You might think of measles as an old-time disease — and you’d be right. Measles used to be a common childhood disease decades ago, but is rare today in this country thanks to widespread vaccination.
However, millions of cases occur worldwide every year, and measles outbreaks in parts of the United States still happen because of international travel and recent declines in immunization rates in children.
This highly contagious viral infection causes a total-body skin rash and flu-like symptoms. And because measles is caused by a virus, there is no specific medical treatment. While anyone who hasn’t been vaccinatedcan get measles, it’s most common in children.
“Measles is the most contagious virus known today,” says Swathi Gowtham, MD, a pediatric infectious diseases specialist at Geisinger. “It’s estimated up to 90% of unimmunized kids who are exposed to measles will get the infection. It’s not something to take lightly, either. Measles can cause dangerous health complications, including brain and lung infections, especially in children younger than 5 years.”
You can catch measles by breathing in tiny droplets released into the air when an infected child coughs, sneezes or even talks. These small droplets can remain in the air for more than two hours — even if the infected child is no longer in the room. If the droplets land on surfaces such as doorknobs or countertops, others can be infected after touching those surfaces, then touching their eyes, nose or mouth.
Measles symptoms
Symptoms usually appear about seven to 14 days after exposure to the virus. Prior to the rash, the initial measles symptoms can be confused with those of the common cold or flu.
The first signs of measles include:
- Dry cough
- Stuffy, runny nose
- High fever (can spike up to 104° F)
- Sore throat
- Red, watery eyes (pink eye)
- Small, red spots with bluish-white centers inside the mouth
The measles rash breaks out about three to five days after other symptoms start. Typically, the rash begins as flat red spots on the forehead and then spreads to the rest of the face, down the torso and to the arms, legs and feet.
“The rash can sometimes be itchy and uncomfortable, and last up to seven days,” says Dr. Gowtham. “The bumps often run together and can look like patches of red, blotchy skin. Kids with the measles are most contagious from about four days before developing the rash until about four days afterward. Children with weaker immune systems can be contagious for a longer duration.”
Measles treatment
Because measles is caused by a virus, there is no specific medical treatment. The virus must run its course, which usually takes about 10 to 14 days.
In the meantime, Dr. Gowtham recommends ways you can manage your child’s mild symptoms:
- Give your child plenty of fluids to avoid dehydration, especially if there’s a high fever.
- Make sure your child gets lots of rest to give the body time to fight the infection.
- Over-the-counter pain relievers, such as acetaminophen or ibuprofen (for kids older than 6 months), reduce fever and discomfort. Never give aspirin, however, as it can lead to dangerous complications in kids.
- Saline nose spray or drops and a cool mist humidifier at night help clear up congestion.
Be on the lookout for complications from measles, including ear infections, croup, pneumonia or encephalitis (swelling of the brain). Children younger than 5 years, pregnant women and people with weakened immune systems are at a higher risk.
When to call the pediatrician
Report measles cases to the health department because it has public health implications. If you think your child has been exposed to measles, call the pediatrician, especially if your child is an infant, is not fully vaccinated or has a weakened immune system. Your doctor may recommend a medication called immunoglobulin, which can be given to high-risk patients within six days of exposure to help prevent severe infection.
“If your child shows signs of dehydration, such as fewer wet diapers or fewer trips to the bathroom, has a very high fever or develops eye pain, contact the pediatrician right away,” advises Dr. Gowtham. “If your child has trouble breathing or is breathing rapidly, is very drowsy or has seizure-like movements, call 911 immediately.”
What to do if there’s a measles outbreak
While measles was declared eliminated from the United States in 2000, it’s still very common in other parts of the world. Even if your family doesn’t travel internationally, you could still come into contact with the virus in the event of a measles outbreak in your community. Measles can spread among pockets of unvaccinated people or international travelers can get infected and bring it back to the United States.
In the unfortunate event of a measles outbreak in your community, Dr. Gowtham offers these tips:
- Get vaccinated. Make sure you and your children have received age-appropriate doses of the measles vaccine. It’s the most effective way to prevent measles. If you’re unsure whether you or your child have gotten the right doses, talk to your doctor.
- Limit exposure. To protect your family and prevent spread, avoid large crowds and close contact with others, especially anyone who’s sick. Especially in the area of an ongoing outbreak, stay away from public areas where infected people might have been.
- Practice good hygiene. Have your family wash their hands frequently with soap and warm water for at least 20 seconds, avoid touching their face, cover coughs and sneezes, and throw away used tissues right away.
- Stay informed. Knowing the latest information from public health authorities and following their recommendations will protect you and your family during a measles outbreak.
Preventing measles
The best way to protect yourself and your children from measles is vaccination. The MMR (measles, mumps and rubella) vaccine is typically given to children when they’re 12 to 15 months and again when they’re 4 to 6 years old.
According to the U.S. Centers for Disease Control and Prevention, one dose of the MMR vaccine is approximately 93% effective at preventing the onset of measles, and two doses are about 97% effective.
“Immunity lasts a lifetime and provides protection against all strains of measles,” says Dr. Gowtham. “Having the vaccine is much safer than your child getting infected with measles. The vaccine does not cause autism. Even if your immunized child contracts measles, though the odds are against it, the risk of serious complications and hospitalization is significantly reduced.”
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