Darin Seehafer
Darin Seehafer
Clinical Scientist, PRA Vaccine Solutions

More children across the world are being vaccinated against measles than ever before, but progress has been uneven between and within countries, leaving increasing clusters of susceptible individuals unprotected and resulting in a record number of people affected by the virus.

On the rise

The number of reported measles cases in the United States this year has reached 695, the highest number of reported cases since measles was declared eliminated in the U.S. in 2000.

Cases have been reported in 22 states. The CDC is attributing this record-breaking number to outbreaks in Washington state and New York. The outbreaks in New York City and New York state are considered the largest and longest-lasting outbreaks since 2000.

In Europe the total number of people infected with the virus in 2018 was the highest this decade: three times the total reported in 2017 and 15 times the record low number of people affected in 2016.

Why the outbreak now?

The CDC says the latest outbreaks started through importation. Misinformation about vaccine safety being spread is also a "significant factor" contributing to the outbreaks, the CDC says. This is leading to a precipitous drop in measles, mumps, and rubella (MMR) vaccinations. More people are failing to vaccinate their children or delaying getting their shots. In some areas of California, 13 percent of young children haven't been immunized.

Some of the reluctance for parents to vaccinate their children is fueled by fears of autism and an intensifying anti-vaccine movement. Although research has disputed any relationship between vaccines and autism, the fears are deeply entrenched in some communities.

Parents are encouraged to speak to their family's health care provider about vaccination, and local leaders are encouraged to provide "accurate, scientific-based information" to counteract the misinformation being disseminated.

(Source: World Health Organization)

How serious is measles?

Measles is a highly contagious respiratory disease and remains one of the leading causes of death among young children globally. In 2017, there were 110 000 measles deaths globally, mostly among children under the age of five, despite the availability of a safe and effective vaccine.

Measles spreads through the air when an infected person coughs or sneezes. It’s so contagious that if one person has it, nine out of 10 people around him or her will also become infected if they’re not protected. The virus remains active and contagious in the air or on infected surfaces for up to two hours.

While some people think of it as just a rash and fever that will clear up in a few days, measles can cause serious health complications, especially in children younger than five years old.

  • About one in four people in the U.S. who get measles will be hospitalized
  • One out of every 1,000 people with measles will develop brain swelling, which could lead to brain damage
  • One or two out of 1,000 people with measles will die, even with the best care

(Source: Centers for Disease Control)

Signs and Symptoms

The first sign of measles is usually a high fever, which begins about 10 to 12 days after exposure to the virus, and lasts four to seven days. A runny nose, a cough, red and watery eyes, and small white spots inside the cheeks can develop in the initial stage. After several days, a rash erupts, usually on the face and upper neck. Over about three days, the rash spreads, eventually reaching the hands and feet. The rash lasts for five to six days, and then fades. On average, the rash occurs 14 days after exposure to the virus (within a range of seven to 18 days).

(Source: World Health Organization)

Treatment

No specific antiviral treatment exists for the measles virus.

Severe complications from measles can be avoided through supportive care that ensures good nutrition, adequate fluid intake and treatment of dehydration with WHO-recommended oral rehydration solution. This solution replaces fluids and other essential elements that are lost through diarrhea or vomiting. Antibiotics should be prescribed to treat eye and ear infections, and pneumonia.

All children diagnosed with measles should receive two doses of vitamin A supplements, given 24 hours apart. This treatment restores low vitamin A levels during measles that occur even in well-nourished children and can help prevent eye damage and blindness. Vitamin A supplements have been shown to reduce the number of deaths from measles by 50%.

(Source: World Health Organization)

How to protect yourself from getting measles

The measles vaccine has been in use for over 50 years. It is safe, effective and inexpensive. It costs approximately one US dollar to immunize a child against measles.

Federal guidelines typically recommend that children get the first vaccine dose at 12 to 15 months of age and the second when they are four to six years old. One dose of measles vaccine is about 93% effective at preventing measles if exposed to the virus. Two doses are about 97% effective.

The CDC considers you protected from measles if you’ve received two doses of measles-containing vaccine, and you are:

  • a school-aged child (grades K-12)
  • an adult who will be in a setting that poses a high risk for measles transmission, including students at post-high school education institutions, healthcare personnel, and international travelers.

Or, you received one dose of measles-containing vaccine, and you are:

  • a preschool-aged child
  • an adult who will not be in a high-risk setting for measles transmission.

The CDC also considers you protected if a laboratory confirmed that you had measles at some point in your life, or you were born before 1957.

(Source: World Health Organization & CDC)

History of measles infographic2

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