Measles has been all over the news as of late, so we wanted to bring you the facts. Amrutha Balakrishnan, MD, Marlborough Primary Care, answered our questions. What is measles and why are vaccinations so important?
What Is Measles?
Measles is an acute viral respiratory illness which is highly contagious, such that approximately 90 percent of individuals without immunity will develop measles after exposure. Measles is transmitted by direct contact with infectious droplets or through the air when an infected person breathes, coughs or sneezes. The virus can remain infectious in the air for up to two hours after an infected person leaves an area.
The infection is characterized by fever, general discomfort, cough, head congestion/runny nose and conjunctivitis, followed by a rash. The rash spreads from head to toe. Patients are contagious from four days before to four days after the rash appears.
Why Is Measles Coming Back?
Measles is still common in many parts of the world, and so travelers with measles continue to bring the disease into the U.S. Additionally, measles spread throughout communities with groups of unvaccinated people.
According to the Centers for Disease Control and Prevention (CDC), from January 1 to June 13, of this year: 1,044 individual cases of measles have been confirmed in 28 states.
Why Are Vaccinations Important?
Measles can be serious in all age groups. For children younger than 5 years old, adults older than 20, pregnant women and people with compromised immune systems, the disease can lead to severe complications, such as pneumonia and encephalitis (swelling of the brain).
One in five unvaccinated people in the U.S. who get measles are hospitalized.
One out of every 20 children with measles gets pneumonia – the most common cause of death from measles in young children.
One child out of every 1,000 who get measles will develop encephalitis, which can lead to convulsions and can leave the child deaf or with intellectual disability.
One to three of every 1,000 children who become infected with measles will die from respiratory and neurologic complications.
Nonimmune pregnant women may give birth prematurely or have a low birth weight baby.
Long-term complications, such as subacute sclerosing panencephalitis (neurological disorder) are very rare, but fatal diseases of the central nervous system develop seven to 10 years after a person has measles even though the person seems to have fully recovered from the illness.
Hence vaccinations (also called MMR for measles, mumps and rubella) are essential to protect public health and prevent deaths.
Vaccination leads to interruption of measles virus transmission preventing the disease in an immunized person, and it provides protection to unvaccinated individuals via herd immunity (the resistance to the spread of a contagious disease within a population because of a sufficiently high proportion of individuals are immune to the disease, especially through vaccination). We need at least a 95% rate of immunization to stop it from spreading within a community.
As an Adult, How Do I Know if I’m Immune?
You could have immunity in one of the following cases:
- You have written documentation showing you received two doses of measles-containing vaccine, and you will be in a setting that poses a high risk for measles transmission, including students in college settings, health care personnel and international travelers.
- You received one dose of measles-containing vaccine, and you will not be in a high-risk setting for measles transmission.
- You have a confirmation from a laboratory that you had measles at some point in your life.
- You have a confirmation from a laboratory that you are immune to measles.
- You were born before 1957.
What Are the Guidelines for Being Vaccinated for Children and Adults?
According to the CDC:
Children: MMR vaccine starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age or at least 28 days following the first dose. Infants who get one dose of MMR vaccine before their first birthday should get two more doses according to the routinely recommended schedule.
Students in college settings: Without evidence of measles immunity, students need two doses of MMR vaccine, with the second dose administered no earlier than 28 days after the first dose.
Adults: People who are born during or after 1957 who don’t have evidence of immunity against measles should get at least one dose of MMR vaccine.
International travelers: Infants 6 through 11 months of age should receive one dose of MMR vaccine; Children 12 months of age or older, teenagers and adults (born during or after 1957 without evidence of immunity) should have documentation of two doses of MMR vaccine with the second dose administered no earlier than 28 days after the first dose.