The recent outbreak of measles across several states in the United States underscores a very sobering fact: A vaccine-preventable disease that was thought to have been eradicated in 2000 is still around.
More than 1,100 individual cases of measles have been confirmed in 30 states since the beginning of the year, including California, according to the Centers for Disease Control and Prevention (CDC). Most of the infections have occurred in children who were not vaccinated.
“Parents should be concerned about these outbreaks and make sure their children are vaccinated against highly contagious diseases like measles,” says Mark Shalauta, MD, a family medicine physician at Scripps Clinic.
Health officials attribute the resurgence of measles in the US to two things: Parents not vaccinating their children out of fear or misinformation about the safety of vaccines, and people traveling to countries where measles outbreaks are occurring and spreading the disease in US communities where there are pockets of unvaccinated people.
“Vaccines are safe and they work,” Dr. Shalauta says. “Parents need to consider the benefits of vaccines and how they outweigh perceived risks.”
Most people in the US today are protected against measles through vaccination, but there continues to be communities with pockets of unvaccinated people. This is important because high immunization rates in a community protect those who are too young to be vaccinated, including infants under 12 months of age.
“When your children receive vaccines, they are protecting themselves and those who cannot be immunized, such as infants who are too young to be vaccinated. They are at the highest risk of serious illness, hospitalization and even death due to measles,” Dr. Shalauta says.
Daniel Lichtmann, MD, a pediatrician at Scripps Clinic Carmel Valley, agrees. “The only safe and effective way to truly protect yourself from the virus is through vaccination,” he says. “For anyone who cannot receive the vaccination for medical or age reasons, the best and safest thing is to vaccinate everyone around them.”
Health officials recommend children receive the first dose of the measles, mumps and rubella (MMR) vaccine at 12 to 15 months of age, then again between 4 and 6 years old. The CDC says a single dose of the MMR vaccine is roughly 93% effective — and a second dose bumps that figure up to 97%.
Measles is highly contagious and spreads through coughing and sneezing. Symptoms usually start eight to 12 days after exposure, with a high fever and a rash that spreads over the body. Before the rash appears, children with measles develop cold-like symptoms, including:
- Runny nose
- Red, watery eyes
Common measles complications include ear infections and diarrhea. And some people may suffer severe complications, ranging from pneumonia and encephalitis (brain swelling) to death.
Health officials advise people who are diagnosed with measles to stay home for four days after they develop the rash. Also:
- Cover your mouth and nose with tissue when coughing or sneezing and put used tissue in the trash can
- Wash your hands often with soap and water
- Avoid sharing drinks or eating utensils
- Disinfect frequently touched surfaces, such as toys, doorknobs, tables and counters
Measles was once a common childhood illness in the US before a vaccination program took on the disease in the early 1960s. Before then, up to 4 million people got measles each year; 400 to 500 died, 48,000 were hospitalized and 4,000 developed encephalitis, according to the CDC.
Public health officials declared measles eliminated from the US in 2000 but the disease did not actually go away. Though still uncommon compared to last century, measles cases and outbreaks have continued. Since 2000, the annual number of measles cases has ranged from a low of 37 people in 2004 to the present high of more than 1,100 in 2019.
Some parents wrongly believe that vaccines cause autism and take advantage of personal-belief exemptions to avoid vaccinating their children. Sixteen states allow non-medical exemptions from vaccination requirements for school entry, according to the National Conference of State Legislatures.
“But research has confirmed that vaccines don't cause autism,” Dr. Shalauta says.
Vaccination rates rose in California after the state passed a law in 2015 making it harder for parents and guardians to opt their children out of immunization based on personal beliefs.
But despite the strict law, there remain schools and neighborhoods with low vaccination rates and efforts to raise awareness about the safety and importance of disease-preventing vaccinations continue.
Immediately call your doctor, Dr. Shalauta says, if you suspect that you or your child has measles or been exposed to someone who has it.
“Your doctor will determine if you are immune to measles based on your vaccination record, age and lab evidence,” he says. “Your doctor can also make special arrangements to evaluate you without putting other patients or medical office staff at risk.”
Although health care officials began recommending two doses of the measles vaccine in 1989, most people immunized before then who received only one dose are likely functionally immune. A second dose is recommended for health care workers and international travelers.
Some adults born between 1963 and 1967 may also need a booster, as they may have originally been given an ineffective form of the measles vaccine. Those vaccinated in the 1960s would need to know either which vaccine they got, or request reimmunization to err on the side of caution.
If you’re not sure if you’re immune to measles, you should first try to find your vaccination records. If you don’t have written documentation of measles immunity, you should get the MMR vaccine. And if you’re experiencing measles symptoms—especially if you’ve recently traveled overseas—you should stay home and call your physician immediately.
This content appeared in San Diego Health, a publication in partnership between Scripps and San Diego Magazine that celebrates the healthy spirit of San Diego.