February 17, 2015 | by Trong Tony Trinh MD, MPH

Stories about measles have been in the news nearly every day since the multi-state outbreak began last month. With all of this increased focus and attention, I wanted to share some detailed information on measles, measles vaccine, who is at risk, and how to prevent the spread of this highly infectious disease.

Measles outbreaks are becoming more common in the U.S. with increasing numbers over the last few years, mostly among individuals who were unvaccinated. In 2014, 644 cases were reported from 27 states. During January 2015 alone, 102 cases from 14 states reported measles, most of which were a part of the outbreak linked to Disneyland.

As you may know by now, measles is a highly contagious disease caused by a virus. Classic symptoms are characterized by fever, cough, conjunctivitis (itchy eyes, pink eyes), and runny nose, typically followed by a rash of red, tiny circular, lumped together that starts on the face and then spreads down to the body and arms. The rash will fade and peel and last for about six to seven days.

Measles has the ability to affect all organ systems. It can cause gastroenteritis, diarrhea, pericarditis and myocarditis or inflammation of the heart muscles. The most life-threatening complications of measles are pneumonia and brain damage.  

There is no specific treatment for measles; care is mostly supportive and directed at managing complications. People at highest risk for contracting measles are those without immunity (antibodies) against measles. Groups at risk include:

  • Children too young to be vaccinated (less than 12 months old).
  • Individuals who have not received a second dose of the measles vaccine.
  • Individuals for whom the vaccine failed to elicit a protective immune response.
  • Individuals who were never vaccinated, which includes those who didn’t get vaccinated due to weakened immune systems, allergies to the vaccine, and those who declined for personal, religious, or philosophical reasons.

Measles is only spread from human to human. Measles can be prevented with the measles vaccine and it is highly effective at promoting life-long immunity for those who receive it. The vaccine is very safe, well tolerated, and does not cause autism. The measles vaccine is combined with vaccines against mumps and rubella, and is commonly referred to by the abbreviation ‘MMR’. The vaccination schedule for children is:

  • 1st dose : between 12-15 months old
  • 2nd dose: anywhere from 4 weeks after first dose, but typically given before the start of kindergarten, around ages 4 to 6.

Unvaccinated healthy adults born after 1957 are recommended to receive 1 or 2 doses of the vaccine. If you don’t know your immunization history, you should contact your doctor who can provide a dose or test your blood for your immunity level.

Prior to the measles vaccine in the U.S. (1967), there were about 500,000 cases of measles reported each year, and possibly millions more that went unreported. After the measles vaccine was introduced, the number of cases has fallen by 99%. Measles is still very common in the developing world, however, where access to vaccines is limited.

These recent outbreaks highlight the importance of vaccinations in preventing future cases, and controlling the spread of measles outbreaks. We strongly recommend strict adherence to MMR vaccine schedules outlined by the Advisory Committee for Immunization Practices (ACIP) which is sponsored by the Centers for Disease Control and Prevention (CDC).