By: Eileen Ruiz, PhD
It is reported an outbreak of measles in the United States. What is measles? What are the symptoms? How people get infected? How can we prevent it?
This article is a brief summary of measles and provide answer to these questions.
I was reading an article about an outbreak of measles in New York and what is perceived as the worst outbreak in decades (1).
According to the website of the New York State Department of Health, some areas of New York State are experiencing a measles outbreak, including the lower Hudson Valley and parts of New York City (2).
I get curious and start searching more information, as measles was a common condition decades ago, but today, it is preventable by vaccination. It is not a common illness in United States. Reports from the Centers for Disease Controls and Prevention (CDC) indicates that measles cases usually range from less than 100 to a couple hundred annually (5).
Then, I found that just in the first weeks of 2019, from January 1 to February 7, 2019, there have been 101 confirmed measles cases in ten states. The states that reported cases to CDC are California, Colorado, Connecticut, Georgia, Illinois, New Jersey, New York, Oregon, Texas, and Washington (3).
Let’s understand what measles is and how to prevent it.
What is measles?
Measles, also known as rubeola, is an infection caused by a virus. It is a serious respiratory disease characterized by an uncomfortable rash and high fever. It is associated mainly with childhood but can be found also in adults.
What are the symptoms?
Measles symptoms appear around 10 to 14 days after exposure to the virus.
When a person is in contact with the virus and get infected, there is an incubation time where the virus replicates in the body. The incubation period is around 10 to 14 days after infected.
Measles signs and symptoms typically begins as a mild illness with non-specific symptoms as fever, that can be accompanied by a persistent cough, runny nose, inflamed eyes or conjunctivitis, and sore throat. Fever may last 4 to 7 days. Also, small white spots known as Koplik’s spots can be observed in the mouth, insides of cheeks, and throat.
Then, the acute illness and rash develops. The rash consists of small red spots, that can be slightly raised. Spots appears in clusters giving the skin a red appearance. The face breaks out first. On the next few days, the rash spreads down the arms and trunk, the thighs, lower legs and feet. Fever rises sharply (40◦C to 41◦C). Then, the rash gradually recedes, fading first from the face and last from the thighs and feet (4).
A person with measles can spread the virus to others for about eight days, starting four days before the rash appears and ends when the rash has been present for four days(4). There is no specific treatment, as medicine does not kill the virus.
Diagnosis is based on signs and symptoms. Blood test confirms the presence of the rubeola virus.
It is not a common condition as more children received the measles vaccine. It was reported in US an average of 60 cases per year from 2000 to 2010, but this increased up to 205 per year recently. Most of the cases occurs outside the country, while traveling, and in people who were unvaccinated. It is more associated to international travels.
It can be a severe or even fatal condition for babies and young children. Globally, the disease kills more than 100,000 people a year, mostly, children under the age of 5 (4). From 2001-2013, 28% of children younger than 5 years old who had measles had to be treated in the hospital
How is obtained?
According to the CDC, Measles spreads when a person infected with the measles virus breathes, coughs, or sneezes. It is very contagious…a person can be infected just by being in a room where a person with measles has been, up to 2 hours after that person is gone. The virus can stay active on surfaces and in the air for up to 2 hours.
An individual can obtain measles from an infected person even before they have a measles rash. Measles is highly contagious from about four days before to four days after the rash breaks out. Almost everyone without the measles, mumps and rubella (MMR) vaccine will get measles if exposed to the virus(5).
Once infected by the measles virus, the virus located and replicates in the nose and throat of the infected individual. When someone with measles coughs, sneezes or talks, infected droplets spray into the air. People can inhale them and get infected. Also, the infected droplets can locate on a surface, where remain active and contagious for several hours. A person can be infected by the virus by touching the surface, and then touching the mouth, nose, or eyes after touching the infected surface.
Measles is common in other parts of the world, including countries in Europe, Asia, the Pacific Islands, and Africa. Worldwide, about 20 million people get measles each year. When people with measles travel into the United States, they can spread the disease to unvaccinated people and to children too young to be vaccinated(5).
Outbreaks can be associated to people in the US that got the measles after being exposed to someone who got measles while in another country.
Since the introduction of the measles vaccine, measles has virtually been eliminated. The rate of measles in the U.S. recently increased from an average of 60 cases a year to 205 cases annually, maybe because a drop in vaccination rates. There are publications that associated the drop in vaccination rates to a study published in 1998, where a possible association of autism to the measles, mumps and rubella (MMR) vaccine was found. This study was not confirmed and according to Center for Disease Controls, scientists in the United States and other countries have studied the MMR shot vaccine and no link has been found between autism and the vaccine (5).
How to prevent it?
It can be prevented by vaccination. Physicians recommends that all children get the MMR shot.
A first dose if given to infants usually between 12 and 15 months. A second dose is given typically between ages 4 to 6 years.
Also, if a person had measles, the body’s immune system has developed the defense to fight the infection, therefore, people are immune and are unlikely to get measles again.
In summary, it is a severe respiratory infection but can be prevented by vaccination. The increase in the cases can be associated to the decrease in vaccination rate. Measles is a condition that continues to be present in other parts of the world. If traveling internationally, it is recommended to get the vaccine. On the other hand, people traveling to the US and its territories with the disease (even if not known that has measles) can easily spread the virus, contaminate those unvaccinated and initiate an outbreak.
This is a brief summary of what is measles and how to prevent it. Hopefully, this will be controlled soon.
*This article was written by Eileen Ruiz, PhD, Founder of Biobusiness Research, an organization that promotes learning in areas related to the biomedical, life sciences industries, business and entrepreneurship.