Measles: What You Need to Know 

February 7, 2024

In the news there are reports of Measles cases! Why is this important? Because every year the number of cases is increasing and it is VERY contagious! The measles virus can stay in the air for upto 2 hours after an infected patient was there. You can get it by simply being in a room where the infected person was. Close to 90% of the people close to the infected person will get measles if they are not protected.

Children are especially vulnerable. One in 3 kids under 5 years of age with measles ends up in the hospital. Before the 1960’s most children were exposed to measles in pre-k or kindergarten. Since the introduction of the vaccine in 1963, there was a 99% decline in the incidence of measles in the United States, with only patients who traveled or were exposed to a traveler, contracting the disease. Unfortunately, due to a decrease in vaccination worldwide, 2 weeks ago, a report showed a 45 fold increase in measles in Europe. In the U.S. we are hearing of scattered cases of measles.  A report was sent to physicians to be on the lookout for measles cases. 

What is measles?

Measles is a disease caused by the measles virus. It is highly contagious in small respiratory droplets in the air or from direct contact with fluid from the nose or mouth of an infected person. 

How does it present? 

• After exposure, you won’t see symptoms until 8-12 days later (incubation period). 
• Infected patients are contagious 1-2 days before symptoms start up until 3-5 days after the rash appears. Unfortunately most people transmit measles because they don’t know that they have it. 
• Usually kids look very sick and start with cold-like symptoms such as a runny nose, cough, and conjunctivitis (eye infections). *first 1-3 days
• A rash appears usually on the face after the initial days of cold-like symptoms. The rash starts in the face and then moves down to the chest, back, arms and finally the legs. It can last 5-8 days. 
• Young kids can develop secondary infections such as pneumonia, croup, ear infections (with potential hearing loss) and diarrhea. 

What do I do if I think my child has measles? 

• Keep your child home and especially away from unimmunized people. Most infants receive the MMR at  1 year of age. 
• Monitor closely for worsening symptoms that can indicate a secondary infection such as pneumonia, encephalitis (brain infection)which can lead to permanent neurological problems and, ear infections with potential hearing loss. 
• Keep your child well hydrated and manage the fever like you would any other fever. 

How can I protect my family? 

• Handwashing
• Avoiding large crowds or people with colds when you have a small infant that is not immunized.
• Breastfeeding- When a mother is immunized, the antibodies are passed on to the baby and can protect them until approximately 6-12 months of age. 

Immunize! Get those vaccines:

Pregnant:

• If you are pregnant and have received the MMR in the past, you should be protected.
• You can not receive the MMR during pregnancy. You have to wait until after you deliver.
• If someone you know has measles, stay away from them. Measles in pregnancy can cause miscarriage, still birth and or premature birth. 

Infants: 

• Most infants receive the MMR at 1 year. If you are traveling to an area with an increased number of measles cases (Europe and many other parts of the world right now), your baby can receive an extra dose as young as 6 months of age. They will still be required to receive the 1 year dose as well. *One dose offers about 93% protection.

Children:

• Children receive an MMR booster somewhere between 4-6 years of age. These children are protected.  *This second dose offers close to 97% protection.

What if I am fully vaccinated? 

Thankfully the Measles vaccine works REALLY well. So basically if you are up to date (received 2 doses at the proper interval), you can consider yourself protected. If you are exposed to measles and you are vaccinated, passing it on to someone else is VERY RARE.

**If you are unsure of your vaccination status, you can request to have your titers checked with your doctor.

“Measles, in essence, is really the most contagious of the vaccine-preventable diseases,” Someone with measles can infect 12-18 people in a susceptible population. Measles also can alter immune memory, wiping out antibodies a person has, making it harder to fight future pathogens. *MedpageToday-Walter Orenstein, M.D. DSc at Emory University School of Medicine.