700 Children's® – A Blog by Pediatric Experts

What Parents Need to Know About Measles

Apr 30, 2021
measles on a child's shoulder

Measles, also known as rubeola, is an infection caused by the measles virus. Symptoms include high fever, cough, runny nose, red eyes, followed by a characteristic rash. The pink-red rash typically starts on the face, spreads to the neck and trunk, and then to the arms and legs.

Is Measles Serious?

Measles can be serious. It is estimated that 1 out of 5 people with a measles infection will need to be hospitalized.1 Measles can also lead to complications including pneumonia (infection in the lungs occurring in 1 out of every 20 patients) and encephalitis (infection of the brain) that, although uncommon (occurring in 1 out every 1,000 patients), can result in deafness or permanent brain damage.

These complications may be more frequent and severe in children younger than 5 years old and in immunocompromised children. Measles can lead to death in as many as 3 out of every 1,000 people infected.

How Is Measles Spread?

Measles can be transmitted from the respiratory droplets of one infected person’s nose or throat to another person, even before the person knows they are infected or develops symptoms. An infected person can shed the virus from four days before the rash develops to four days afterwards. The virus can remain in the air after a cough or sneeze and spread (airborne) for up to two hours after the infected person leaves the room. These two things make measles highly contagious; in fact, 9 out of 10 people who have been near a person with measles will become infected.1

Is There a Treatment?

There are no specific antiviral therapies approved for use in the United States.

How Can I Avoid Getting Measles?

Measles is preventable with vaccination. One vaccine dose is 93% effective at preventing measles infection and two doses are 97% effective.2 It is estimated that measles vaccination has prevented approximately 20.4 million deaths from 2000 to 2016.3

Two doses of the measles-mumps-rubella (MMR) vaccine are recommended for eligible children in the United States: the first dose should be given at 12-15 months of age and the second dose at 4-5 years of age. During outbreaks or in certain situations, the MMR vaccine may also be appropriate to be given to children as young as 6 months of age. In addition, MMR vaccine can be given to susceptible individuals (those who have not been vaccinated or received only one measles vaccine dose) within 72 hours after measles exposure to protect against developing disease in many cases.

Children with weakened immune systems (because of transplantation, chemotherapy, or other medications) cannot receive this vaccine. Therefore, it is very important that all household and close contacts be appropriately vaccinated against measles to protect the vulnerable immunocompromised child.

Why Am I Hearing More About Measles Lately?

Measles was declared eliminated in the United States in 2000. However, due to low vaccination rates in recent years and introduction of the virus from unvaccinated travelers, there have been increasing reports of large measles outbreaks in different communities across the United States, including Ohio. In fact, the number of new measles cases in the United States in the first nine months of 2019 had surpassed the total number of cases in the previous 25 years, combined.4 Deaths from measles globally in 2019 was also at its highest level in 23 years.

To stop transmission of the virus, measles immunity (by natural infection and vaccination) needs to be greater than 95% in a community (herd immunity). The COVID-19 pandemic has caused many children to miss their routine health maintenance visits and recommended immunizations, including the measles vaccine.5 This puts our children and community at higher risk for a vaccine-preventable infection.

Routine childhood vaccinations have declined 26-50% this year alone compared with 2019.6 Given the rising number of measles cases and decreased vaccination rates, there is grave concern that more measles outbreaks may occur. As such, it has become even more critically important to ensure that children see their medical providers and receive age-appropriate vaccines to be protected. Contact your health care provider to get your measles vaccine to protect you, your child and your community. 

References:

  1. Centers for Disease Control and Prevention. Measles (Rubeola). (Accessed Nov 16, 2020, at https://www.cdc.gov/measles/.)
  2. American Academy of Pediatrics. 'Measles', Red Book 2018-2021: Report of the Committee on Infectious Diseases, 31st edition.: American Academy of Pediatrics; 2018.
  3. Dabbagh A, Patel MK, Dumolard L, et al. Progress Toward Regional Measles Elimination - Worldwide, 2000-2016. MMWR Morb Mortal Wkly Rep 2017;66:1148-53.
  4. Patel M, Lee AD, Clemmons NS, et al. National Update on Measles Cases and Outbreaks - United States, January 1-October 1, 2019. MMWR Morb Mortal Wkly Rep 2019;68:893-6.
  5. Santoli JM, Lindley MC, DeSilva MB, et al. Effects of the COVID-19 Pandemic on Routine Pediatric Vaccine Ordering and Administration - United States, 2020. MMWR Morb Mortal Wkly Rep 2020;69:591-
  6. Bramer CA, Kimmins LM, Swanson R, et al. Decline in child vaccination coverage during the COVID-19 pandemic - Michigan Care Improvement Registry, May 2016-May 2020. Am J Transplant 2020;20:1930-1.
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NCH Blog Author
Monica Ardura, DO
Infectious Diseases

Monica I. Ardura, DO is a member of the Section of Infectious Diseases at Nationwide Children’s Hospital and Assistant Professor of Clinical Pediatrics at The Ohio State University College of Medicine.

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700 Children’s® features the most current pediatric health care information and research from our pediatric experts – physicians and specialists who have seen it all. Many of them are parents and bring a special understanding to what our patients and families experience. If you have a child – or care for a child – 700 Children’s was created especially for you.