measles, but that number may be higher depending on a subgroup, such as people with immunity.

"While many people assume or believe that measles is just an upper respiratory infection that may have a rash, for many people, especially those who are susceptible — or immunosuppressed or unvaccinated — the acute and long-term complications can be very serious," he said.

Because she was having trouble breathing, Ashley said, Makayla was given a standard nasal cannula to increase oxygen flow.When that wasn't enough, medical staff put Makayla on a CPAP machine to maintain airway pressure.The next morning, he was placed on a BIPAP machine that offers different pressure levels, Ashley said.

Ashley said Makayla was in and out of response.The doctors told her they needed Makayla's urine so she could get the blood out.

"So fast, what did you do in that time?"Ashley said.

Doctors told Makayla's family they had to move her to Minnesota so she could receive the care she couldn't receive in North Dakota.If he were to stay in North Dakota, he would have to undergo high-frequency oscillatory ventilation, which is a ventilation method in the ICU used to treat severe respiratory failure, Ashley said.

"At the last moment she was stable, they told us exactly that we had three hours to get people [to Fargo]," said Ashley. We can't do more, if we put her on it, she's going to die.

According to Ashley, Makayla was taken by ambulance to the University of Minnesota M Health Fairview Medical Center - West Coast in Minneapolis.She said there wasn't enough room in the ambulance because of the number of emergency medical personnel, so she and Makayla's mother made the three-hour drive to the hospital.

Michaela's condition gradually improved in Minneapolis, Ashley said.After about two days, doctors stopped Michaela's paralysis to confirm that she had movement in her head and legs and was able to answer questions with fingers or head movements.

"She was on painkillers," Ashley said."She was on steroids and on a wide, wide, wide range of antibiotics. And then she got pretty stable. They finally got her out of the coma, and it was a slow process to make sure she was getting her oxygen levels up."

According to Ashley, the main reason for the urgency of the move from Fargo to Minneapolis was because doctors planned to put Makayla on an extracorporeal membrane oxygenation (ECMO) machine.

The machine takes the patient's blood out of the body, deoxygenates it and then returns it to the blood, allowing the heart and lungs to relax.

However, the medical team in Minneapolis was able to leave Makayla on the ventilator and gradually decrease her dependence on it, Ashley said.

He added that doctors are treating Makayla to prevent meningitis, which can be a serious - but less common - complication of measles.

Vaccines 'can save lives'

Mikaela was gradually weaned off the ventilator and her condition improved enough to be transferred to Sanford Medical Center in Fargo on Saturday, Feb. 28, Ashley said.By early March, doctors successfully removed all the threads and began weaning Mikayla off her medication.

Ashley said Makayla was taken off the feeding tube and has been able to eat real food since March 3, in addition to walking slowly.

“She had to use a walker and could bite slowly,” Ashley said.“She had to chew for a really long time because the tube made [her throat] really, really, really sore.”

Makayla was discharged from the hospital on Friday, March 6th.Ashley said Makayla struggled to walk because she was so weak and underweight, but she was glad to be able to go home.

Ashley said that Makayla has "a long way to go" and that she and her husband are currently in the process of finding the right school for Makayla.He has many doctor's appointments ahead of him in Fargo, as well as a once-every-four-month visit to Minneapolis.

Ashley said she and other family members feel angry and sad that Makayla was exposed to measles in the first place, but said she believes it was nothing wrong.

She said people need to understand that getting the measles vaccine not only protects them, but also those with weakened immune systems or those with severe autoimmune diseases like Makayla.

"I understand that people have the right to get vaccinated or not, but think about the fact that millions of people are at risk for autoimmune diseases," Ashley said.