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Dr. Ehmann: Measles: Resurgence of a Preventable Disease

Measles: Resurgence of a Preventable Disease

by, Jennifer Ehmann, MD
Barton Community Health Center

Recently, measles made headlines after an outbreak linked to exposure at Disneyland in mid-December.  More than 140 cases, mostly in California, have been confirmed. 

Measles is caused by a highly contagious virus and more cases are likely to emerge.  Fourteen states have been affected and previous statistics from the California Alert Health Network showed 86% of past measles cases are patients who have not been vaccinated or the vaccination status is unknown. 

In two years, cases of the measles in the United States have increased. Vaccination can help prevent the spread of the illness and the CDC reports a two-dose series has been found to be 97% effective. 

Measles is not a new disease.  A Persian doctor wrote the first description in the 9th century, but the disease may date back to Roman times. Before 1963, when a vaccine became available, most children had the disease by age 15. Prior to the use of the measles vaccine, the CDC estimates that 500 deaths, 48,000 hospitalizations, and 4,000 cases of encephalitis (infection of the brain) occurred in the US annually. 

Without the vaccine, nearly 90% of people who come into contact with an infected person get the measles.  Measles spreads through respiratory droplets in the air, such as coughing and sneezing, and touching contaminated surfaces.  Some reports note the virus can survive for up to two hours on surfaces.  

Symptoms include a fever (often quite high), runny nose, cough, red eyes, and a sore throat followed by a distinctive rash on the whole body. The flat and sometimes bumpy rash may appear three to five days after the other symptoms, starting on the head and spreading down the rest of the body.  People are contagious up to four days before they show signs or symptoms until four days after the rash appears. 

The measles has no specific treatment. Complications include diarrhea, ear infections, and pneumonia. Encephalitis, an infection that causes a swelling of the brain, is a more serious problem that can leave the person with deafness, seizures, mental retardation, or death. Another complication is Subacute Sclerosing PanEncephalitis (SSPE), which is a progressive, fatal infection of the nervous system that occurs seven to ten years after having the illness. Pregnant women can have severe complications that can affect them and their unborn child.

In 2000, measles was considered eradicated from the United States largely through immunization efforts. Immunization is achieved with the MMR (Measles, Mumps, and Rubella) vaccine or MMRV (Measles, Mumps, Rubella, and Varicella) vaccine. A young child usually gets the vaccine between the first twelve and fifteen months and a second dose between four and six years old. Travel outside the country may prompt earlier vaccination between six to eleven months old for younger children at risk. The American Academy of Pediatrics reports that mild side effects may occur from the vaccine, but a severe reaction is very rare.

If you are unsure of your or your child’s vaccination status or have concerns regarding your child having the illness, please contact your pediatrician. The Centers for Disease Control and the American Academy of Pediatrics also have valuable, updated information. 

Dr. Jennifer Ehmann is a pediatrician at the Barton Community Health Center.  She can be reached at (530) 543-5623.