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With insights from Melinda Cooper, RN, BSN, CIC, WakeMed Infection Prevention Nurse, and Dr. Chris Ingram, Infectious Disease Physician & Medical Director of WakeMed Infection Prevention
Caused by a virus, measles is one of the most contagious respiratory diseases known to us. It is preventable via vaccine. Measles is spread through close contact with an infected person, or a surface they have touched, and through the air. Coughing, sneezing, and infected nasal and throat secretions all spread the virus. Disturbingly, the virus can hang in the air or on surfaces for at least two hours. Measles is so contagious that if one person has it, 90 percent of the non-immune people close to that person will catch it (from the Centers for Disease Control & Prevention). Measles is also called Rubeola.
According to the Centers for Disease Control & Prevention (CDC), from January 1 to 30, 2015, 102 people from 14 states were diagnosed with measles. Most of these cases have been linked to a large, continuous outbreak that originated at California’s Disneyland/Disney California Adventure Park in December. A traveler from the Philippines brought measles to the park, and it spread. See weekly updates on this current U.S. outbreak from the CDC.
View a recent news story by WTVD ABC 11 about measles in North Carolina with comments from Dr. Mark Piehl, medical director of the WakeMed Children’s Hospital.
Symptoms of Measles
Measles typically starts with a fever, cough, runny nose, and red and watery eyes. Red spots called Koplik’s spots develop in the mouth and then a rash begins to progress across the body, spreading from the head and face to the trunk and then to the arms and legs. The fever and rash typically last for around seven days but can last for longer. People who have been infected with measles can be contagious for up to four days before symptoms appear and up to four days after the rash appears.
Most deaths that are related to measles happen due to secondary complications caused by the illness, such as very high fever, pneumonia, encephalitis (swelling in the brain) and diarrhea (which can lead to dehydration). Complications are most common for unvaccinated children under the age of 5 and unvaccinated adults older than 20.
According to the World Health Organization, in developing countries where health care and nutrition are insufficient, up to 10 percent of measles cases result in death. Children in these countries can also go blind from measles because they have a Vitamin A deficiency.
Treatment for Measles
No anti-viral medication exists for measles so it is best to treat the symptoms of the illness until the body is strong enough to fight it off. This includes rest, lots of liquids and fever reducing medications (follow age-appropriate dosage instructions). Additionally, stay home and avoid contact with others to help prevent transmission of the disease. With any high fever or a fever that is accompanied by a rash, it is imperative that a person calls his or her doctor or child’s pediatrician to discuss next steps.
Prevention of Measles & the Measles Vaccine
A safe and highly effective measles vaccine has been in use for 50 years. It is also inexpensive, costing about one U.S. dollar to immunize a child.
“Of all the preventable childhood illnesses, I would say measles is the most serious and it is therefore extremely important for parents to vaccinate their children,” commented Dr. Chris Ingram, Infectious Disease physician and medical director of WakeMed’s Infection Prevention program. “Before we had a vaccine, measles killed children at an alarming rate. In the 1950s and 60s in the United States, up to ten children out of 1,000 would die from the measles. Or, they would die from or experience brain injury as a result of secondary conditions of the illness such as measles encephalitis.”
Dr. Ingram continued, “Data does not substantiate that the measles vaccine causes adverse effects, and any risks to children from receiving this vaccine are far outweighed by the great benefit to being vaccinated and avoiding illness.”
The measles vaccine (MMR), which also includes the rubella and mumps vaccine, should be given to a child at 12 to 15 months of age and then a second dose should be given at 4 to 6 years. It’s unusual but not impossible for a vaccinated child to catch measles. The first dose protects with 95 percent efficiency and the second dose protects with 97 to 99 percent efficiency. After receiving the vaccine, a child’s immunity does not fade.
Parents should vaccinate not only to protect their own children from measles but to help create “herd immunity” in their respective communities. Herd immunity results when a community of children and adults are vaccinated from an illness, making it difficult for people in that community to contract or spread the illness.
In 2000, the United States was declared measles-free by the CDC. This was in large part due to the strength, effectiveness and widespread use of the MMR vaccine. However, unvaccinated visitors from other countries coupled with a culture shift, mainly in parts of California, where many parents refuse to vaccinate their children have helped create new transmissions of the disease as well as the current outbreak.
The best advice – vaccinate your children! Help your own family and other families avoid this painful and potentially fatal illness.
For more information on measles:
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