What you should know about measles

By Meredith S. Jensen, Special to the Sun

Saturday, June 22, 2019 | 2 a.m.

It begins with a fever, runny nose, cough, red eyes and a sore throat—common enough symptoms. What follows is a more telltale sign—a blotchy red rash that spreads across the body. Measles, also known as rubeola, is a viral infection that was once a common childhood illness and is now preventable with a vaccine. While it can be serious and fatal for small children, death rates have fallen worldwide. Still, more than 100,000 individuals—most under the age of 5—die each year, and because of the anti-vaccine movement and international travel to and from areas experiencing outbreaks, the measles virus has been rebounding.

What is an outbreak?

Officials define a measles outbreak as three or more reported cases. Current ongoing outbreaks are linked to travelers who brought the virus back from countries where large outbreaks are occurring. The CDC recommends making sure you are vaccinated against measles before any international travel.

According to the CDC, from January 1 to June 13, 1,044 cases of measles had been confirmed in 28 states.

• Current cases: States with reported cases are Arizona, California, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kentucky, Maine, Maryland, Massachusetts, Michigan, Missouri, New Mexico, Nevada, New Hampshire, New Jersey, New York, Oklahoma, Oregon, Pennsylvania, Texas, Tennessee, Virginia and Washington.

• This is the greatest number of cases reported in the U.S. since 1994 and since measles was declared

Transmission

Measles and mucus are happy bedfellows. The virus lives in the membranes of the nose and throat, and spreads through coughing, sneezing and general respiration. Measles can sustain itself for up to two hours in the air and on surfaces, which means even if the infected person is no longer in the room, the virus may remain.

According to the Centers for Disease Control and Prevention (CDC), measles is so contagious that if one person has it, up to 90% of the people close to that person who are not immune will also become infected.

• About one in 20 children with measles develops pneumonia.

• About one in 1,000 children with measles will develop encephalitis. This can lead to convulsions and can leave the child deaf or with intellectual disabilities.

• One to two of every 1,000 children who become infected with measles will die from respiratory and neurologic complications.

By the 1960s, nearly all children got measles by the time they were 15. According to the CDC, an estimated 3-4 million people in the U.S. were infected each year, and of those cases, 400-500 people died, 48,000 were hospitalized and 1,000 suffered encephalitis.

Measles became a noteworthy disease in the U.S. in 1912. In the first decade of reporting diagnosed cases, there were an average of 6,000 measles-related deaths each year.

Symptoms

The virus works through the body during a period of two to three weeks. Measles incubates for 10-14 days before the first symptoms appear. It is communicable for about eight days after symptoms begin.

• Days 1-2: Fever, cough, runny nose, sore throat, swollen, red eyes (conjunctivitis)

• Days 2-3: Tiny white spots with blue centers (Koplik spots) may appear in the mouth

• Days 3-5: Blotchy, flat rash spreads quickly over entire body; fever spikes

• Complications: ear infection, diarrhea, pneumonia, bronchitis, brain swelling (encephalitis), pregnancy complications (low birth weight, preterm labor, maternal death), death

Vaccine

Recent outbreak concerns have prompted health officials to encourage people to know their immunization status. People who need the vaccine include the following:

• Children ages 1-6 need to get the MMR (measles, mumps, rubella) vaccine as part of their routine vaccine schedule. They should have their first dose at 12-15 months old, then at 4-6 years old. Children younger than 12 months need one dose of the measles vaccine if they’re traveling outside the United States.

• Any adult who wasn’t exposed to measles or received the vaccine as child may need to get it as an adult. Everyone age 18 and older born after 1957 who has not had measles needs at least one dose of the measles vaccine. Most people born before 1957 were exposed to the illness and do not need the vaccine. Anyone vaccinated from 1963-1967 should have their blood tested unless they can find the appropriate documentation. Two vaccines were used during this time, one of which was ineffective. A new vaccine was developed in 1968, then expanded in 1971 to include immunization against mumps and rubella. The MMR vaccine is safe, effective and still used today. Anyone who has had the recommended two doses is covered.

Measles in Nevada

After a measles case was reported in Clark County, the Southern Nevada Health District encouraged all Southern Nevadans to review their immunization status.

According to a press release from the SNHD this spring, an international visitor to Las Vegas potentially exposed vulnerable people to the measles virus at Treasure Island resort March 9, as well as Desert Springs Hospital on March 10 and 11. Those who may have had contact with the individual have been notified. No other cases have been reported at this time.

For information about area immunization clinics, call 702-759-0850. Immunizations are available at the following locations:

• Main Public Health Center, 280 S. Decatur Blvd., Las Vegas

• East Las Vegas Public Health Center, 570 N. Nellis Blvd., Suites D1 & E12, Las Vegas

• Southern Nevada Health District Henderson Clinic, 874 American Pacific Drive, Henderson

• Mesquite Public Health Center, 830 Hafen Lane, Mesquite