Measles: What You Need to Know to Stay Safe

Measles is a highly contagious disease that can cause serious problems, especially for young children. It can lead to blindness, pneumonia, or even brain swelling, and in some cases, it can be deadly. This is especially true for kids under 5 years old. In fact, about 1 in 5 unvaccinated people with measles will need to go to the hospital, and as many as 1 in 20 children with measles will get pneumonia, which is the most common cause of death from measles in young children. Overall, it’s estimated that up to 3 out of every 1, 000 children who become infected with measles will die from respiratory and neurologic complications. The best way to protect against measles is to get vaccinated. But, there's a problem. A record number of kindergartners in the US had exemptions for required vaccinations last school year, leaving more than 125, 000 new schoolchildren without coverage for at least one state-mandated vaccine. The US Department of Health and Human Services has set a goal that at least 95% of children in kindergarten will have gotten two doses of the measles, mumps and rubella (MMR) vaccine, a threshold necessary to help prevent outbreaks of the highly contagious disease. But the US has fallen short of that threshold for four years in a row. Most of the cases in the current outbreak in West Texas are centered in Gaines County, where coverage of the MMR vaccine is particularly low: Nearly 1 in 5 incoming kindergartners in the 2023-24 school year did not get the vaccine. This is a big concern because measles can spread very easily. The virus can linger in the air or on surfaces for up to two hours – even after the infected person has left the room. It’s estimated that one person infected by measles can infect 9 out of 10 of their close contacts, if those contacts are unvaccinated. Measles is so contagious partly because an infected person can spread the virus to others even before knowing they have it – from four days before through four days after the rash appears. Early on, measles can cause symptoms that may appear similar to those of other respiratory illnesses, such as the flu or the common cold. But if you see a combination of cough, red eyes, and a very congested or stuffy nose, that’s reason to be concerned. Other key symptoms of measles include a high fever that may spike to more than 104 degrees Fahrenheit, a red blotchy measles rash and Koplik spots, which are tiny white spots that may appear inside the mouth two to three days after symptoms begin.

If someone develops any of those symptoms, it’s important to have a conversation with their physician or medical care team before taking them to the doctor’s office, urgent care center or hospital. Calling ahead allows the health care provider to make accommodations and provide guidance on how to safely see the patient while reducing the risk of measles spreading in a busy waiting room. The measles, mumps and rubella vaccine has been found to be safe and effective. One dose is 93% effective against measles, and two doses are 97% effective. Children should get two doses of the MMR vaccine: the first between 12 and 15 months and the second around age 4, before starting school. These two doses usually protect people against measles for life. Because the vaccine is not 100% effective, the more measles spreads, the higher the risk that a vaccinated person may be infected if they’re exposed to the virus. However, disease symptoms are generally milder in vaccinated people, and they are also less likely to spread it to others. There is no specific antiviral therapy for measles, but some of the complications associated with the illness can be treated. Sometimes measles can result in a secondary infection such as an ear infection or pneumonia that needs antibiotic treatment. Vitamin A can be an important adjunctive therapy for measles that can help protect against severe disease and some of the adverse effects of measles. Measles is a “strongly immunosuppressive” virus, meaning it weakens the infected person’s immune system, and bacterial infections like bacterial pneumonia are a major cause of measles-related death. Children may have bacterial infections in the respiratory tract that require antibiotic treatment. Additionally, any child that’s sick enough to get hospitalized will probably get high-dose vitamin A. Vitamin A has been shown to have a very strong impact during acute measles, and for children that are very ill, it can lead to a 50% reduction in mortality. People whose doctors say they should stay home can be treated with fever-reducing medications, rest and lots of hydration. It’s important to isolate the child during the period where the child might be contagious and to stay in close contact with the pediatrician. If a child begins behaving excessively sleepy or very irritable, those would be reasons to get back in touch with the pediatrician.

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