The U.S. is experiencing the greatest number of reported cases of measles since the disease was declared eliminated in 2000, according to the Centers for Disease Control and Prevention. I've received many questions from parents regarding the current measles outbreak so I've put together this blog about what you need to know.
So far (knock on wood), we have not seen any cases in Kansas. Yet, we did have our own little measles outbreak in April 2018 so we aren't immune to this issue. You can get the latest measles outbreak information from the CDC website.
What is measles?
Measles is a HIGHLY contagious disease. According to the Children's Hospital of Philadelphia's Vaccine Education Center, if 10 susceptible people are in an elevator with one measles-infected person, 9-10 of them will likely become infected. It starts out like a bad cold – fever, congestion, cough, and red, irritated/watery eyes. Then a few days later, a red, pinpoint rash develops on the face and spreads down the rest of the body. What's really scary is people without the rash are already contagious! Plus, measles virus is spread from droplets and can remain in the air up to two hours after the infected person has left the area.
Why do we care about measles?
It can be FATAL. Not just in the acute phase, but even 10 years down the road! Nearly one out of every three children under the age of five who catches measles ends up in the hospital. Complications of measles infection include, pneumonia, encephalitis, ear infections, hemorrhagic measles, clotting disorders and death. Death occurs in about 1 out of every 500 people infected. Even if measles doesn't result in death, complications from encephalitis can result in permanent brain damage. Up to 10 years later, previously infected individuals can develop something called subacute sclerosing panencephalitis (SSPE), which is a progressive neurological disorder that results in death. Studies have shown that measles infection can wipe out your immune system so much that you’re no longer immune to diseases you previously were. This disease is no joke!
Why is there an outbreak when we have a vaccine?
While many of us know the value of vaccinating against measles, others see the vaccine as something they can opt out of. It's important to know the facts about the MMR vaccine.
The MMR vaccine is a live, "weakened," viral vaccine that protects against measles, mumps and rubella. Before the measles vaccine was introduced in 1963, more than two million deaths occurred annually worldwide, mostly in kids under the age of five. The MMR vaccine (with mumps and rubella protection) was introduced in 1971, so it has been around for more than 40 years. Common side effects from the vaccine include fever, pain at the injection site, non-contagious measles like rash, and sometimes short-lived arthritis. Rare side effects include short-lived decrease in circulating platelets (less than 1 affected in 30,000 vaccine recipients) and fever-associated seizures (1 in 3,000-4,000 vaccine recipient affected). The first dose of the vaccine is 93 percent effective at preventing measles infection and receiving two doses increases the effectiveness to 97 percent. We give the MMR vaccine at one and four years old. Bottom line? Getting the MMR vaccine is far safer than getting measles. It does not cause autism.
I also have parents who say they would prefer their child to get "natural" immunity, but I caution against that because natural immunity risks death. It's really as simple as that. The discomfort from the common cold is bad enough, do you really want your child to suffer through measles and risk pneumonia, encephalitis and other very serious complications?
Who is at risk of getting the measles?
- Infants under six months of age are protected against measles if their mother received the MMR vaccine. If they are exposed to measles though, they will likely need an IV medication called IVIG to protect them.
- If a child between 6 and 12 months old is traveling outside of the U.S., or is currently somewhere there is a known measles outbreak, we would recommend getting the MMR early. They will still have to get their one year and four years doses, but this will provide some temporary protection.
- Children who haven't received their second dose of MMR and reside in areas where current outbreaks exist can get their second dose early IF it has been more than 30 days since their first dose. As of now, there are no known outbreaks in Kansas (again, knock on wood).
Do parents need to get revaccinated?
Parents may have seen articles online recommending getting revaccinated, particularly if you were born between 1957 and 1989. It is thought if you were born before 1957, you were likely naturally exposed to measles anyway, and therefore have lifelong immunity. If you were born during this time period, you probably received one dose of MMR, which results in 92 percent immunity. Interestingly, people born between 1967 and 1976 actually have the highest rate of being LESS immune (up to 20 percent). Anyone born between 1957 and 1989 should talk with their doctor about whether or not they need a booster. If you were born after 1989, when the recommendations changed from one dose to two doses, you should be immune if you received both doses.
If you're unsure if you're immune to measles, first try to find your vaccine records or documentation of measles immunity, called titers. If you do not have written documentation of measles immunity, talk to your doctor and you should likely get the MMR vaccine. Another option is to have a doctor test your blood to determine if you're immune, but this option will take two doctor's visit and may cost more than just getting an MMR booster. There is no harm in getting another dose of MMR vaccine even if you may already be immune to measles (or mumps or rubella).
Choosing not to vaccinate your child only leaves them susceptible to measles, but also exposes other children to measles. Measles is not just a rash – it's a very serious disease.
For more information, you can check out these additional resources:
- Download the "CHOP Vaccines on the Go" app on your phone for free
- Measles Q&A
- CDC Information about Vaccinations
- How to Protect Your Baby During a Measles Outbreak (HealthyChildren.org)
- How to Protect Your Children During a Measles Outbreak (HealthyChildren.org)
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