Measles Outbreak: What You Need to Know

You might think of the measles as a disease that we no longer have to worry about in this country. Although the Centers for Disease Control and Prevention (CDC) considered the measles eradicated at one time, unfortunately, it’s now back and is spreading. This is no reason for alarm, but it’s important to be knowledgeable about what could be a deadly disease.

The Disney measles outbreak

When cases of the measles began cropping up in California in December, they were swiftly linked to a patient who had visited Disneyland in California around Christmastime. Because of the highly contagious nature of the disease, the number of cases has increased to over 100 in fourteen states, including Alaska, Michigan and New York, as well as Mexico. That number is growing daily.

Because Disneyland is a vacation destination and lots of guests use air travel to get there, this particular outbreak has more range than one that is contained, perhaps, to a specific state or community. Dr. Gil Chavez, the California state epidemiologist, has warned that more cases are likely to stem from this particular outbreak. The cases from the California outbreak include several infants, Disneyland employees, and a 50-year-old woman.

Should I be concerned about measles?

Experts have advised that if you’re planning a trip to Disneyland, or anywhere cases have been recently documented, you should be sure that everyone in your party is fully vaccinated against the measles. Most children receive the MMR (measles, mumps, rubella) vaccine in two doses: the first at 12 to 15 months and the second between ages 4 and 6. People born before 1956 are presumed immune because so many children had the disease at that time that they likely have natural immunity at this point. If you are an adult and you’re not sure if you had the MMR vaccine, you can request a blood test from your physician to determine whether or not you’re immune.

A child is considered fully vaccinated after the second vaccine (between age 4 and 6), but 95 percent of children are immune after receiving the first dose of the MMR vaccine.

Plenty of people make a full recovery from the measles, but it can be severe and even fatal. Some complications include:

• bacterial ear infection
• bronchitis, laryngitis, or croup (inflammation of the voice box or the main air passageways of your lungs)
• pneumonia (sometimes fatal)
• encephalitis (inflammation of the brain that could cause vomiting, convulsions, coma, or even death)
• pregnancy complications, including miscarriage, preterm labor, or low birth weight
• low platelet count (which could prevent blood from clotting)

About one in 1,000 measles patients develops encephalitis, and it can occur either immediately following the measles infection or several months later.

How contagious is the measles?

Measles is highly contagious. It lives in an infected person’s nose and throat mucus and spreads to others when the person coughs or sneezes. The virus can survive for up to two hours on a surface or in the airspace where an infected person coughed or sneezed. That means that if someone who is not immune breathes contaminated air or touches a contaminated surface and then touches his or her eyes, nose, or mouth, infection is likely. In fact, the CDC says that the disease is so contagious that 90 percent of exposed people who are not immune will become infected. An infected person can spread measles from four days before a rash (the second phase of the illness) appears to four days after it goes away.

What are the symptoms?

One of the reasons why measles outbreaks spread so quickly is that since the disease was basically non-existent for so many decades, physicians don’t always think to diagnose it right away when a patient presents with the symptoms. Often, a measles infection can resemble the common cold or flu in the early stages. Common signs and symptoms include:

• fever
• dry cough
• runny nose
• sore throat
• inflamed eyes (conjunctivitis)
• Koplik’s spots (tiny white spots with bluish centers inside the mouth)
• skin rash (large, flat blotches that might touch one another)

Symptoms can last as long as three weeks. Often, measles begins with fever, cough, runny nose, sore throat, and conjunctivitis. The rash usually appears after two to three days and will start at the patient’s face and spread gradually downward over the arms, torso, legs, and feet. Often, once the rash appears, the fever will rise quickly. The rash will eventually begin to disappear in the same progression with which it appeared, from the face downward.

When do I call my doctor?

If you or your child might have been exposed to measles or have a rash that resembles what’s described above, call your doctor immediately. Know your family’s vaccine status, especially if you intend to travel internationally or to somewhere in the U.S. that is experiencing a measles outbreak.

Photo by Dave Haygarth / CC BY