Measles

Measles is a highly contagious, serious respiratory disease caused by a virus that can lead to severe health problems and hospitalization. In rare cases, it can be deadly.

The virus lives in the nose and throat and spreads easily through the air when an infected person breathes, talks, coughs, or sneezes. The virus remains active and contagious in the air or on surfaces for up to two hours. People can get infected when they breathe contaminated air or touch their eyes, nose, or mouth after touching contaminated surfaces. A person infected with measles can spread the disease to others 4 days before they have a rash through 4 days after the rash appears. Measles spreads so easily that anyone who is exposed to it and is not immune (such as someone who has not been vaccinated) will probably get the disease.

Measles can be a serious illness for all age groups and can cause conditions like pneumonia, ear infections, and permanent brain damage. About one out of 10 children with measles also gets an ear infection, and up to one out of 20 gets pneumonia. One or two out of 1,000 die from measles. Measles can also cause those who are pregnant to miscarry or give birth prematurely. Serious health problems from measles are more common among children younger than five and adults older than 20.

Measles symptoms appear 7 to 21 days after coming into contact with the virus. It usually progresses in two stages.

• In the first stage, illness begins with fever, runny nose, cough, and red, watery eyes that can last 2 to 4 days.
• The second stage begins with the appearance of a rash. The non-itchy raised, red, spotty rash starts on the face and spreads downward covering the body, arms, and legs.

Symptoms usually last 7-10 days.

The measles, mumps, rubella (MMR) vaccine is the best protection against measles. Two doses of MMR vaccine are about 97% effective at preventing measles. One dose is about 93% effective. Decades of studies of the MMR vaccine by doctors and scientists conclude that the MMR vaccine is safe and effective.

Measles vaccine is recommended for everyone 1 year old and older. When more than 95 percent of people are vaccinated against measles, the disease slows down and doesn't spread. This is called community (or herd) immunity.

You develop immunity if you've had measles in the past or have had MMR vaccinations. If you're unsure whether you're immune to measles, you should first try to find your vaccination records or documentation of measles immunity. If you do not have written documentation of measles immunity, you should get vaccinated with measles-mumps-rubella (MMR) vaccine.

Another option is to have a doctor test your blood to determine whether you're immune. But, this option is likely to cost more and will take two doctor's visits. There is no harm in getting another dose of MMR vaccine, even if you may already be immune to measles (or mumps or rubella).

The Centers for Disease Control and Prevention offers photos that show what measles looks like.

There is no cure for measles. Treatment focuses on relieving symptoms and managing any serious conditions that can develop. This may include fluid replacement, medications to control fever or pain, antibiotics to treat bacterial infections, and vitamin A supplements.

Vitamin A cannot prevent or cure measles, but is used to prevent severe health problems, including preventing death in children who don't have enough vitamin A through their diet. Severe measles cases among children, such as those who are hospitalized, should be treated with vitamin A. This should be done with the guidance of a medical provider, as too much Vitamin A may cause toxicity and organ damage.

Before the measles vaccine, measles caused thousands of cases and about 400 deaths in the U.S. each year. Most people in the U.S. are now vaccinated against measles or are immune from having measles as a child, but outbreaks do happen. Most commonly, measles is brought into the U.S. by someone who has traveled outside the country. When unvaccinated people are exposed, measles spreads very quickly.

Anyone who hasn't been vaccinated or had measles in the past is at risk. Babies younger than 12 months are at risk because they are too young to have been vaccinated. Others at highest risk include children under 5 years, adults over 20 years, anyone who is pregnant, and people with weakened immune systems.

Call your doctor, nurse, or clinic right away. Before you go to the doctor's office, call to tell them that you or your family member might have measles. This will allow them to take steps to avoid exposing other people. Stay away from other people until at least four days after the rash starts or a test proves it's not measles.

All children, adolescents, and adults born in 1957 or later should have documentation of vaccination or other evidence of immunity, such as a blood test or a documented history of measles infection. For recommendations based on your age, health status, or risk of measles, talk to your doctor. Information is also available on the CDC website for recommended vaccines.

The measles vaccine is very effective; it protects about 93% of after just one dose. However, because approximately 7% of people are not protected after one dose, it is recommended that a second dose be given to make sure people are well protected against measles.

For children, the second dose of the measles vaccine is typically given around 4-6 years of age. However, the second dose can be given as early as 28 days (four weeks) after the first dose.

In outbreak areas, it is permissible to give the second MMR vaccine early and at least 28 days after the first valid dose (after the first birthday).

- An early second dose is considered valid if given at least 28 days after the first valid dose and does not need to be repeated to meet school entry requirements.

There are two combination vaccines available in the U.S. that protect against measles:

• The MMR (measles, mumps, and rubella) vaccine
• The MMRV (measles, mumps, rubella, and varicella [chickenpox]) vaccine

They are both live attenuated vaccines, which means they contain weakened strains of the viruses they protect against. The MMR vaccine is approved for anyone 6 months of age and older. The MMRV vaccine is approved only in children ages 12 months to 12 years.

A small group of people may have a low-grade fever or mild rash seven to 12 days after they receive the measles vaccine. They are not contagious and no exclusions from work or school are necessary. However, if someone was vaccinated after a recent exposure to someone with measles, they should consult with their doctor, as their symptoms could be related to a measles infection related to that exposure.

The measles vaccine is given either by injection either intramuscularly (IM), or subcutaneously, into the fatty layer of tissue just under the skin.

Who should not get the vaccine?

• Anyone who has had a severe, life-threatening allergic reaction after a previous dose of MMR or to any vaccine component should not receive the vaccine.
• People who are severely immuno-compromised, for example:
  • People on chemotherapy
  • People on immunosuppressive therapy
  • People on high dose steroids
  • Those with health conditions like leukemia or AIDS
• Women who are pregnant, or planning to become pregnant within the next month should not be vaccinated until after delivery. Women who are breastfeeding can be vaccinated.
• If you have any questions on whether or not you should be vaccinated based on your health status or if you had a reaction to a previous dose of vaccine, talk to your doctor.

In the past it was believed that people who were allergic to eggs would be at risk of an allergic reaction from the vaccine because the vaccine is grown in tissue from chick embryos. However, recent studies have shown that this is not the case. MMR may be given to egg-allergic individuals without prior testing or use of special precautions.

If you were born before 1957, you most likely had the disease as a small child and are protected against getting infected again. If you were born in 1957 or later, and don’t have your shot record, visit your primary care physician. Your doctor can perform a simple blood test to test to see whether or not you are protected against measles. Your doctor may also recommend that you receive the measles shot.

People born before 1957 lived through several years of epidemic measles before the first vaccine was available. As a result, these people are very likely to have had the measles disease. Thus, 95–98% of those born before 1957 are immune to measles.

Not necessarily. People who have documentation of receiving a live measles vaccine in the 1960s do not need to be revaccinated. People who were vaccinated prior to 1968 with an inactivated (killed) measles vaccine, or vaccine of unknown type, should be revaccinated with at least one dose of the MMR vaccine. If you are unsure about your vaccine history, your doctor can help determine if you need additional vaccination against measles.

Yes. Measles vaccine contains weakened viruses and are not passed from the vaccinated person to other household members.

There is no scientific evidence that any vaccine, including MMR, causes autism. View information on Autism and Vaccines from the CDC.