Measles, a highly contagious respiratory illness, might seem like a relic of the past, but outbreaks are unfortunately still a concern. This preventable disease can cause a cascade of uncomfortable symptoms and, in rare cases, lead to serious complications. Let’s delve into what measles is, how to identify it, what causes it, and how to manage its effects.
What is measles?
A highly contagious viral infection, measles (rubeola) is characterized by fever and a telltale rash. It spreads easily through the air when an infected person coughs, sneezes, or talks. While there’s no specific cure for measles, the virus typically resolves on its own. The best defense against measles is vaccination.
Measles outbreaks have re-emerged in recent years due to declining immunization rates in the United States and around the world. This means you can contract measles while traveling internationally. Anyone who is unvaccinated is susceptible to the disease.
It’s important to distinguish measles from rubella, also known as German measles. These are two separate illnesses.
Does anyone still get measles?
Prior to the measles vaccine’s introduction, infection was practically inevitable for everyone in childhood. Now, immunity is achieved through either vaccination or having had the disease itself. The success of vaccination programs in the U.S. dramatically reduced measles cases, nearly eliminating them by 2000. However, recent years have seen a resurgence, with the CDC reporting close to 120 cases in 2022 alone. This rise is partly attributed to declining vaccination rates and travel from countries with limited measles control programs. Fortunately, the risk of measles remains readily manageable through vaccination. The global picture paints a different story, with millions of cases occurring worldwide annually.
Symptoms and Causes
What are the symptoms of measles?
Measles symptoms typically surface after 8-12 days of exposure, although it can take up to 3 weeks. The initial phase often mimics a cold, with a high fever, fatigue, a hacking cough, red, watery eyes, and a runny nose. This is followed a few days later by the telltale measles rash – a red, blotchy eruption that starts on the face and progresses down the body, lasting for about a week to ten days. Other potential symptoms include a sore throat, white mouth spots, muscle aches, and light sensitivity.
What does the measles rash look like?
The measles rash unfolds in stages. It begins as flat red spots on your face, then marches downwards to envelop your entire body. As this happens, tiny raised white bumps may erupt on top of the red rash. These spots can even merge together as the rash progresses down your body.
Which virus causes measles?
Measles is highly contagious and spread through the air by an airborne virus called morbillivirus. When an infected person coughs, sneezes, talks, or even breathes, the measles virus gets released in tiny droplets. These droplets can linger in the air for up to two hours after the infected person leaves, and can also land on surfaces where the virus can survive for a time. Here’s how measles can spread:
- Direct contact: Inhaling respiratory droplets from an infected person.
- Indirect contact: Touching a contaminated surface and then your face, particularly the mouth, nose, or eyes.
- Close contact: Sharing utensils, drinks, or food with someone who has measles.
- Physical contact: Kissing, shaking hands, holding hands, or hugging someone with measles.
- From mother to baby: During pregnancy, delivery, or breastfeeding if the mother is not immune.
How long is measles contagious?
Measles infectivity isn’t limited to the time you have the rash. You can actually spread the virus for around eight days in total, starting four days before the rash appears and lasting until four days after it begins.
Is it safe to be around someone with measles?
Measles boasts an alarming level of contagiousness. Imagine a room with ten unvaccinated people and just one infected individual—a staggering nine out of ten would contract measles. This stark reality underscores the importance of vaccination as the ultimate defense against this disease.
Who is at risk for measles?
Susceptibility to measles falls into two main categories: vaccination status and travel. Anyone unvaccinated is wide open to infection. Travelers venturing to regions with higher measles prevalence face an increased risk as well.
For healthcare and childcare workers, the constant interaction with potentially sick individuals elevates their risk. To mitigate this, meticulous hygiene practices and proper personal protective equipment (masks, gowns, gloves) are crucial. For childcare workers specifically, promoting handwashing among children and educating parents about viral illness symptoms are additional lines of defense.
What are the complications of measles?
Measles carries the potential for various complications, some quite severe. Certain groups are especially vulnerable: infants and toddlers, pregnant women, adults over 20, and individuals with compromised immune systems. Complications can include diarrhea, ear infections, pneumonia, encephalitis (brain inflammation), and for pregnant women, miscarriage, premature birth, or low birth weight babies. Before widespread vaccination, measles was a leading cause of childhood death, claiming an estimated 400-500 lives annually.
Diagnosis and Tests
How is measles diagnosed?
Diagnosis of measles typically involves a healthcare provider considering your medical history and performing a physical exam to examine the rash. In some cases, additional confirmation might be sought through laboratory tests. These tests can involve analyzing samples of your blood, nose and throat secretions, or even urine to detect the presence of the measles virus.
Management and Treatment
How is measles treated?
Measles has no specific cure; the body fights off the virus on its own, usually within 10-14 days. Fortunately, you can manage symptoms at home with:
- Pain relievers: Acetaminophen or NSAIDs can help with aches, fever, or discomfort. Important note: Always avoid giving aspirin to children or teenagers unless explicitly instructed by your doctor due to the risk of Reye’s syndrome.
- Rest and hydration: Getting plenty of sleep and fluids is crucial for recovery.
- Soothing measures: Gargling with salt water can ease a sore throat, and avoiding bright light can help with light sensitivity.
- Isolation: Stay home from work or school to prevent spreading the virus. Typically, you can resume normal activities after four days of the rash being present. Anyone unvaccinated in your household should avoid contact with the infected person to minimize their risk of getting measles.
Prevention
Can you prevent measles?
Vaccination is the undisputed champion in preventing measles. Getting vaccinated confers immunity, making it highly unlikely you’ll ever contract the virus. The measles vaccine boasts an exceptional effectiveness rate. There are two injectable vaccines that offer protection:
- Measles, Mumps, Rubella (MMR) vaccine: This trivalent vaccine shields you from three diseases – measles, mumps, and rubella (German measles).
- Measles, Mumps, Rubella, Varicella (MMRV) vaccine: This four-in-one powerhouse protects against measles, mumps, rubella, and varicella (chickenpox).
When should people be vaccinated for measles?
Inclusion of the measles vaccine in your childhood immunization schedule is ideal. However, vaccination is effective at any age, and getting it later is far better than not getting it at all. The standard practice is for babies to receive the vaccine, but adults can also be vaccinated for complete protection.
MMR vaccine
The MMR vaccine is the recommended defense against measles for children. It’s administered in two doses: the first between 12 and 15 months old, and the second between 4 and 5 years old. Even if your child hasn’t been vaccinated yet, the MMR vaccine can offer protection within three days of exposure to the virus. For international travel with young children, an earlier dose at 6 months old might be recommended, though the standard two-dose schedule would still need to be completed later.
Adults unsure of their vaccination status should consult their healthcare provider about getting the MMR vaccine, particularly if international travel is planned. In most cases, there’s no harm in receiving another dose for added peace of mind.
MMRV vaccine
The MMRV vaccine is a four-in-one powerhouse, protecting against measles, mumps, rubella, and chickenpox (varicella). It’s specifically designed for children between 12 months and 12 years old (adults and children over 12 receive the MMR vaccine). The recommended schedule involves two doses: the first between 12 and 15 months and the second around 4 or 5 years old. However, there’s flexibility; the second dose can be given as early as three months after the first. Consulting with your child’s healthcare provider is key to determining the most suitable timing for your child’s vaccination.
Can a child still get measles after vaccination?
Vaccination is the key to shielding your child from measles. The MMR vaccine, given in two doses, offers exceptional protection. MMRV, a four-in-one vaccine guarding against measles, mumps, rubella, and chickenpox, is another option for children aged 12 months to 12 years. While both vaccines are effective, receiving both doses is crucial for maximizing your child’s immunity and minimizing their risk of contracting measles. Discuss the ideal vaccination schedule with your child’s healthcare provider.
Who shouldn’t get a measles vaccine?
The measles vaccine is not recommended for pregnant women due to theoretical risks to the developing baby. However, there are other reasons why someone might not be able to receive the vaccine, such as having a weakened immune system or experiencing a severe allergic reaction to a component in a previous vaccine. If you have any concerns about getting the measles vaccine, consult your healthcare provider to determine the best course of action.
Prognosis
What is the outlook for someone who has measles?
Fortunately, most people recover from measles without any lasting issues and develop immunity to the disease after getting sick. However, for those who experience severe complications, the long-term prognosis can vary depending on the specific case.
When can I go back to work or school if I’ve had measles?
You should wait at least four days after you get the rash to go back to work or school.
When should I contact my healthcare provider?
If you suspect you or your child may have been exposed to measles, contact your healthcare provider right away. The same applies if you or your child have measles and symptoms worsen instead of improving. Particular vigilance is recommended for pregnant women and infants under 12 months, as these groups are more susceptible to complications. Don’t hesitate to seek medical attention if you fall into either category and contract measles.
Some other questions
What disease mimics the measles?
A measles rash and fever can be confused with other viruses. Roseola and rubella, for instance, can cause similar symptoms. If you experience a skin rash, fever, or any combination of symptoms that resemble measles, it’s best to consult your healthcare provider for an accurate diagnosis. Early diagnosis and proper treatment can significantly improve your outcome.
What rash can be mistaken for measles?
Other diseases that cause a rash that may be mistaken for measles include:
Hand, foot and mouth disease.
Rubella.
Scarlet fever.
