The Recent Measles Outbreak: A Worrisome Development
In the United States, many contagious diseases have gone by the wayside, thanks to childhood vaccinations. Earlier advances in public health, such as clean water and an end to overcrowded housing, have played a role as well.
Potentially serious childhood diseases, including measles, used to be quite common in this country. Before the measles vaccine became available in 1963, an estimated 3 to 4 million people—mostly children—got the disease and 500 died each year.
However, although vaccine-preventable diseases are far less widespread today than they were 60 to 70 years ago, they aren’t gone. If vaccination rates drop, these diseases can start to make a comeback.
Witness the recent measles outbreak in rural West Texas and New Mexico. Roughly 300 cases have been recorded in these states thus far, along with 2 deaths.
A smaller number of measles infections have been reported in Oklahoma, Vermont and Kentucky, as well as in New Jersey, Pennsylvania and New York City. The majority of these infections have occurred in unvaccinated individuals.
Keep reading for the latest vaccine guidance from the New York State and New York City Health Departments. But first, let’s review the nature of the disease itself.
What is measles?
Measles is a serious viral respiratory disease that causes a rash and fever. It’s also highly contagious. The measles virus spreads through the air when an infected individual sneezes or coughs. If one person has it, up to 90 percent of people around them will also get it if they’re unvaccinated or otherwise not immune to it.
The virus can stay in the air for up to 2 hours. That means people can get the disease just by being in a room where a person with measles has been within the past 2 hours. People can also contract it by touching a surface that has the virus on it, and then touching their own eyes, nose or mouth.
What are its symptoms?
Between one to three weeks after exposure, the first symptoms of a measles infection make an appearance, including:
- high fever (which make spike to more than 104° Fahrenheit)
- cough
- runny nose
- red, watery eyes
Then, 3 to 5 days after the onset of these early symptoms, the characteristic measles rash appears.
- The rash usually starts as flat red spots on the face at the hairline and quickly spread downward to the neck, trunk, arms, legs and feet.
- Small, raised bumps may also appear on top of the flat red spots.
- The spots may join together as they spread from the head to the rest of the body, creating one continuous rash.
Complications
A small number of people who get measles—adults and children alike—need to be hospitalized, and even with the best care, some will die. Many develop complications such as pneumonia, ear infections and brain swelling.
There’s also a rare, long-term complication called subacute sclerosing panencephalitis—a brain infection that can lead to permanent brain damage or even death.
Measles during pregnancy increases the risk of early labor, miscarriage and low birth weight infants.
If you suspect your child has measles
Keep them home and call your family physician or your local health department immediately for guidance around you how to get your child checked for the disease without infecting others.
Treatments
There are no treatments for measles, but acetominophen or ibuprofen can help to reduce a fever. Bed rest and fluids are also helpful.
The best treatment, though, is prevention, and the best way to prevent your child from getting measles is the MMR vaccine.
The measles vaccine
The MMR vaccine is actually a combination shot that provides immunity to measles, mumps and rubella. Developed in the 1960s, it has been tested over and over, and it has been proven safe and effective. There is no link between the MMR vaccine and autism, or between the vaccine and SIDS (sudden infant death syndrome).
Are you immune?
If you were born before 1957, you probably had measles when you were a child. That means you’re immune to the disease.
For everyone else, two doses of the MMR vaccine confer immunity in 97 percent of those who get the shots.
Dr. Roy Gulick, Rochelle Belfer Professor in Medicine and Chief of the Division of Infectious Diseases at Weill Cornell Medicine, says that even with one shot, there’s a 90 percent chance that you’re immune.
“Anyone who doesn’t know whether they got two doses should go ahead and get a second dose,” he advises. “There’s no downside to doing that.”
Here are two other ways to check your immunity: Locate your old immunization records here, or request a blood test to see if you have antibodies against measles.
Who shouldn’t be vaccinated
Children and adults with cancer or who have certain immune-related disorders shouldn’t receive the MMR vaccine. Nor should people taking immunosuppressive medications.
Where and when to have your child vaccinated
In New York state, the MMR vaccine is required for entry in the public school system, starting with day care and pre-K and extending to kindergarten through 12th grade.
Be aware that as of 2019, there’s no longer a religious exemption from mandated vaccinations in the state of New York.
Most pediatricians offer the MMR vaccine. But if you need help finding a vaccination site:
- Call 311
- Visit the NYC Health Map.
- Visit the Fort Greene Immunization Clinic
Children should get their first MMR shot at 12 through 15 months old. The second dose may be safely given as soon as one month after the first dose, but it is usually given between 4 and 6 years of age.
The New York State Department of Health recommends an early dose of the MMR vaccine for children 6 to 11 months of age who are living in an outbreak setting or will be traveling internationally. These children will still need the 2 routine doses given at 12 to 15 months and 4 to 6 years of age, meaning they’ll receive a total of 3 doses in all.
Have your child vaccinated by making an appointment with a Weill Cornell Medicine pediatrician here.