The Centers for Disease Control and Prevention (CDC) has measured the greatest number of measles cases since 1992, spanning confirmation in 30 states. The outbreak of this disease is alarming, especially considering that it was declared eliminated from the U.S. in 2000 due to the widespread implementation of the measles vaccination.

Dr. John Kaiser, OB/GYN and president of Saltzer Health, explained in an episode of The Healthcare Podcast how dramatic the resurgence of measles had become by the summer of 2019:

“From January 1 to July 11, there was 1,123 cases in 28 states — just to show you how widespread it has been. This is obviously one of the worst years — it waxes and wanes, but it has usually been significantly lower in prior years since it was declared eliminated in 2000.”

Measles is on the rise, and still common in many parts of the globe. It is one of the world’s most highly contagious diseases and spreads easily through communities where groups or pockets of people are unvaccinated. Measles contributed to over 110,000 deaths globally (mostly children under the age of 5) in 2017, according to the World Health Organization (WHO). While this death count may seem high, it is relatively lessened, considering the 80% drop in measles-caused deaths between 2000 and 2017 due to vaccinations.

With the ease of transmission globally from country to country, measles is just as easily transmitted internally in the United States. Idaho residents and parents should be aware that an outbreak began in May 2019 in Washington State, and that Idaho has already reported cases of the disease. Measles is safely preventable with the MMR vaccine. One dose of the vaccination is about 93% effective while two doses are about 97% effective, according to the CDC.

What Does Measles Look Like?

The first symptom of the virus appears 10 to 12 days after exposure. A high fever is typically the first symptom, which may last 4 to 7 days. Cold-like symptoms that may concurrently develop include: red, watery, or inflamed eyes, a runny nose, dry cough, and small white spots (Koplik’s spots) with bluish-white centers on a red background that develops inside the cheeks. After several days of initial symptoms, a rash erupts on the face and upper neck. Over the next 3 days, the rash spreads, eventually reaching the extremities, hands, and feet. The rash may last 5-6 days and then fade. The rash occurs between 7-18 days after exposure, and on average, at day 14.

Symptoms

Other symptoms may include:

• Muscle pain; 
• Fatigue; 
• Loss of appetite; 
• General feeling of discomfort or uneasiness (malaise);
• Diarrhea;
• Headache;
• Sensitivity to light;
• Sore throat (Koplik’s spots).

How Is Measles Spread?

Measles outbreaks are easily triggered, as the virus is one of the world’s most contagious diseases. 

“Measles is a viral illness, but it is probably one of the most contagious viral illnesses of all viruses. It’s more contagious than influenza [the flu],” said Dr. Katie Copeland, a pediatrician at Saltzer health, on the same episode of The Healthcare Podcast with Dr. Kaiser. “If you have an un-immunized patient pass through an area two hours after someone with measles was in that area, there’s a 90% chance they will contract measles. It spreads quite rapidly in an un-immunized or under-immunized area.”

The virus may be spread through coughing, sneezing, close personal contact, or direct contact with infected nasal or throat secretions. The virus may remain active and infectious in the air or on a surface for more than two hours.  An infected person may be contagious 4 days prior to the rash, and 4 days after the rash has erupted. 

Those with the highest risk are unvaccinated young children, unvaccinated pregnant women, any non-immune person or people with compromised immune systems, impoverished communities, and those that live in areas with weak health infrastructure.

Is Measles Deadly?

Most measles-related deaths are caused by complications associated with the infection. WHO states that serious complications are more likely to occur under the age of five, or over the age of thirty. Measles may cause serious illnesses that require hospitalization, such as:

• Otitis media; 
• Pneumonia, bronchopneumonia, or severe respiratory infections;
• Laryngotracheobronchitis;
• Diarrhea and dehydration;
• Blindness; 
• Encephalitis (an infection that causes brain swelling);
• Ear infections.

Measles can easily be prevented through vaccination. According to WHO, before the availability of the widespread vaccination in 1963, major epidemics caused an estimated 2.6 million deaths each year. Accelerated immunization activities between 2000-2017 helped prevent an estimated 21.1 million deaths. 

At What Age Should I Vaccinate My Children?

The CDC recommends that the first dose of the MMR vaccine be administered at 12-15 months of age, followed by a second dose at 4-6 years of age. The second dose may be provided after 28 days following the first dose, if an outbreak has occurred near the location of the child, or if the family is intending on traveling in a high-risk area. 

Infant immunizations for MMR can be administered after the age of 6 months to facilitate international travel. If an immunization is administered before one year of age, the recommendation is to continue to receive the routine doses at 12 months and 4-6 years.Students seeking post-high school education will need to provide evidence of two doses of measles immunization.

Can Adults Get Measles?

Anyone who does not have evidence of immunity may be susceptible to the disease. Evidence of immunity includes written documentation of adequate vaccination, laboratory evidence of immunity, laboratory confirmation of past measles infection, and birth before 1957.

WHO states that measles may result in the most serious complications for those under the age of five and over the age of thirty, so it is important not to just protect children, but also adults. 

Vaccination Is Key

An article published on Cureus states that Anti-vaccine movements have existed as long as the vaccines themselves. In a day and age with global travel, and the likelihood of infectious diseases spreading, it is more important now than ever to continue vaccinations and stay up to date on medical information. The Cureus article later addresses the strong rejuvenation of the anti-vaccine movement that came with the publication of a paper by a former British Doctor and researcher, Andrew Wakefield, which implied that measles vaccines produced autism in children. Several studies followed that quickly debunked Wakefield’s paper, and found that Wakefield received funding from litigants against vaccine manufacturers.

Speaking on The Healthcare Podcast, Dr. Copeland detailed how vaccines, in general, are among the safest healthcare resources available today.

“The chance of having a serious reaction from any vaccine is about one in a million doses. So it’s probably more dangerous to drive your child in a car, let them swim in a pool, let them jump on a trampoline, than it is to vaccinate your child.” 

Participating in research studies helps the medical industry understand the best ways to deal with intensive medical issues. 

Checking records and speaking with a family doctor is the surest way to check for past immunizations, and ensuring that all family members are up to date on immunizations is the best way to prevent this extremely contagious diseases from spreading. 

Due to health issues, some children and adults may not receive the vaccine, but by community effort in making certain that a large percentage of the population has received the vaccine, those that cannot receive the vaccine due to health conditions are protected by herd immunity. Vaccination doesn’t just save one life from the disease; it has the potential to protect many others as well.