Measles

There was a time when measles was a major health concern. Prior to 1963 when a vaccine became available, nearly all children (3 to 4 million people) got measles by the time they were 15 years of age. Of those, an estimated 400 to 500 died, 4,000 suffered encephalitis (inflammation of the brain) and 48,000 were hospitalized. The introduction of a vaccine drastically reduced the numbers of cases, culminating in the announcement in 2000 that the disease was “eliminated” (no longer constantly circulating) in the United States.

The risk of contracting measles in this country remains small, as most Americans are protected against measles through vaccination. However, the rising numbers of unvaccinated individuals is cause for concern and the most significant factor cited in the growing incidence of measles outbreaks in this country. In 2014, the United States had 644 measles cases, the highest number since 1996. New York state had 32 cases of measles in 2014.

What is measles?

Measles is a serious, highly contagious and potentially fatal virus that is spread by contact with nasal or throat secretions of infected people. Symptoms include fever, cough, runny nose and a characteristic rash that appears three to five days after the onset of illness. Without complications, the typical duration of the illness is seven to 10 days.

It should be noted that measles can produce serious complications and, in rare cases, death. Major complications can include pneumonia and encephalitis. Complications occur in up to 30 percent of all measles cases, with those under the age of 5 and over the age of 20 at greatest risk. Pregnant women who contract measles have an increased risk of low-birth-weight infants, premature labor, miscarriage and babies born with birth defects.

Who can get infected with measles?

Anyone who has not been vaccinated against measles or who has never had the disease is susceptible to becoming infected and spreading it to others, including those who cannot get vaccinated because they are too young or have specific health conditions.

What are the symptoms of measles?

Measles symptoms, which typically appear 10 to 14 days after exposure, begin with cold-like symptoms including a fever, cough and runny nose. Eyes may become reddened and sensitive to light and fever may continue to rise, often peaking as high as 103°to 105° F. The second stage of the illness features a rash that usually begins on the face and spreads downward to the back, trunk and then limbs. Parents should contact their family physician if children display symptoms.

How does the virus spread?

With an extremely high transmission rate of 90 percent, measles is one of the most contagious viral illnesses in existence. It is transmitted primarily through coughing and sneezing. However, the virus can also live on contaminated surfaces and in the air for up to two hours.

Infected individuals are contagious up to four days before and four days after the onset of the measles rash.

How can I protect myself and my children?

According to the CDC, vaccination is the single best way to protect against measles. The recommended two doses of measles, mumps and rubella (MMR) vaccine are 97 percent effective in preventing the illness. The first dose should be given at 12 to 15 months of age. The second dose is routinely given at 4 to 6 years of age. However, unprotected persons can get the vaccine at any age.

For those travelling internationally, the CDC recommends that all U.S. residents older than 6 months who have not been previously vaccinated receive the MMR vaccine prior to departure.

If you are unsure if you or your children were vaccinated, talk with your doctor.

Is vaccination required by schools in New York state?

Yes. In New York state, measles immunizations are required of all children enrolled in pre-kindergarten programs and public and private schools as mandated by New York Public Health Law §2164. Limited exemptions to the vaccination requirement are permitted for medical reasons, pending the appropriate documentation from a student’s physician.

What happens if there is an outbreak at my child’s school?

In the event a case of measles is diagnosed in a student or staff member at your child’s school, school officials are required to report the case to their local department of health in compliance with state and federal confidentiality laws. Schools will work in consultation with their medical director or physician and the DOH to develop a policy for notification and disease surveillance and control among students and staff.

How can I get more information?

Visit the CDC website or the New York State Department of Health website. You can also contact your family physician.