Across America, a dangerous and highly contagious airborne disease thought to be eradicated is sweeping the nation and hitting one of our most vulnerable populations: children. Measles was officially eliminated in the United States in 2000, a historic health achievement accomplished due to the advent of the MMR (measles-mumps-rubella) vaccine in 1963 and later the recommended second dose of the vaccine in 1989. Unfortunately, as vaccination among children has declined, this once eradicated virus is now resurfacing across the United States. In 2023, the CDC recorded 58 total cases of measles in the US, but in April 2024 (just four months into the new year), they’ve already seen 125 cases, 54 percent of which resulted in hospitalizations. While alarming, we’ve seen proof from 2000 that, with the right interventions, measles can be eradicated.
What is measles?
Measles is an infection caused by a virus that results in serious complications, disease, and even death. While measles can affect anyone, it is most commonly seen in children. Measles is a devastating illness that infects the entire respiratory tract and spreads through the body leading to complications including respiratory issues (such as, pneumonia, etc.), severe diarrhea and dehydration, ear infections, seizures, blindness, and encephalitis (an infection that triggers swelling of the brain and eventually brain damage). Most deaths relating to measles are due to its severe complications. Pneumonia is the leading cause of hospitalization among children with measles.
Another complication associated with measles is immunity amnesia. Since the measles infection is so overwhelming to the system, it can make the body forget how to fight off infections your body has already had. Even after an outbreak, an individual undergoing immunity amnesia will have to re-learn how to fight off basic forms of infection. In fact, it can take a child’s immune system two to five years to return to normal.
What are the symptoms?
Symptoms for measles typically appear 10-14 days after exposure to the virus. It should be noted that you can contract and spread measles for days before becoming symptomatic, making it even more difficult to stop the spread of infection to others. Symptoms include:
- Fever greater than 100 degrees
- Dry cough
- Runny nose
- Sore throat
- Inflamed eyes (conjunctivitis)
- Koplik’s spots (tiny white spots with bluish-white centers on a red background in the mouth)
- Red, blotchy rash (typically appearing on the head and spreading down)
How does it spread?
Unfortunately, the prevailing lack of understanding regarding the highly contagious nature of measles is likely contributing to the increased spread of the disease. Measles is transmitted through the air, spreading whenever an infected individual breathes, coughs, talks, or sneezes, thereby making it extremely transmissible among those who are unvaccinated. Simply put, an unvaccinated child who has spent time around someone infected has a 90 percent chance of contracting measles as well. Furthermore, the virus can remain active in the air and on surfaces for up to two hours, implying that one does not even have to be in the same room as an infected person simultaneously to be exposed.
How do I protect myself and my children?
The first step anyone should take to protect themselves and their children from measles is to talk to a trusted, certified healthcare provider. The MMR vaccine contains vaccines that protect you against three dangerous viral infections: measles, mumps, and rubella. The vaccine is typically given in a series of two doses, with the first dose at 12-15 months old and the second at 4-6 years old. Once vaccinated, children have 92 percent protection against the measles and then 95 percent protection after the second vaccine. Immunity from the MMR vaccine is also lifelong and won’t require any more than the two doses. The CDC recommends all children receive two doses of the MMR vaccine, especially those who travel internationally. Other areas of the world have a smaller percentage of the population vaccinated, and thus, have a greater incidence of measles.
Why are we seeing a problem now?
Regrettably, misinformation during the COVID-era led to widespread mistrust in the safety and efficacy of vaccines, including the MMR vaccine. Consequently, this mistrust has resulted in a steady decline in childhood vaccination rates, which, in turn, caused an uptick in measles cases as more children are left without immunity to this dangerous condition.
The good news is that the misinformation purporting the danger of vaccines is not supported by any factual evidence. In fact, common theories such as vaccines contributing to autism and other dangerous conditions have been thoroughly debunked by the scientific community.
At the end of the day, if you have concerns regarding the safety or efficacy of the MMR vaccine, bring them to the attention of a trusted and certified healthcare provider. While measles is an incredibly transmissible and dangerous disease, with the right interventions, we need not fear its effects.
About Dr. Carol M. Steiner, MD, FAAP
TPMG board certified pediatrician, Carol M. Steiner, MD, FAAP has over 22 years of experience caring for patients from the first days of life to young adulthood. A premature infant herself, Dr. Steiner’s experience with a devoted pediatrician inspired her to enter the medical field. She graduated from the University of North Carolina at Chapel Hill with a Bachelor of Science in Medical Technology and earned her medical degree from Georgetown University in Washington D.C.
TPMG welcomed Dr. Carol Steiner to TPMG James River Pediatrics in 2019.