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What You Need to Know about Measles – Dr. Allison Nied

By Allison J. Nied, MD, FAAP | Pediatrics

What You Need to Know about Measles

In light of the recent outbreaks in the United States, measles has become a hot topic of conversation. There are heated debates between parents of children vulnerable to this extremely contagious infectious disease and those who choose not to vaccinate. Given the possibility of serious complications, it is understandable why parents are concerned about measles.

Let’s get the facts. Measles (rubeola) is caused by a virus and is one of the most communicable of all infectious diseases. It is transmitted through the air. Symptoms include high fever, cough, runny nose, conjunctivitis (pink eye), white spots in the mouth, and skin rash. Most people with measles experience sensitivity to light, known as photophobia. The rash consists of red spots that start on the face and spread towards the hands and feet. People with measles are contagious for 4 days before the rash develops and 4 days after it starts. It usually takes 7-18 days to get the symptoms after you have been exposed to measles. Children with measles typically look very ill.

Although the symptoms of measles may not sound different from many viral illnesses, serious complications are more common with measles then most viral illnesses. As with other viral illnesses, measles can be associated with bacterial superinfections such as ear infections and pneumonia. One in 1000 cases of measles is complicated by acute encephalitis (brain swelling) which can cause permanent brain damage or death. Although most people who contract measles recover, 1-3 per 1000 cases in the United States are fatal. The serious complications are typically worse in those under 5 years of age and in anyone who is immunocompromised.

The best way to prevent measles is through immunization by the MMR (measles mumps rubella) vaccination. The vaccine was licensed in the United States in 1963 and resulted in a 99% decrease in measles cases. From 2001-2011 there were approximately 60 cases of measles diagnosed annually in the United States. As of February 27, 2015 there have been 170 cases this year. Cases have been reported in 17 states and Washington DC. 89% of the cases are associated with 4 outbreaks. The majority of people who contract measles are unvaccinated. In 2014 there were 644 cases in the US. 81% of these cases were in unvaccinated people. Only 5% of cases occurred in patients who received 2 or more MMR vaccines.

What you need to know about the MMR vaccine:

  1. The first MMR vaccine is recommended by the Academy of Pediatrics between 12 and 18 months of age.
  2. The MMR vaccine can be given as young as 6 months of age when a patient is at increased risk of contracting measles because of international travel or a local outbreak.
  3. A booster dose of MMR is typically given between 4 and 6 years of age but can be given at any age, 28 days or more after the first dose.
  4. If you are planning any travel via plane or train with a child over the age of 6 months who has not yet received the MMR vaccine, you may want to discuss this with your child’s pediatrician.
  5. Numerous well designed studies have discredited claims linking MMR vaccine to autism.
  6. The initial article that made this connection was published by the British medical journal Lancet, in 1998 and has since been retracted. The leading author, Andrew Wakefield was charged with falsification of data and is barred from practicing medicine in the UK.

At this point in time, there are no outbreaks in our area. The CDC continues to post updates on their website (http://www.cdc.gov/measles/cases-outbreaks.html) However, remember, with global travel an everyday occurrence, measles is just a plane ride away.