Measles 101: What You Need to Know

MMR Vaccine_bloglargeThe concern about measles is spreading as quickly as the disease and rightly so. The United States is currently in the midst of the largest measles outbreak in 25 years. Measles is one of the most contagious viruses on Earth. If you enter a room where someone with measles has coughed or sneezed within the last two hours, even if that person is no longer in the room, you can get it if you haven’t been vaccinated or had the disease in the past.
 
It’s so dangerous that the name should be changed to the “red-spotted plague.” You should avoid it like the plague. Here’s what to know about measles and how to protect yourself and loved ones.
 
What is measles?
Measles is an acute viral illness transmitted by coughing or sneezing. The incubation period – the time from exposure to the first signs or symptoms – varies from seven to 21 days.
 
What are the symptoms?
The first sign is a very high fever (up to 105 degrees), followed by a flat, then raised, red rash. The tiny red spots of the rash start on the head/face and travel down to the neck, chest, arms and legs. The rash usually appears about 14 days after the initial exposure. It’s characterized by 3Cs: cough, coryza (inflammation of the mucous membrane in the nose) and conjunctivitis (redness in the white part of the eyes). The rash is the tell-tale sign that you’ve gotten measles. The bad news is that you can get measles (if you haven’t been vaccinated or had the disease) from someone up to four days before their rash shows up and up to four days after it appears.
 
How dangerous is measles?
You can end up in the hospital or even die from a measles-related complication such as pneumonia. Other complications are diarrhea (especially in young children) and ear infections. Also possible, but not as common, is development of encephalitis (a swelling of the brain with altered mental capacity) that could lead to permanent brain damage and deafness. If you’re pregnant and get measles, you could go into premature labor, have a miscarriage or deliver a low-birth-weight baby. 
 
Can measles be treated?
No. There’s no treatment for measles other than supportive care. There may be treatment for complications (pneumonia, ear infections, etc.). If you suspect someone has the measles and is seeking medical care, it’s critical that you call ahead and alert the hospital or clinic so precautions can be taken. Place a mask on the patient upon arrival and request airborne isolation, which will help prevent the patient from infecting others.
 
Why are we seeing so many cases now? 
An anti-vaccination movement has been on the rise for several years, with parents refusing to vaccinate their children for religious, philosophical or other reasons. Very few who refuse the vaccine have been around to see how devastating this infection actually is -- out of sight, out of mind. 
 
Is there a link between vaccinations and autism?
No. The U.S. Centers for Disease Control and Prevention says there’s “no convincing evidence that any vaccine causes autism or autism spectrum disorder.” Development of encephalitis after measles, however, can lead to deficits.
 
How effective is a vaccination?
Very effective. If you get two doses of the measles, mumps and rubella (MMR) vaccine, the risk of getting measles is less than 3 percent. Children usually get their first shot at 12 to 15 months, and the second shot is at 4 to 6 years, before they start school. If your baby is traveling to a country or area with a measles outbreak, it’s possible to get the first shot as young as 6 months old -- check with your pediatrician. 
 
Do adults need a new vaccination? 
It depends. The CDC says if you were born before 1957, you probably had the measles and are immune. If you were born between 1957 and 1989, you may have only received one MMR vaccine, meaning you may want to get a booster shot for maximum protection. If you got the MMR vaccine between 1963 and 1967, you got what was later determined to be an ineffective vaccine for measles. If so, you should either have your blood checked to see if measles antibodies are present or go ahead and get the MMR vaccine. There’s no harm in getting another dose if you may already be immune. When in doubt, vaccinate. 
 
Who shouldn’t be vaccinated?
The MMR vaccine is a live virus and not advised for children under the age of 1 (except under special circumstances, like travel to an area with a measles outbreak.) Also, if you’re pregnant or have a weakened immune system due to cancer or HIV/AIDS, or if you’re undergoing medical treatment such as radiation, immunotherapy, steroids or chemotherapy, you shouldn’t receive the vaccine.
 
How can I reduce the risk of getting measles if vaccination isn’t an option?

Stay home if there’s a measles outbreak at your school or workplace and you or your children haven’t had two MMR shots or if you’re pregnant or have a compromised immune system.

• Stay away from anyone with a high fever, runny nose and red eyes. 

Always cover your mouth and nose with a tissue when you cough or sneeze, and put used tissues in a trash can.

Wash your hands frequently with an alcohol hand rub or with soap and water.

Always avoid touching your face, eyes, nose and mouth with your hands.

 
Dr. Julie E. Mangino is professor emeritus at The Ohio State University Wexner Medical Center in the Department of Internal Medicine and the Division of Infectious Diseases.