Measles on the Rise: What You Need to Know

As your trusted partners in health and wellness, our physicians and providers have heard from a number of their patients with questions surrounding the current measles outbreak. With this troubling, and preventable, return of a disease long thought to be eliminated from the United States, we wanted to take this moment to share some additional information about the measles, its transmission, and what you can do to protect yourself, your children, and your community.

While we haven’t experienced any known or suspected cases of measles at Sturdy Health to date, we have seen an increase in adult vaccination requests for measles as many are concerned with the most recent outbreaks across the country.

For those who are currently unvaccinated and who are not immunosuppressed or pregnant, we strongly encourage you to get vaccinated as it is the most effective way to prevent measles. If you are unsure of your vaccination status, talk to your or your child’s pediatrician, physician, or provider about whether or not you should receive the MMR vaccine. The vaccine has decades of proven safety history and is the reason measles was originally declared eliminated from the U.S. in 2000.

Measles is an exceedingly contagious virus spread through direct contact with infectious droplets and airborne reach. Up to 90% of non-immune people can develop measles after exposure to someone with measles. The virus can last in a room as an infectious particle for up to two hours after someone with measles leaves. People usually don't develop symptoms until 7-21 days after exposure. Symptoms begin with high fevers up to 105 in conjunction with cough, runny nose, and conjunctivitis. People can also develop white spots, known as Koplik spots, inside their mouths. The classic rash usually develops 3-5 days after onset of illness. People are considered contagious and able to spread measles from 4 days before the onset of rash until 4 days after the onset of rash, but people who are immunocompromised may be infectious longer.

People with symptoms of fever and rash are at high risk to have measles if they have not been vaccinated, have been exposed to someone diagnosed with measles in the last 21 days, or have traveled recently to areas with known measles outbreaks.

Common complications of measles include respiratory infections such as pneumonia, bronchitis, and pharyngitis. About 1 in 20 people will develop pneumonia. Severe complications include acute encephalitis that can result in permanent brain damage and deafness. The incidence of neurologic complications is about 1 in 1,000 people, and 1 to 3 in 1,000 people will die due to respiratory or neurologic complications.

The MMR (Measles, Mumps, and Rubella) vaccine typically is given to children in two doses, one between the age of 12 and 15 months old, and the second between the age of 4 and 6 years old. Two doses of MMR vaccine in childhood are about 97% effective at preventing measles and providing lifelong immunity. Ensuring vaccination rates stay above 95% decreases the likelihood of measles spreading among those who aren’t immune. This is known as "herd immunity" which protects people who can’t receive the vaccine, such as infants who are too young or people who are too immunocompromised. Due to the significant spread and contagiousness of measles prior to the availability of the vaccine, adults born before 1957 are considered immune to measles. High-risk persons (including school-aged children, college students, healthcare personnel born after 1957, and adults who received a killed measles vaccine or unknown measles vaccine between 1963 and 1967) should receive 2 doses of MMR at least 28 days apart. Infants 6-11 months of age who are in an outbreak area should receive 1 dose of MMR but will still need the above described 2 doses.

As always, your healthcare team is here for you! Please reach out to your or your child’s pediatrician, physician, or provider to partner on the best path forward.

Contributors:

Owen Debowy, MD, PhD

Internal Medicine and Pediatric Physician

Medical Director Population Health and Vaccines

Vice Chair Department of Pediatrics

Vice Chair Department of Medicine

Antonella Fine, MD, FIDSA

Physician Director, Hospital Infection Control and Antimicrobial Stewardship

Infectious Disease Specialist

Brian Patel, MD, FACEP

Senior Vice President

Chief Medical and Quality Officer

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Media@sturdyhealth.org