Learn about this vaccine-preventable disease that used to be common in childhood and is well known for a characteristic red, splotchy rash and high fever.
Measles is a childhood infection caused by a virus. Once quite common, measles can now almost always be prevented with a vaccine.
Also called rubeola, measles can be serious and even fatal for small children. While death rates have been falling worldwide as more children receive the measles vaccine, the disease still kills more than 100,000 people a year, most under the age of 5.
As a result of high vaccination rates in general, measles hasn't been widespread in the United States for more than a decade. The United States had about 30 cases of measles in 2004 but more than 600 cases in 2014. Most of these cases originated outside the country and occurred in people who were unvaccinated or who didn't know whether or not they had been vaccinated.
Measles signs and symptoms appear around 10 to 14 days after exposure to the virus. Signs and symptoms of measles typically include:
The infection occurs in a sequence of stages during a period of two to three weeks.
Acute illness and rash. The rash consists of small red spots, some of which are slightly raised. Spots and bumps in tight clusters give the skin a splotchy red appearance. The face breaks out first.
Over the next few days, the rash spreads down the arms and trunk, then over the thighs, lower legs and feet. At the same time, the fever rises sharply, often as high as 104 to 105.8 F (40 to 41 C). The measles rash gradually recedes, fading first from the face and last from the thighs and feet.
Call your doctor if you think you or your child may have been exposed to measles or if you or your child has a rash resembling measles.
Review your family's vaccination records with your doctor, especially before your children start elementary school or college and before international travel.
Measles is a highly contagious illness caused by a virus that replicates in the nose and throat of an infected child or adult. Then, when someone with measles coughs, sneezes or talks, infected droplets spray into the air, where other people can inhale them.
The infected droplets may also land on a surface, where they remain active and contagious for several hours. You can contract the virus by putting your fingers in your mouth or nose or rubbing your eyes after touching the infected surface.
About 90% of susceptible people who are exposed to someone with the virus will be infected.
Risk factors for measles include:
Complications of measles may include:
The Centers for Disease Control and Prevention recommends that children and adults receive the measles vaccine to prevent measles.
To prevent measles in children, doctors usually give infants the first dose of the vaccine between 12 and 15 months, with the second dose typically given between ages 4 and 6 years. Keep in mind:
You may need the measles vaccine if you're an adult who:
If you're not sure if you need the measles vaccine, talk to your doctor.
If someone in your household has measles, take these precautions to protect vulnerable family and friends:
Isolation. Because measles is highly contagious from about four days before to four days after the rash breaks out, people with measles shouldn't return to activities in which they interact with other people during this period.
It may also be necessary to keep nonimmunized people — siblings, for example — away from the infected person.
If you've already had measles, your body has built up its immune system to fight the infection, and you can't get measles again. Most people born or living in the United States before 1957 are immune to measles, simply because they've already had it.
For everyone else, there's the measles vaccine, which is important for:
Promoting and preserving widespread immunity. Since the introduction of the measles vaccine, measles has virtually been eliminated in the United States, even though not everyone has been vaccinated. This effect is called herd immunity.
But herd immunity may now be weakening a bit, likely due to a drop in vaccination rates. The incidence of measles in the U.S. recently increased significantly.
Preventing a resurgence of measles. Steady vaccination rates are important because soon after vaccination rates decline, measles begins to come back. In 1998, a now-discredited study was published incorrectly linking autism to the measles-mumps-rubella (MMR) vaccine.
In the United Kingdom, where the study originated, the rate of vaccination dropped to an all-time low of about 80% of all children in 2003-2004. In 2008, there were nearly 1,400 lab-confirmed cases of measles in England and Wales.
Your doctor can usually diagnose measles based on the disease's characteristic rash as well as a small, bluish-white spot on a bright red background — Koplik's spot — on the inside lining of the cheek. However, many doctors have never seen measles, and the rash can be confused with a number of other illnesses. If necessary, a blood test can confirm whether the rash is truly measles. The measles virus can also be confirmed with a test that generally uses a throat swab or urine sample.
There's no specific treatment for an established measles infection. However, some measures can be taken to protect vulnerable individuals who have been exposed to the virus.
Fever reducers. You or your child may also take over-the-counter medications such as acetaminophen (Tylenol, others), ibuprofen (Advil, Children's Motrin, others) or naproxen sodium (Aleve) to help relieve the fever that accompanies measles.
Don't give aspirin to children or teenagers who have measles symptoms. Though aspirin is approved for use in children older than age 3, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked to Reye's syndrome, a rare but potentially life-threatening condition, in such children.
If you or your child has measles, keep in touch with your doctor as you monitor the progress of the disease and watch for complications. Also try these comfort measures:
If you suspect that you or your child has measles, you need to see your child's doctor.
For measles, some basic questions to ask your doctor include:
The doctor may ask that you come in before or after office hours to reduce the risk of exposing others to the measles. In addition, if the doctor believes that you or your child has the measles, he or she must report those findings to the local health department.
Your doctor is likely to ask you a number of questions, such as:
While you're waiting to see the doctor:
Bring a fever down safely. If a fever is making you or your child uncomfortable, medications such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Children's Motrin, others) can help bring the fever down.
Don't give aspirin to children or teenagers who have symptoms of measles. Though aspirin is approved for use in children older than age 3, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked to Reye's syndrome, a rare but potentially life-threatening condition, in such children.
December 22nd, 2020