With travel returning to pre-COVID levels and back-to-school season not far off, the Centers for Disease Control and Prevention (CDC) is urging parents and travelers to be aware of a rise in cases of measles. While the disease is extremely contagious, there are things you can do to protect your family.
What is measles?
Measles (also called rubeola) is a serious respiratory illness. This means it affects the lungs and breathing tubes. It also causes a rash and a fever. It is one of the most contagious diseases there is, and it can be spread to others very easily. In rare cases, it can be deadly.
Measles used to be a common childhood illness, but in 1971 a vaccine was created to prevent it. Measles had been nearly eliminated in the United States, but measles outbreaks have increased in recent years. According to the CDC, as of July 7, 2023, a total of 18 measles cases were reported by 12 jurisdictions. That may not seem like a lot, but during the same time in 2022 there were just 3 cases. By the end of 2022 there were 121 cases. Compare that to 13 in 2020. Just one infected person can infect 9 out of 10 unvaccinated people they come into close contact with.
The increase in measles cases is partly because of a continued decline in the vaccination rate. During the 2020-21 school year, state-required vaccines among kindergarten students fell from 95% to 94%. During the 2021-2022, it fell again to 93%. Part of this was due to disruptions from the COVID-19 pandemic. That’s why it’s more important than ever to make sure your child is up to date on vaccinations as they return to in-person learning.
Measles outbreaks also occur when the virus is brought into the country from abroad. The disease is still common in other parts of the world. Twice as many Americans are planning to travel internationally in 2023 compared to 2022. Many other countries such as England have seen measles outbreaks recently. Because of this, the CDC is urging anyone planning to travel to another country to make sure their vaccines are up to date.
Symptoms
Measles often starts with the following symptoms:
- High fever
- Runny nose
- Cough
- Red, watery eyes
A few days after these symptoms start, tiny white spots called Koplik spots may appear inside the mouth. Following this, a rash of small, flat red spots appear on the skin. Sometimes small, raised bumps may appear on top of the flat red spots. The rash usually starts on the face and then spreads down the rest of the body. After a few days, the fever and rash start to slowly go away.
Symptoms usually begin 8 to 12 days after a person has been exposed to the virus. A person infected with the measles virus is contagious for 3 to 5 days before the rash breaks out, and the contagious period continues for 4 days after the rash appears.
What causes measles?
Measles is caused by a virus. The virus is spread when an infected person breathes, coughs, or sneezes. You can catch measles by being in the same room as an infected person, even for 2 hours after the person left the room. It is very contagious. If you are exposed to measles and you haven’t received the vaccine, you will likely catch the virus.
Most cases of measles in the United States come from an unvaccinated person who has traveled to a region where the virus is more common. These areas include Europe, Asia, the Pacific Islands, and Africa. When people infected with measles travel into the United States, they spread the disease to unvaccinated people. Children who are too young to be vaccinated are not protected and can easily get the measles infection.
Unvaccinated people at highest risk of getting the measles infection include:
- Infants
- Pregnant women
- People with weakened immune systems
Diagnosis
Your doctor will examine you. They will ask you about your symptoms. Usually doctors can diagnose measles based on the rash and the Koplik spots (spots in the mouth caused by measles). There is also a test that can be run when a clinical diagnosis is unclear.
Can measles be prevented or avoided?
Measles is almost completely preventable through the measles vaccine. The vaccine is called the MMR vaccine. MMR stands for measles, mumps, and rubella. This one vaccine protects you from all 3 diseases. The MMR shot is a safe vaccine. Doctors recommend that children get 2 doses of the vaccine for the best protection. The first vaccination dose is given when a child is 12-15 months old. The second is given when they are 4-6 years old. Ask your doctor about the right time for vaccinating your child.
Treatment
There is no cure for measles. The infection must run its course. Treatment usually involves relieving symptoms. This can include:
- Taking over-the-counter pain relievers for pain or fever. Some OTC pain relievers include acetaminophen (1 brand name: Tylenol) or ibuprofen (1 brand name: Advil). Never give aspirin to a child who has a viral Aspirin has been linked to Reye’s syndrome, which can affect the brain and liver.
- Drinking plenty of fluids.
- Getting extra rest.
It is important to keep your child out of school or childcare when they have measles. They need to stay away from anyone who may not have been vaccinated against the disease. In some cases, people who have been vaccinated can still get measles, so they should follow their doctor’s instructions on isolation and other precautions.
Living with measles
Measles used to be common before the vaccine was developed. While some people think it isn’t a harmful disease, measles can cause serious health problems. Children under age 5 are most at risk of complications from measles. About 1 in 4 people who get measles need to be hospitalized.
Common complications of measles include ear infections and diarrhea. Severe complications could include:
- Pneumonia (infection of the lungs). This is the most common cause of death from measles in young children.
- Encephalitis (swelling of the brain). This can leave a child deaf or with an intellectual disability.
- It is important that you and your child get the measles vaccine. It provides long-lasting protection from the disease.
Questions to ask your doctor
- My child has been exposed to measles. What should I watch out for?
- How long do I need to keep my child away from others?
- What signs should I look out for that could mean my child is developing complications from measles?
- Why is it important that my child gets the MMR vaccine?
- Can adults get the MMR vaccine?
Acknowledgement: This resource is supported by an unrestricted grant from Johnson & Johnson Services, Inc.
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
