While measles is technically classified as “eliminated” in the United States and we no longer have to worry about the constant threat of this disease, a recent uptick in the number of measles cases—and news coverage surrounding unvaccinated communities—have caused concern among my patient’s parents.
If you’re confused about whether or not you need to worry about measles affecting your child you’re not alone. Today we’ll be exploring exactly what measles is, how contagious this disease is, how you can best prevent measles, and much more.
What Is Measles?
Measles, also known as rubeola, is an extremely contagious childhood disease caused by a virus. Measles lives in the nose and throat mucus of afflicted individuals and then spreads when that person coughs or sneezes into the air or on objects in the area. Due to the fact that measles can stay active for hours after an infected person has left an area, it can be very hard to stop measles from spreading if people are not properly vaccinated.
Though they’re often confused with each other, measles is not the same as German measles, or rubella, which is another viral infection that also causes a rash. Despite the similarities between the two conditions, German measles is typically much milder in presentation than measles.
Signs and Symptoms of Measles
Typically, measles patients show signs of the disease 1-2 weeks after coming into contact with the virus. Early measles symptoms include high fever, cough, runny nose, general fatigue, and what may feel like allergy eyes. A few days after the first set of symptoms, a rash of red spots shows up on the patient’s head or hairline, eventually moving to the rest of the body.
Another early symptom is white spots inside of the mouth. If you or your child may have been exposed to measles and you see any of these measles symptoms, call your doctor immediately. It’s important that you get an early diagnosis to avoid unknowingly spreading the disease to others.
How Does Measles Spread?
Measles is mostly spread through airborne transmission, when someone with measles coughs or sneezes into the air or onto objects in the room. You might think that avoiding the disease is as easy as staying clear of infected people, but measles is a tricky disease—most of my patient’s parents are surprised to learn that measles can stay active for up to two hours after an afflicted person has left an area! That makes it pretty much impossible to know whether or not you’re being exposed to the virus.
While in many developed countries, measles is not a consistent threat, measles is still common in many other areas of the world and when people from those countries travel, they may bring measles with them. Complications can arise when residents are not vaccinated; for example, in recent years, communities in the United States in which many children were not vaccinated became susceptible to measles outbreaks and caused worry across the country.
In 2019, there were 1,282 documented cases in 31 states, which was the highest number of cases in the U.S. since the early 1990s. Of course, as a doctor, I don’t want to see this trend continue. Though I don’t want you to panic if you suspect your child has measles, this disease should not be taken lightly; 128 of those who had measles were ultimately hospitalized and many had secondary complications.
In the event you suspect a measles infection, make an appointment to see your doctor as soon as possible. Your doctor can diagnose your child and determine an appropriate course of action. To confirm whether or not your child has measles, your doctor will look at their skin and any rash outbreaks and check for other symptoms like high fever or cough. If measles is suspected at that point, a blood test is used to confirm the diagnosis.
Is Measles Really That Contagious?
The answer to this question is a loud and resounding yes. Measles is incredibly contagious and spreads very easily; in fact, according to the Center for Disease Control and Prevention (CDC), up to 90% of the people around an infected person will also develop measles if they’re not adequately protected.
People who have measles can spread the disease for four days before they even show signs of the illness and for four days after the rash appears.
Because measles is caused by a virus and not bacteria, there is no medication to specifically target it.
Depending on your child’s condition, the doctor may prescribe the measles vaccine within three days of the outbreak, which can provide some protection against the effects of the infection and possibly shorten the length of the illness. For certain patient populations, a dose of immune proteins called immunoglobulin may also be given to help prevent measles or lessen symptoms.
Usually, a patient’s symptoms will go away within 2-3 weeks. During that time, treatment centers primarily around symptom relief, or at least lessening the intensity of symptoms. If there are co-existing conditions present, your child may receive medication to treat those conditions as well.
Home Remedies for Measles
The best thing to do as your child recovers from measles is to prioritize their comfort. To reduce your child’s symptoms at home, try the following:
- Make sure they are drinking plenty of water or other hydrating fluids like pedialyte or oral rehydrating solution. This will help to replace any lost fluids and support other body processes.
- Let your child sleep and rest as much as they need.
- Consider buying a humidifier to ease throat discomfort.
- Ask your doctor about pain or fever relievers you can safely use to bring down your child’s fever or mitigate pain.
The most important way to prevent the spread of measles is to receive the vaccination. Additionally, be sure to practice good hand hygiene, which is important to promote wellness in general. You should be washing your hands regularly and only using sanitizer if you can’t physically wash your hands.
Here are the five steps to washing your hands correctly:
- Wet your hands with clean water and apply soap.
- Rub your hands together to create a lather with the soap. Focus on all areas of your hands, including under your nails.
- Continue to wash your hands for at least 20 seconds.
- Rinse your hands with clean water.
- Dry your hands.
Another good rule of thumb is to try and avoid sharing personal items like toothbrushes or beverages with people who might be sick.
If your child does have measles, they should stay home from school or daycare until they’re no longer contagious. Ask your doctor for specifics on when they’ll be okay to return to public spaces.
The Measles Vaccine
Safeguard your family against measles by getting the MMR vaccine, which is especially important if you’re traveling. The vaccine will protect your family against measles, mumps, and rubella. Unlike many childhood vaccinations, which are given earlier, the MMR vaccine schedule starts with one dose given between 12-15 months; this is because the mother’s antibodies provide some protection in the first year of infant life. The second dose is given between 4-6 years of age.
However, if you’re planning to do international travel a different vaccination schedule is recommended. Infants 6-11 months of age should receive MMR if they are at increased risk of exposure which includes international travel.
There is also the option of the MMRV vaccine, which also protects against varicella, or chicken pox, and requires one less shot than the MMR vaccine. To weigh your options between MMR and MMRV, read more from the CDC here.
Despite concerns about the safety of the MMR vaccine, it’s actually very safe. One of the more recent concerns has been surrounding whether the vaccine causes autism. However, there is no link between the two. Most importantly, the vaccine works. If your child gets both doses of the vaccine, there’s a 97% chance they will be protected from measles for life.
Measles vaccine for adults
The general guideline for adults is that if you don’t have proof of immunity (written documentation of vaccines or other evidence that you’re immune, like having been exposed to the disease before) and you meet either of the following criteria:
- You were born after 1957
- You undertake an activity that might expose you to measles (i.e., you’re in school, you travel a lot)
You should usually receive the vaccine. If you don’t have proof of immunity and meet one of those two criteria (or both), follow up with your doctor for confirmation.
Can I still get measles if I’m vaccinated?
Only about 3% of people who receive two doses of the vaccination will get measles in the event of an exposure. However, even if you do get measles after you’ve been vaccinated, it probably won’t be as severe as it would have been otherwise, and you’ll be less likely to spread the disease to others, which is important for the health of the overall population.
Risk Factors and Complications
You are at risk of contracting measles if you did not receive the vaccine. The vaccination provides 97% protection from measles, and not having it leaves you and your child at a much higher risk of developing the virus. The risk of complications is also increased among:
- Adults older than 20 years of age
- Pregnant women
- Undernourished children (particularly those with vitamin A deficiency)
- People with immune suppression (i.e., cancer or HIV)
- Persons who frequent international travel (due to potential exposure to measles-affected individuals in other countries)
While complications are rare, many times when your child gets sick, their immune system is compromised and that can lead to other illnesses cropping up. Complications associated with measles infection in industrialized countries include:
- Otitis media: Also called a middle ear infection, occurs in about 7-9% of patients.
- Diarrhea: Occurs in about 8% of patients.
- Pneumonia: Occurs in about 1-6% of patients.
- Post-infectious encephalitis: Occurs approximately once for every 1,000 patients.
- Subacute sclerosing panencephalitis (SSPE): This a progressive degenerative disease with onset usually 5-10 years after acute measles. It occurs approximately once for every 10,000 patients.
- Mortality: In developing countries, mortality can range from 1-15%, while in industrialized societies is much lower at 0.1%.
When to See a Doctor
If you suspect you or your child has been exposed to measles and are showing signs of the virus, call your doctor immediately. The sooner you are diagnosed, the better your chances of not exposing others to measles.
How K Health Can Help
If you or your child are suffering from measles, talk to a doctor. Did you know you can get affordable primary care with the K Health app? Download K to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.