by Mary Nell Wegner
If you put 100 people in a room with someone who has the flu, one or two people around the infected person will become infected. With measles the math is different, explains Dr. Ron Cook, a family physician in Lubbock, Texas, who is trying to manage the outbreak in Gaines County, where measles rates are climbing. In the same room, in the same amount of time, with a person infected with measles, easily 80-90 people would become infected.
Listen to Dr. Cook interviewed on NPR.
What is it?
Measles is an airborne disease caused by a virus that is highly contagious. When an infected person coughs, sneezes, or just exhales in the presence of others, the odds are good that anyone unvaccinated (or non-immune) nearby has a significant chance of becoming infected through contact with the respiratory droplets. It can be transmitted by an infected person from four days prior to the onset of the rash to four days after the rash erupts. The virus remains active and contagious for up to two hours on surfaces or in the air. Once infected, measles can cause severe disease and even death, an ongoing issue in much of the global South but, until recently, not in the United States, which declared measles “eliminated” in 2000.
Who gets it?
Although measles can affect anyone – namely the unvaccinated and children, infectious disease specialists believe that children below age five and adults over age 30 are at increased risk, as well as those who are pregnant or with compromised immune systems.
What are the symptoms?
First infecting the respiratory tract, measles takes hold and spreads throughout the body, often causing a high fever, runny nose, cough, and a rash all over the body.
Symptoms usually emerge 10 to 14 days after exposure, with a rash on the face and upper neck and spreading over the course of the next few days, eventually to the hands and feet. The rash often lasts five to six days before beginning to fade.
What happens to the infected person?
Normally, the person infected feels miserable for seven to 10 days, and then recovers and is fine. In addition to feeling miserable, however, conditions ranging from severe ear infections to blindness can accompany a measles infection. When deaths occur, it is usually from complications related to the disease such as encephalitis (an infection causing brain swelling and potentially brain damage); severe diarrhea and related dehydration; and breathing problems including pneumonia. WHO notes that children who are malnourished, without enough vitamin A, or with a weakened immune system from HIV or other diseases, are the least able to fight the infection.
Prevention
Vaccination is the most effective way to prevent an individual’s vulnerability to measles.
In the United States, the recommended protocol has been for a first dosage at 15 to 18 months and a second dosage between four and six years for all children for a combined MMR (measles, mumps and rubella) or MMRV vaccine, which includes varicella or chickenpox. (In the global South, in countries where measles has been more common, the first recommended dose has been at 9 months, with the second given at 15 to 18 months.) The measles vaccine is often combined with vaccines for mumps, rubella and/or varicella as a way to ease the burden on children and parents, lessening the need for repeat visits with a health care provider.
Treatment/Caregiving
There is no specific treatment for measles other than a focus on symptom relief and trying to help the infected person feel as comfortable as possible. As with any other infection, good nutrition and hydration, replacing fluids lost to diarrhea or vomiting is key. Additionally, if measles has led to susceptibility to other infections (such as in the eyes or ears, pneumonia, etc.) antibiotics may be prescribed. In an individual with low levels of vitamin A (which is rare in the U.S.), a supplement is often given 24 hours apart, as vitamin A is crucial for eye health. Given that vitamin A is fat soluble, it should not be taken without the guidance of a healthcare provider as too much can cause serious health conditions.
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