Measles is a highly contagious virus that spreads through the air from coughing and sneezing. It is a vaccine-preventable infection.
Prior to the development of a measles vaccine, nearly all children became infected with measles before reaching high school. Measles was a frequent cause of hospitalization in the pre-vaccine era with nearly 50,000 hospitalizations per year. Since the widespread use of vaccination, measles infections declined significantly to fewer than 100 cases annually. However, over the past year, there have been an increased number of measles cases related to international travel in unvaccinated people. This has caused further spread in U.S. communities among pockets of unvaccinated people.
What Are the Symptoms of Measles?
Symptoms of measles usually occur one to two weeks after exposure to an infected individual. Measles begins with a runny nose, cough, and red eyes (conjunctivitis). Small white spots may occur inside the mouth two to three days after symptom onset along with low-grade fevers (101-102°F). A rash breaks out and high fever spikes (104°F) develop three to five days after symptom onset.
The rash starts as red spots on the face and scalp and then spread downward to the rest of the body. As the rash spreads, it may become raised and the spots may join together.
Measles infection can be serious in children. Complications from measles include an infection of the lungs (pneumonia) which may require hospitalization and is the most common cause of death from measles in young children. Swelling of the brain (encephalitis) may also occur, leading to seizures, permanent hearing loss or intellectual disability.
How Do Children Become Infected with Measles?
Measles is one of the most contagious viruses and can infect nine of ten non-immune people who are exposed. Measles virus spreads through the air from coughing and sneezing. Children become infected with measles from breathing contaminated air or by touching a contaminated surface and then touching their eyes, nose, or mouth. People are contagious starting four days prior to the onset of rash and remain contagious four days after the onset of rash.
How Is Measles Treated?
There is no specific antiviral treatment for measles infection. Vitamin A is used to prevent severe complications in vitamin A deficient children who are infected with measles. Vitamin A does not prevent or cure measles.
What Can I Do for My Family to Prevent Measles?
Immunization with the MMR vaccine is the best protection against measles. MMR is a safe and effective vaccine. Two doses of MMR vaccine is 97 percent effective in preventing measles. Review your own and your family’s vaccine records to ensure MMR and all other immunizations are up-to-date. Children need two doses of MMR vaccine; the first dose should be given at 12-15 months of age and the second dose given at four to six years of age.
Stay informed and plan ahead if your family is preparing for an international trip. Infants as young as 6 months of age can receive one dose of MMR vaccine prior to travel to provide protection. Older children may also be eligible to receive their second dose of MMR vaccine ahead of schedule. Speak with your child’s primary care provider to discuss your child’s individual risk related to travel.
There may be members of your family who cannot receive the MMR vaccination, including infants, pregnant women and those with weakened immune systems. Non-immunized people should avoid contact with anyone infected with measles from four days before to four days after rash onset. If an exposure occurs, contact your child’s primary care provider to discuss the need for immune serum globulin.
December 2022 Resources:
Concerned you have been exposed or your symptoms might be measles?
If you aren’t experiencing a medical emergency, then a call to your pediatrician or primary care physician is the best first step.
Matthew C. Washam, MD, MPH, is an assistant professor in the Department of Pediatrics at The Ohio State University College of Medicine and member of the Section of Infectious Diseases at Nationwide Children’s Hospital. Dr. Washam’s research interests include understanding the risk factors for transmission of multidrug-resistant bacteria in children within the hospital environment.
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