Measles outbreaks: What parents need to know

Measles is one of the most contagious infections. It is so contagious that up to 90% of close contacts of someone with measles will also get measles if they are not immune. To prevent the spread of measles in a community, about 95% or more of the population must be vaccinated or immune to measles. This is called herd immunity.

Q: What caused the current measles outbreak?

A: Because of global outbreaks and frequent travel, measles is brought back to the U.S. and can spread in populations of under-vaccinated individuals.

Q: What are symptoms of measles?

A: Measles is highly contagious and transmitted through the air. Contagious particles can remain in the air for hours after an infected person leaves an area. Symptoms typically begin eight to 10 days after initial exposure to the virus, and then develop in stages. Early symptoms include a high fever – typically between 103 and 105 degrees Fahrenheit – cough, red watery eyes and runny nose. A rash develops around the third day of symptoms, starting on the face and continuing to spread downward over the body as the disease progresses. People are contagious for about four days before the rash begins and four days afterward, according to the U.S. Centers for Disease Control (CDC).

Q: How do you treat measles?

A: There is no specific antiviral treatment for measles. Supportive care is provided while monitoring for possible complications, such as dehydration due to diarrhea or pneumonia. The CDC reports that pneumonia is the complication most likely to cause death in young children.

Q: When can you receive the measles vaccine?

A: The MMR vaccination — which covers measles, mumps and rubella — is administered in two doses. The first does is usually given between 12-15 months and the second dose at 4-6 years of age. However, the second dose can be given as soon as 28 days after the first dose. For children traveling internationally, the vaccine is recommended as an extra dose for infants 6 to 11 months of age. To protect those who are unable to receive the vaccination, it’s vital that everyone eligible be vaccinated. Some people, including those with a weakened immune system due to disease or medical treatments, or pregnant women may not be eligible. Ask your healthcare provider for more information. Here’s some tips for making shots less stressful.

Q: Do I need an MMR booster?

A: According to the U.S. vaccination schedule, people who received two doses of the MMR vaccine as children are usually considered protected for life and don’t need a booster dose.

Q: Is the measles vaccine safe?

A: The measles vaccine is safe and readily available. Following the vaccination, some children have mild reactions, such as short-lived, low-grade fever.

Q: Can you die from measles?

A: Measles is a very dangerous disease and can lead to complications including ear infections, pneumonia, a brain infection called encephalitis, and death. Before mass vaccination in the 1980s, measles affected three to four million people per year in the U.S., and 400 to 500 died. We have a very effective and safe vaccine to prevent measles. Getting the measles vaccine is the very best way to prevent measles. All parents should be vaccinating their children at the recommended ages.

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The Ugly Facts About Measles

The United States is experiencing a record number of measles cases, with California leading the states inDoctor vaccinating small redhead girl. the number of individuals confirmed to have had the disease. While some community members don’t perceive measles as serious, health care providers and agencies encourage everyone to consider the ugly facts about the disease — and vaccinate.

Measles is Highly Contagious

Measles is a highly contagious virus that lives in the nose and throat mucus of an infected person. It’s easily spread through coughing and sneezing. The virus can live up to two hours on a surface or in an airspace where an infected person coughed or sneezed. In other words, even after an infected person leaves a room, an unvaccinated individual could get measles as a result of breathing the contaminated air or touching the infected surface.   In fact, 90 percent of unvaccinated individuals in close proximity to a person with measles will become infected.

Measles is Not Simply a Rash

Measles do carry complications, from mild to severe. The most common complications are diarrhea and ear infections, which can result in permanent hearing loss. Severe complications include pneumonia, the most common cause of death from measles in young children, and encephalitis (swelling of the brain) that can lead to convulsions and leave a child with hearing loss and cognitive delays.

There is no treatment for measles. Vaccination is the best protection against the disease. Please talk to your health care provider about the importance of vaccinations for you, your child, and your community.

 

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Protect Your Family From Measles

Measles has now been confirmed in ten Orange County residents, in conjunction with the recent outbreak affecting California and more than 20 other states. The Orange County Health Care Agency reminds the public that the best way to prevent measles is by getting vaccinated.

Measles is an acute infection caused by the measles (rubeola) virus. The disease spreads very easily by air and by direct contact with an infected person. The illness usually begins about 8 to 12 days (but up to 21 days) after exposure with fever, cough, runny nose and red eyes. Complications of measles include pneumonia and, less commonly, encephalitis (inflammation of the brain).

Anyone suspecting they have measles should call their health care provider immediately, and before going to the medical office to avoid exposing others to the virus. The Orange County Health Care Agency recommends the following guidelines to help protect you and your family from measles:

• Children should receive their first MMR (measles, mumps, and rubella) vaccine at 12-15 months of age. The second dose of MMR is given at 4 to 6 years of age before going to school.
• Vaccinating children, adolescents and adults is the best way to protect infants who are too young to receive the MMR vaccine.
• Vaccinations are very safe. The benefits far outweigh any risks. Side effects are usually mild, such as soreness where the shot was given.
• Measles is found in many parts of the world, including Europe, Asia, Africa, and the Middle East. Vaccination before traveling is recommended.

Most people in the U.S. are considered immune to measles from previous measles infection or vaccination. Please contact your health care provider to review your measles vaccination history.

Read this related CHOC article to learn more.

Or, visit the Orange County Health Care Agency or Centers for Disease Control and Prevention.

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Childhood Vaccinations

To ensure maximum protection against diseases, children should receive vaccinations at the correct, recommended age, a CHOC Children’s infectious disease specialist tells Research 360,° a podcast highlighting research at the hospital.

In this segment, Dr. Antonio Arrieta discusses proper timing of vaccinations, dispels myths surrounding vaccinations, and details his current research at CHOC. Listen in to hear more about childhood vaccinations.

Hosted by Executive Director of Research Brent Dethlefs, Research 360° features interviews with scientists, physicians, educators, scientific news-and policy-makers to provide the listening audience with context, and scientific and social commentary intended to engage and inform.

Learn more about CHOC’s Research Institute.

Health Workers on Alert for Measles

New measles cases continue to be reported in Measles_alertOrange County, leaving health care providers on alert for potential cases of the contagious disease.

“Any one case is troubling,” says Dr. Antonio Arrieta, CHOC Children’s director of infectious diseases. ”We shouldn’t be seeing measles in the U.S.”

The state has seen an increase in measles cases this year: Less than four months into the year, California has seen more measles cases in 2014 than in the entire year of 2010, the most recent year of available data.

Symptoms begin with high fever, transition to rash

Highly contagious, measles is transmitted through the air, Dr. Arrieta says. The disease is also strong: Contagions can remain in the air for hours after an infected person leaves an area, he says.

Symptoms typically begin to surface eight to 10 days after initial exposure to the virus, and then develop in stages. Early symptoms include a high fever – typically between 103 and 105 degrees Fahrenheit – cough, watering eyes and runny nose. A rash becomes apparent around the third day of symptoms, worsening the next day and continuing to spread over the body as the disease progresses.

People are contagious about four days before the rash begins and four days afterward, according to the Centers for Disease Control (CDC).

Measles is not treated. Instead, physicians allow the disease to run its course, while monitoring for possible complications, which are more dangerous than the disease itself. Dr. Arrieta says that most children with measles will develop pneumonia, which the CDC reports as the complication most likely to cause death in youth. One in 10 measles cases leads to ear infections, and 8 percent of sufferers report diarrhea, the CDC says.

A child with measles. Source: Centers for Disease Control
A child with measles. Source: Centers for Disease Control

Further, one child in every 1,000 measles cases will develop a brain inflammation that can lead to convulsions, the CDC reports.

Immunity ‘critical mass’ is necessary

“This highlights the problem that if you’re not immunized, you are at risk,” Dr. Arrieta says.

Dr. Arrieta emphasizes that the vaccine is safe and readily available. Following the vaccination, some children have mild reactions, such as a short-lived, low-grade fever.

Ninety percent of the population must be immune to measles to stop or prevent the spread of the disease – and that rate must factor people who cannot have the vaccine for health reasons or age, or those who don’t develop immunity from the vaccine, says Dr. Arrieta.

“If you account for many people who are not immune because they are too young, or have a condition that prevented them from getting the vaccines, then you are in a constant state of being close to that critical 90 percent,” he says. “If you account for all of those who can’t have the vaccine, and those who don’t want to, you’re getting even closer to going below 90 percent. In that case, at any given time, it will spread.”

The MMR vaccination – which covers measles, mumps and rubella – is administered in two doses. The first is given between 12 and 15 months of age, and yields a 90 percent chance of developing immunity against measles. The second dose can be given four weeks later, but is typically administered at age 4 or 5, and pushes the likelihood of measles immunity to 95 percent.

Measles widespread in foreign countries

Most measles cases in the United States – including two of Orange County’s reported cases in 2014 – are contracted by international travel, according to the CDC.

The CDC reports that measles is widespread throughout the world, including parts of Europe, Asia, the Pacific and Africa. Dr. Arrieta cautions parents that even developed countries report measles cases.

“Oftentimes, people don’t recognize that the countries they are traveling to have frequent measles cases,” he says. “Cases come from Europe, where people don’t think they’re at risk. It is a very small world these days.”

Learn more about the infectious diseases division at CHOC.

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