The Measles: What do I need to know?

WHAT IT IS:

Measles (rubeola virus) is a highly contagious viral illness characterized by fever, generalized aching, rash, cough, sore throat, and conjunctivitis that occurs worldwide; it remains prevalent in areas with low vaccination rates, particularly in the developing world.

One or more complications occur in approximately 30 percent of measles cases. Diarrhea is the most common complication; most deaths are due to respiratory tract complications or encephalitis.

HOW IT SPREADS:

Measles is highly contagious; the attack rate in a susceptible individual exposed to measles is 90 percent. It is spread via person to person contact and airborne transmission. Population immunity of >95 percent is needed to stop ongoing transmission.

The incubation period for measles is 6 to 21 days (median 13 days). The period of contagiousness is estimated to be from five days before the appearance of rash to four days afterward.

HOW IT IS PREVENTED:

The live attenuated measles vaccine was introduced in the United States in 1967; since that time, the number of cases has fallen by approximately 99 percent. Measles is no longer considered an endemic disease in the United States, although isolated outbreaks due to measles importation continue to occur.

In general, immunity to measles may be presumed for adults born before 1957.

WHY WE ARE TALKING ABOUT IT NOW:

From January 1 to April 26, 2019, 704 individual cases of measles have been confirmed in 22 states. This is an increase of 78 cases from the previous week in April. This is the greatest number of cases reported in the U.S. since 1994 and since measles was declared eliminated in 2002.

In 2018, more than 41,000 cases were reported. Seven countries (France, Georgia, Greece, Italy, Russia, Serbia, and Ukraine) reported more than 1,000 infections.

Cases continue to occur in under-or unvaccinated populations associated with exposure. Among infected individuals who were United States residents, 85 percent were not vaccinated or had unknown vaccination status but were considered eligible for vaccination.

SO WHAT SHOULD I DO?

We suggest that if you don’t have known immunity to the disease, you get the MMR vaccine. If the MMR vaccine is needed, your local pharmacy is the best place to get it.  Contact us to check your immunity.

Low Risk of Exposure – 1 Dose of MMR Vaccine

Adults who do not have evidence of immunity to all three viruses should be administered at least one dose of MMR vaccine. (Unless there is written documentation of adequate vaccination).

There is no increase in vaccine-associated adverse reactions in people who are already immune to measles, mumps, and/or rubella.

Elevated Risk of Exposure – 2 Doses of MMR Vaccine

Formal documentation of immunity to measles should be established for adults in the below categories. In the absence of immunity, two doses of MMR vaccine should be administered for this group at least 28 days apart.

  • Students in post-secondary educational institutions
  • Health care workers
  • International travelers
  • Individuals at risk for exposure during an outbreak
  • Close contacts of immunocompromised individuals
  • Individuals previously vaccinated with a measles vaccine of unknown type between 1963 and 1967
  • Certain medical groups including HIV-infected individuals and stem cell transplant recipients