Measles: Not Just a Harmless Childhood Illness

In the year 2000, the US declared the United States to be free of measles, and everyone heaved a huge sigh of relief. You may think measles is a common but harmless childhood disease, but if this is your view then you are very much mistaken. In the decade before vaccination was introduced to the US, 3-4 million people caught the disease, with 48,000 needing hospitalization. Around 500 people died from measles, and 4,000 suffered inflammation of the brain. In reality, measles can cause significant and life-changing effects, and, in the worst-case scenario, it can be deadly.

But if the US is now “free” of measles, why do we still need to worry? The truth is that there’s been a recent resurgence of measles, and nowadays we need to be as vigilant as ever in recognizing the symptoms of measles and getting medical help quickly.

Recent outbreaks of measles

In 2015, measles was reported in 24 states as well as the District of Columbia. Admittedly the numbers were much lower than in pre-vaccination days, with “only” 189 people affected, but 60% of those cases occurred in one outbreak centered around an amusement park in California. This statistic shows how contagious measles is, and how easily it can take hold in the wider population.

Why have there been recent outbreaks of measles?

There may be several reasons why we’ve seen more measles outbreaks recently, but one factor is concern amongst some parents about the measles vaccination. This immunization is usually given together with mumps and rubella vaccines, so it’s known as the MMR. In the past, spurious scientific claims cited a link between the MMR and autism, causing many parents to shun the vaccine. Other parents have more general concerns about vaccinations. However, almost all cases of measles have occurred in unvaccinated patients.

How is measles passed on?

Measles is a highly contagious disease, which lives in the secretions of the mouth, throat, and nose. More importantly, it can live in the air for up to two hours (perhaps after a cough or sneeze), and 90% of non-immunized people will catch it if exposed. Measles patients are contagious for 3-4 days before symptoms occur, so it’s not easy to tell if someone is infected. There is also an incubation period of 7-14 days before symptoms appear.

What are the measles symptoms to watch out for?

In the early days, patients will have a fever and cough, as well as a runny nose. The eyes will also run and this may develop into conjunctivitis. A couple of days later, there may be small white spots inside the mouth (called “Koplik spots”). Within 3-5 days, a rash will begin at the hairline and spread across the whole body. The rash will be formed of flat red spots—these can merge together in some cases. At this time, fevers can rise as high as 104F. In simple cases, these symptoms will subside after a few days.

What are the complications of measles

It’s the complications of measles that can have such serious consequences. Children under 5 years and adults over 20 are most at risk, and the common complications are diarrhea and painful ear infections. However, 1 in 20 children will develop pneumonia, and this is the most common cause of death from measles. In every 1,000 cases, one person will develop encephalitis (swelling of the brain), which can lead to deafness, brain damage and mental or physical impairment. In extremely rare cases, patients can develop a problem in the central nervous system 7-10 years after the initial infection. Further, pregnant women may give birth to premature or low-birthweight babies.

How can I protect against getting measles?

Finally, although measles is not endemic in the US, many people travel to the US each year from areas where measles is still found. Consequently, it’s important to protect yourself properly. Vaccination is still the best form of protection, as it’s extremely rare for a non-vaccinated person to get measles, and they should only have a mild case of measles if they do develop the disease. If you have concerns about vaccination, talk things over with a health professional and be sure you fully understand the risks of measles before making a decision. If you’re traveling to an area of the world where measles is still present, ensure you have the proper vaccinations before you travel.