You Got What!?! Measles!?!

Gorakhpur, India

1960, when measles killed many

Measles virus - up close

The CDC recently reported increased cases of measles across the country.  Here are some abridged questions and answers provided by the “Ask The Experts” panel from CDC:

Q: How many cases are we seeing across the United States, and where did they come from?

A: during the first 19 weeks of 2011, 23 states reported 118 cases (usually 56 cases for an entire year). Of those cases, 89% were associated with importation from other countries.

Q: How serious is measles?

A: Measles can lead to serious complications and death, even with modern medical care. Of the 118 cases reported in the U.S. in the first 19 weeks of 2011, 40% had to be hospitalized and nine had pneumonia.  Of the 118 cases, 47 (40%) resulted in hospitalization. All but one hospitalized patient were unvaccinated. The vaccinated patient reported having received 1 dose of measles-containing vaccine and was hospitalized for observation only.

Q: What are the signs and symptoms of measles?

A: Look for

  • a generalized rash lasting 3 or more days, and
  • a temperature of 101 degrees F or higher, and
  • cough, runny nose/congestion, and/or conjunctivitis.

especially if you have recently traveled abroad or have had contact with international travelers.

Q: How contagious is measles?

A: Measles is highly infectious. Droplets has been documented in closed areas for up to 2 hours after a person with measles occupied the area.  Following exposure, up to 90% of susceptible people develop measles. The virus can be transmitted from 4 days before the rash becomes visible to 4 days after the rash appears.

Q: How long does it take to show signs of measles after being exposed?

A: It takes an average of 10-12 days for the first symptom, which is usually fever. The measles rash doesn’t usually appear until 2-3 days after the fever begins.

Q: If a susceptible person is exposed to measles, can anything prevent them from developing the disease?

A: If the person has not been vaccinated, measles vaccine may prevent disease if given within 72 hours of exposure. Other treatment may also help.  See your doctor.

Q: I don’t remember if I ever received MMR vaccine or had measles disease and I am planning an international trip. How should I handle this situation?

A: You have the choice of testing for immunity or just getting 2 doses of MMR at least 4 weeks apart. There is no harm in giving MMR vaccine to a person who may already be immune to one or more of the vaccine viruses.

Q: I’m a healthcare worker or student. How can I ensure I am protected against measles?

A: If you do not have acceptable evidence of immunity for healthcare workers–documented receipt of 2 doses of live measles virus-containing vaccine at least 4 weeks apart or laboratory evidence of immunity–either get tested for immunity or get 2 doses of MMR at least 4 weeks apart. If you choose the testing route, and your result is negative, indeterminate, or equivocal, get 2 doses of MMR at least 4 weeks apart.

Q: Does the increase in measles cases indicate that vaccination with MMR isn’t effective?

A: No. Unvaccinated people accounted for 105 (89%) of the 118 cases. Among the 45 U.S. residents ages 12 months through 19 years who acquired measles, 39 (87%) were unvaccinated, including 24 whose parents claimed a religious or personal exemption and eight who missed opportunities for vaccination.

Among the 42 U.S. residents age 20 years and older who acquired measles, 35 (83%) were unvaccinated, including six who declined vaccination because of personal objections to vaccination. Of the 33 U.S. residents who were vaccine-eligible and had traveled abroad, 30 were unvaccinated and one had received only 1 of the 2 recommended doses.

Roger Miller, MD
Student Health Services
The Ohio State University

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Source: The Immunization Action Coalition (http://www.immunize.org/express/issue937.asp)

Images: Public Health Image Library

 

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