- Is measles dangerous?
- How contagious is measles?
- How common is measles in the United States?
- What can you do to protect your children?
The brief answers to these questions are: –
- Is measles dangerous? YES
- How contagious is measles? VERY
- How common is measles in the United States? IT IS RARE
- What can you do to protect your children? VACCINATE/ISOLATE
If you are reading this article, you are probably the parent or carer (childminder or teacher) of a young person(s). You do not only need brief answers to these questions, but you also need explanations.
Is measles dangerous?
Until the 1960s, the best way to deal with measles (rubeola) was to allow the disease to spread. Most of the victims were children under five, and it was recognized that once the child recovered, they were immune and could neither pass the disease on nor become infected again.
Before the development of an effective vaccine and its introduction in 1963, there were between three and four million measles cases in the USA per year. Measles was so commonplace that only 12% to 16% were reported to the CDC. Of these, there were: –
- 48,00 hospitalizations
- 1,000 cases of encephalitis
- 400 to 500 deaths
We have come a long way since then. But measles itself has not changed. It remains a highly contagious and potentially life-threatening disease. Infected people, primarily children, are infectious, i.e., they can pass the disease on four days before the appearance of the rash and four days after.
Data Source: National Center for Immunization and Respiratory Diseases
How contagious is measles?
The measles virus may not be the deadliest, but it is among the most contagious. It lives and breeds in an infected person’s nose and throat mucus. It can spread on the airborne particles emitted by the cough or sneeze of an infected person. Other people (unvaccinated) can be infected by breathing the same air or by contacting an infected surface and touching their eyes, nose, or mouth.
- The virus can remain viable for up to two hours in the air even when the infected person has left.
Measles is so contagious that it can infect up to 90% of non-immune people close to an infected individual.
Measles is relatively slow to develop. It may be 7-14 days after exposure that the first symptoms begin to show.
- high fever (may spike to more than 104°),
- cough,
- runny nose
- red, watery eyes
After a further 2-3 days
- tiny white spots may appear inside the mouth
At days 3-5, the characteristic measles rash breaks out, initially on the face and spreading down to the neck, trunk, and limbs.
The sufferer is infectious four days before and for four days after the
If you detect any of these symptoms in a child in your care or suspect they have been exposed to measles, contact your healthcare provider immediately.
In most cases, the effect of measles is limited to the symptoms described above, but there can be complications that require hospitalization: –
- Diarrhoea and vomiting.
- Ear infection.
- Bronchitis, laryngitis, or croup.
- Pneumonia.
- Encephalitis.
- Pregnancy problems, including premature or low-birth-weight babies.
If you need further information, go to www.cdc.gov/measles/symptoms/signs-symptoms.html
How common is measles in the United States?
Sixty years ago, there were between 3-4 million cases of measles and 400 and 500 reported deaths in the USA (CDC).  The measles vaccination program (MMR, measles, mumps, rubella) was introduced in 1963. The program was so successful that in 2000, the CDC declared that measles had been eliminated in the USA. This does not mean that the vaccination program can be suspended. Measles is so infectious that lasting population immunity can only be sustained if vaccination (immunity) rates remain at or above 95%. For that reason, all ACA-compliant health insurance plans include MMR vaccination entirely cost-free.
Over the four years 2020-2023, the average number of reported measles cases in the USA was less than 70. In 2019, there were 1274 reported cases (the highest since 1992). Most of these cases are centered on communities with low inoculation rates (less than 95% immunity) or infected travelers visiting the U.S. or returning from overseas territories with a low vaccination rate.
What can you do to protect your children?
The numbers speak for themselves. Before 1963, when the measles vaccination program was introduced, the annual number of notified cases of measles in the USA has fallen from 3-4 million cases to an average of less than 70. There have been occasional isolated outbreaks, such as in 1992 and 2019. These outbreaks have been identified mainly with travel from overseas from countries or communities with low vaccination (immunity) rates.
Vaccination
The most important step you can take is to ensure that any child in your care is vaccinated. A single dose of the MMR vaccine is 93% effective against measles and is routinely given to infants at age 12-18 months. A second dose at (pre-school) age 4 to 6 years old provides a lifetime protection of 97%. If you are uncertain of your child’s vaccine status, check with your doctor.
If you plan to travel abroad, ensure you are fully vaccinated or have evidence that you are immune and check the CDC travel notices.
INFANTS UNDER 12 MONTHS OLD
Infants under 12 months should be vaccinated at least two weeks before travel (age not less than six months) and again at 12-15 months, with a final dose at 4-6 years.
CHILDREN (UNVACCINATED) OVER 12 MONTHS OLD
Unvaccinated children over 12 months old should have the first vaccine dose as soon as possible, not less than two weeks before travel, and a second 28 days after or immediately on return, whichever is later.
Isolation
The initial symptoms of measles are common in many childhood conditions, but it makes sense to minimize contact with other potentially unvaccinated people (children under 18 months). Measles can only be diagnosed with certainty after the characteristic rash has developed. The infected individual should be isolated (there is little risk to immune adults), but they will have been infectious for the preceding four days and will be for a further four days.
Some families and communities are reluctant to adopt vaccination (injection) as a protective medical procedure. For those groups of people, isolation (at any age) is the only protection. Carers exposed to infectious patients should use respiratory protection (facemasks) and be aware that the virus remains viable on any surface, e.g., bed linen and used tissues, for up to two hours.
IN ALL CASES, when you suspect a case of measles, you should contact your healthcare provider.
