Measles
Symptoms & cause
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.
Following this worldwide
trend, 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.
Symptoms
Measles signs and symptoms
appear around 10 to 14 days after exposure to the virus. Signs and symptoms of
measles typically include:
Fever
Dry cough
Runny nose
Sore throat
Inflamed eyes (conjunctivitis)
Tiny white spots with
bluish-white centers on a red background found inside the mouth on the inner
lining of the cheek — also called Koplik's spots
A skin rash made up of
large, flat blotches that often flow into one another
The infection occurs in a
sequence of stages during a period of two to three weeks.
Infection and
incubation. For the first 10 to 14 days after you're
infected, the measles virus incubates. You have no signs or symptoms of measles
during this time.
Nonspecific signs and
symptoms. Measles typically begins with a mild to
moderate fever, often accompanied by a persistent cough, runny nose, inflamed
eyes (conjunctivitis) and sore throat. This relatively mild illness may last
two or three days.
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.
Communicable period. A
person with measles can spread the virus to others for about eight days,
starting four days before the rash appears and ending when the rash has been
present for four days.
When to see a doctor
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.
Causes
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
Risk factors for measles
include:
Being unvaccinated. If
you haven't received the vaccine for measles, you're much more likely to
develop the disease.
Traveling
internationally. If you travel to developing countries,
where measles is more common, you're at higher risk of catching the disease.
Having a vitamin A
deficiency. If you don't have enough vitamin A in your diet, you're more likely
to have more severe symptoms and complications.
Complications
Complications of measles may
include:
Ear infection.
One of the most common complications of measles is a bacterial ear infection.
Bronchitis,
laryngitis or croup. Measles may lead to inflammation of
your voice box (larynx) or inflammation of the inner walls that line the main
air passageways of your lungs (bronchial tubes).
Pneumonia.
Pneumonia is a common complication of measles. People with compromised immune
systems can develop an especially dangerous variety of pneumonia that is
sometimes fatal.
Encephalitis.
About 1 in 1,000 people with measles develops a complication called
encephalitis. Encephalitis may occur right after measles, or it might not occur
until months later.
Pregnancy problems. If
you're pregnant, you need to take special care to avoid measles because the
disease can cause preterm labor, low birth weight and maternal death.
Prevention
The Centers for Disease
Control and Prevention recommends that children and adults receive the measles
vaccine to prevent measles.
Measles vaccine in
children
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:
If you'll be traveling
abroad when your child is 6 to 11 months old, talk with your child's doctor
about getting the measles vaccine earlier.
If your child or teenager
didn't get the two doses at the recommended times, he or she may need two doses
of the vaccine four weeks apart.
Measles vaccine in
adults
You may need the measles
vaccine if you're an adult who:
Has an increased risk of
measles — such as attending college, traveling internationally or working in a
hospital environment — and you don't have proof of immunity. Proof of immunity
includes written documentation of your vaccinations or lab confirmation of
immunity or previous illness.
Was born in 1957 or later
and does not have proof of immunity. Proof of immunity includes written
documentation of your vaccinations or lab confirmation of immunity or previous
illness.
If you're not sure if you
need the measles vaccine, talk to your doctor.
Preventing measles
during an outbreak or known infection
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.
Vaccinate. Be sure that
anyone who's at risk of getting the measles who hasn't been fully vaccinated
receives the measles vaccine as soon as possible. This includes infants older
than 6 months and anyone born in 1957 or later who doesn't have written
documentation of being vaccinated, or who doesn't have evidence of immunity or
having had measles in the past.
Preventing new infections
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.
Jan Ricks Jennings, MHA,
LFACHE
Senior Consultant
Senior Management
Resources, LLC
JanJenningsBlog.Blogspot.com
412.913.0636 Cell
724.733.0509 Office
January 13, 2022
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