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HEALTH HOTLINE: Measles – extremely contagious and prone to outbreaks, even though vaccine is available

By Dan Palmquist, M.D.

In 1980, measles caused an estimated 2.6 million deaths worldwide each year. And while measles is still common in many developing countries, widespread vaccination resulted in a 75 percent drop in measles deaths between 2000 and 2013. In the U.S., widespread use of the measles vaccine has led to a greater than 99 percent reduction in cases compared with pre-vaccination times.

Unfortunately, outbreaks can still occur. Currently, the U.S. is experiencing a large, multi-state outbreak with 125 cases of measles reported from seven states between December 2014 and February 2015. The majority of people who got measles during this outbreak were unvaccinated.

Measles is caused by a virus that infects the mucous membranes and spreads throughout the body. It is transmitted via tiny droplets that are released into the air when a person sneezes or coughs. The droplets remain airborne or fall on surfaces where they can live for up to two hours. The disease is spread when an uninfected person breathes in these droplets, touches a surface containing the droplets and then touches his eyes, nose or mouth. It can also be spread when an infected person shares food or drinks with others.

Measles is extremely contagious; it is estimated that 90 percent of people who aren’t immune will get the disease if they are in close proximity to someone who has it.

The first symptoms occur about one to two weeks after exposure and resemble those of a bad cold. They can include: high fever, runny nose, sneezing, sore throat, red eyes, hacking cough, swollen lymph nodes, lethargy, white spots in the mouth and diarrhea. Initial symptoms last from four to seven days. As they begin to dissipate, red spots form on face and upper neck. Over about three days, the rash spreads to the body, typically fading after five to six days. A person is contagious from four days before getting the rash until four days after it appeared.  

Treatment often involves rest and recuperation at home and involves using over the counter medications to help lower a fever and drinking plenty of liquids. Patients are advised to stay home from school, work, day care and public places until at least four days after the rash first appeared.

Most people recover from the measles within about two weeks. However, the disease can cause serious problems including ear infections that cause hearing loss, pneumonia, encephalitis, seizures, meningitis and in very rare cases death. The CDC estimates that one or two out of every 1,000 children who get the measles will die from it.

Measles can be prevented through vaccination. The vaccine has been in use for 50 years and is safe, effective and inexpensive. Despite false claims in the news, studies have found no link between the measles vaccine and autism. In fact, the autism advocacy group, Autism Speaks, has joined with medical experts urging parents to vaccinate their kids.

Two doses of the vaccine are recommended. Children should get the first dose at 12 to 15 months old and a second dose when 4 to 6 years old. The CDC rates the vaccine as very effective. Teens and adults who have not been vaccinated and show no evidence of immunity against measles as well as those at increased risk of getting measles — college students, international travelers and healthcare workers — should get two doses of the vaccine separated by at least 28 days. People born before 1957 are presumed to be immune, because many children had the disease then. If you have questions about whether you should receive the vaccine, talk with your primary care physician.

Before the vaccine, the CDC estimates that 3 to 4 million people in the U.S. contracted the measles each year and 400 to 500 of them died from it. Worldwide, measles remains one of the leading causes of death among young children even though a safe and cost-effect vaccine is available. Approximately 145,700 people died from the measles worldwide in 2013 — most of them children under age 5.

The current U.S. outbreak is a reminder of how contagious this virus is and how vaccinations are just as important as ever in keeping disease like the measles at bay. If you or your children have not been vaccinated, talk to your healthcare provider about what options are the best for you.