For most Americans, measles may seem like an old-fashioned disease that worried our parents and grandparents. But measles is hardly a thing of the past.
In fact, recent measles outbreaks serve as frightening reminders that eradication of this and other diseases may not be permanent. It is important to vaccinate children against the disease to prevent measles outbreaks.
In 1912, measles became a “nationally notifiable disease” in the United States, according to the Centers for Disease Control and Prevention.
An estimated three to four million people got measles each year in the United States. Of these, approximately 500,000 cases were reported each year to CDC. Of these, 400 to 500 died, and 48,000 were hospitalized.
In the late 1970s, the CDC set a goal to eliminate the virus by 1982. Although the percentage of those infected was drastically reduced — fewer than 80% contracted it compared to the previous year — another uptick in outbreaks occurred in 1989 among vaccinated school-aged children. This prompted a second recommended dose of the MMR (measles, mumps, and rubella) vaccine for all children.
In the year 2000, infectious disease experts considered measles eliminated in the United States. However, despite the United State’s vigilance in educating and eradicating the virus, measles is still common in other countries.
Unvaccinated people continue to contract it while abroad and bring the disease back into this country where they spread it to others. Its incidence has been increasing steadily over the past several years.
How Contagious Is Measles?
Measles is highly contagious. That’s because it’s an airborne virus that is transmitted when an infected person breathes, coughs, or sneezes. The infectious droplets come into direct contact with anyone in close contact with the host.
The infectious virus can remain in the air for two hours and continue to sicken others long after the person with the virus has left. It can remain on surfaces for up to two hours after initial contact.
Nearly 90% of those who come into close contact with an individual with measles will acquire it if not immune. In an unimmunized population, one person with measles can infect 12 to 18 others, which greatly exceeds the infection rate with other viruses like Ebola, HIV, or SARS. With Ebola, for example, one case usually leads to two additional cases, while with HIV and SARS, another four people may become infected.
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The virus is progressive and somewhat deceiving, as its initial symptoms mimic other colds and viruses. Measles symptoms typically don’t reveal themselves until 10 to 14 days post exposure. People with measles are contagious four days prior to the appearance of a rash and remain contagious until four days after.
The measles virus is considered the deadliest of all childhood rash and fever illnesses. The virus typically causes:
- A rash
- Bloodshot, watery eyes
- Runny nose
- High Fever
- Sore throat
- Dry cough
- Swollen lymph nodes
- Muscle pain
- Tiny white spots with bluish-white centers on a red background found inside the mouth on the inner lining of the cheek
Complications of measles can include:
- Ear infections
- Encephalitis (inflammation of the brain)
- Hearing loss
Before immunization was widespread, most people had developed measles by age 20.
There is no treatment once an individual has contracted the disease. Doctors will administer fluids, proper nutrition, and antibiotics when necessary for associated conditions such as infections in the eye or ears as a result of contracting measles.
In these cases, patients are made to feel more comfortable and doctors work to get ahead of any serious complications such as encephalitis or pneumonia, which is most common in children with the disease.
You can see why it’s important to do everything you can to prevent measles. Yet one of the main reasons for the recent measles outbreak appears to be the decision of some parents not to vaccinate their children against the disease. Despite fears to the contrary, the combined measles, mumps, rubella (German measles), and varicella (chicken pox) vaccine, also known as MMRV, is safe and effectively prevents measles. There is no evidence that it can cause autism or other disorders.
As this latest measles outbreak shows us, choosing to forgo vaccines may be a personal choice, but it can have far-reaching — and dangerous — consequences for the general public.
Some of the children who have been diagnosed with measles were too young to be immunized, so their health and safety depended on something called “herd immunity.” In other words, when the majority of people in a community are immunized against measles, there is little opportunity for an outbreak. That means that even people who cannot receive certain vaccines (such as infants and pregnant women) still get some protection against the disease. But when parents decide not vaccinate, the chances of an outbreak increase, putting everyone at risk.
Vaccinate Your Children
The biggest step you can take toward protecting yourself and others against the disease is to make sure that your child is immunized against it. The MMRV vaccine is credited with dramatically decreasing the number of measles cases in the U.S.
The vaccine contains an active, yet weakened version of the virus. This causes the immune system to produce antibodies that would fight it should you become exposed. If that happens, those antibodies shift into high gear and protect you against the disease.
For people who live or work in close quarters such as schools, camps, daycares, or hospitals, the vaccine is especially important given the contagious factor. For those who may have been exposed to measles and have no evidence of immunity, it is recommended they ask for a blood test to determine their status and should consider post-exposure prophylaxis (PEP) or remove themselves from the setting until the risk is gone.
The MMR vaccine should be administered within 72 hours of initial measles exposure, or immunoglobulin (IG) given within six days of exposure. Both the MMR vaccine and IG should not be given at the same time, because it cancels or invalidates the vaccine.
Per the CDC, the recommended dose for the MMR vaccine according to ages are as follows:
Children: Routine childhood immunization for the vaccine starting with the first dose at 12 through 15 months of age, and the second dose at four through six years of age.
College Students: Students at post-high school educational institutions without evidence of measles immunity need two doses of MMR vaccine, with the second dose administered no earlier than 28 days after the first dose.
Adults: People who are born during or after 1957 who do not have evidence of immunity against measles should get at least one dose of MMR vaccine.
International Travelers: People 6 months of age or older who will be traveling internationally should be protected. Before traveling internationally:
- Infants six through 11 months of age should receive one dose.
- Children 12 months of age or older should have documentation of two doses of the vaccine (the first dose of MMR vaccine should be administered at age 12 months or older; the second dose no earlier than 28 days after the first dose).
- Teenagers and adults born during or after 1957 without evidence of immunity against measles should have documentation of two doses of MMR vaccine, with the second dose administered no earlier than 28 days after the first dose.
Immunity from the vaccine lasts for decades, but you should ask your health provider about booster shots if you’re an adult. Talk to your primary care provider about your vaccine schedule.
From nutrition to illnesses, from athletics to school, children will face many challenges growing up. Parents often will make important health care decisions for them. We hope to help guide both of you in that journey. UPMC Children’s Hospital of Pittsburgh is a national leader in pediatric care, ranking consistently on U.S. News & World Report’s Best Children’s Hospitals Honor Roll. We provide expert treatment for pediatric diseases, along well-child visits, urgent care, and more. With locations across Pennsylvania, Maryland, and West Virginia, you can find world-class care close to home. We also work closely with UPMC Magee-Womens Hospital, a national leader in care for newborns and their mothers. Our goal is to provide the best care for your children, from birth to adulthood and beyond. Visit our website to find a doctor near you.