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Measles

What’s the deal with measles?

 

If you’ve tuned into the national news (or local if you live in my neck of the woods),  you’ve heard about measles.

Measles outbreak in Disneyland

Measles case in Omaha 

Measles case in Lincoln

Q: What is measles?
Measles is a viral infection that is very contagious.   The normal symptoms include high fever, hacking cough, red eyes, light sensitivity, and rash.  A very characteristic rash occurs first in the mouth and then a full body rash that starts on the forehead.  Because it’s a viral infection, antibiotics don’t work.  Supportive care and monitoring for complications (discussed below) are the only treatments.

Q: How do we prevent measles?

Measles is HIGHLY CONTAGIOUS.  Before we had a vaccine for measles, nearly EVERY child got measles usually in the first decade of life.  Measles used to peak in the late winter or early spring as groups were crowded indoors.   Measles is still prevalent around the world, especially in developing countries where vaccines aren’t readily available.

For the past 50 years, we have had a very effective vaccine against measles.  Nowadays, measles in almost extinct in the United States. In the decades after the measles vaccine was first introduced, there was a 99% reduction in measles cases in the US.   Children get their first measles vaccine when they are 12 months old (leaving younger babies who are most vulnerable to severe measles complications unprotected) and a booster when they enter kindergarten.  The vaccine is very effective with 95-99% developing immunity.  Because it’s so contagious, a high percentage of the population but be vaccinated to prevent the spread.  With the outbreak in Disneyland this month, there are a higher rate than average of unvaccinated (due to parental preference) children both infected and spreading the illness.  In fact, measles has been seen in California at higher than normal rates in recent years because of parental vaccine refusal.

Q: Measles is a contagious viral infection, makes kids get a rash and feel crummy for a, but what’s the big deal?

Measles is usually self-limited (meaning most kids recover without complication).   Your grandparents survived measles. Your great-grandparents survived measles.  Unfortunately, not everyone comes out unscathed after contracting measles.  In fact, 1 in 1000 children with measles dies from the infection.

The common complications are respiratory issues, especially pneumonia which can require hospitalization, antibiotics, and breathing assistance with a breathing tube in some cases.

The scariest complications involve the brain.  During the acute infection, inflammation can develop in the brain causing changes in mental status, headaches, and seizures. About 15% of children who develop the acute brain inflammation don’t survive it and many (+25%) of the survivors are left with seizures, developmental delay, hearing loss, or paralysis.

Measles is much more common and devastating in developing countries.   Measles accounts for more than 1 millions deaths each year in developing countries.  

Q: What can I do to protect my child?

On-time vaccination is the only way to prevent the spread of measles.  Children should get their first dose of measles vaccine (MMR) at 12 months.   Children get a booster at their kindergarten checkup.  If your child has received the first dose and they haven’t yet reached kindergarten age, they don’t need an early booster UNLESS exposed to someone known to have measles.  Once they’ve received two doses, no more boosters are needed or provide extra protection even if they are exposed.

On a side note, the previous “research” that suggested MMR is associated with autism has been totally and completely debunked as falsified!  MMR is safe. Vaccines don’t cause autism.

Q: Should I be freaking out?

No! Don’t freak out.  We have a very effective vaccine against measles and most kids have received it on time.  If you have questions or concerns, talk with your pediatrician.  In the meantime, take a deep breath (unless there’s someone with measles nearby!).