Measles Outbreak Puts Virus Back in Focus

January 29, 2019

The recent measles outbreak in Washington state raises many questions about the disease that was once nearly eliminated in the United States. According to the Centers for Disease Control and Prevention, there were 349 individual cases of measles in 26 states and the District of Columbia - the second-largest number of annual cases since the disease was eliminated in the U.S. in 2000.

The measles virus is highly contagious and spreads through the air with coughing and sneezing.

“Unlike many other viruses that are only contagious by touching a contaminated surface, measles can live in the air for up to two hours,” said Dr. Ann Marie Hennessey, Mercy Kids pediatrician. “And, because you’re contagious four days before symptoms arise and four days after the rash appears, it’s very important to stay out of public spaces until the disease has passed.”

Measles symptoms may initially seem like a bad cold with runny nose, watery eyes, cough and high fever. The rash develops soon after. While measles isn’t serious for everyone who contracts it, according to Dr. Hennessey one in four people who get it will be hospitalized. One of every 1,000 with measles will develop brain swelling and one or two of 1,000 will die, even with the best care.

With just one measles (MMR) vaccine – which most kids get around age 1 – there is 93 percent protection and with both in the series there is 97 percent protection. So Dr. Hennessey said for those concerned about possible exposure, if you’re immunized you’re safe and don’t need to worry.

“For those who aren’t immunized there’s a higher risk, especially for the younger children,” Dr. Hennessey said. “There’s no cure for it. We can provide comfort measures such as hydration and Tylenol, but there are additional complications that can lead to more serious concerns.”

What is measles?

Measles is a very contagious (easily spread) infection that causes a rash all over your body. It is also called rubeola or red measles.

The measles vaccine protects against the illness. This vaccine is part of the MMR (measles, mumps, and rubella) and MMRV (measles, mumps, rubella, and varicella [chickenpox]) vaccines. Most children get the vaccine as part of their regular shots. This is why measles is rare in the United States and Canada.

What causes measles?

Measles is caused by a virus. It is spread when an infected person coughs, sneezes, or shares food or drinks. The measles virus can travel through the air. This means that you can get measles if you are near someone who has the virus even if that person doesn't cough or sneeze directly on you.

You can spread the virus to others from 4 days before the rash starts until 4 days after the rash appeared. The virus is most often spread when people first get sick, before they know they have it.

If you have had measles, you can't get it again. Most people born before 1957 have had measles.

What are the symptoms?

The first symptoms of measles are like a bad cold—a high fever, a runny nose, sneezing, a sore throat, and a hacking cough. The lymph nodes in your neck may swell. You also may feel very tired and have diarrhea and red, sore eyes. As these symptoms start to go away, you will get red spots inside your mouth, followed by a rash all over your body.

When adults get measles, they usually feel worse than children who get it.

It usually takes about 7 to 18 days to get symptoms after you have been around someone who has measles. This is called the incubation period.

How is measles diagnosed?

If you think you have measles, call ahead and explain your symptoms before you go to a doctor's office.

After you've had an exam, your doctor may order a blood test and/or viral culture if he or she suspects that you have measles.

How is it treated?

Measles usually gets better with home care. You can take medicine to lower your fever, if needed. Read and follow all instructions on the label. Also, get plenty of rest and drink lots of fluids. Stay away from other people as much as you can so that you don't spread the disease. Anyone who has measles should stay out of school, day care, work, and public places until at least 4 days after the rash first appeared.

Your doctor may suggest vitamin A supplements if your child has measles.

Most people get better within 2 weeks. But measles can sometimes cause dangerous problems, such as lung infection (pneumonia) or brain swelling (encephalitis). In rare cases, it can even cause seizures or meningitis.

If you have been exposed to measles and you have not had the vaccine, you may be able to prevent the infection by getting immunoglobulin (IG) or the measles vaccine as soon as possible. Babies who are younger than 12 months, pregnant women, and people who have impaired immune systems that can't fight infection may need to get IG if they are exposed to measles.

Why is prevention important?

Getting your child vaccinated is important, because measles can sometimes cause serious problems.

False claims in the news have made some parents concerned about a link between autism and vaccines. But studies have found no link between vaccines and autism.footnote1

Measles is one of the most contagious diseases. Outbreaks can easily occur. For instance, a person from another country may have measles and not know it yet. If that person travels outside his or her own country, he or she could spread measles to people who are not immune. Also, if you travel to another country and you are not immune to measles, you may be at risk.

If you don't know whether you're immune to measles and you plan to travel, check with your doctor or local health clinic to see whether you should get the vaccine before you travel.

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