02/16/2025
The United States is currently experiencing a measles outbreak. As of today, there are 61 cases across 5 states. 13 of those are severe enough to require hospitalization. Most of us practicing physicians have never seen measles. Many of us are re-educating ourselves so that we are prepared to diagnose it. It is HIGHLY contagious. It is much more contagious than most viruses we are used to seeing currently. There is no known treatment other than supportive care. Here is some basic information:
Measles is a highly contagious viral infection caused by the measles virus. It primarily affects the respiratory system and spreads through respiratory droplets when an infected person coughs or sneezes. The disease was controlled in many countries throughout the world through vaccination but has seen resurgences in areas with low vaccination rates.
Signs Your Child Might Have Measles:
Symptoms usually appear 7–14 days after exposure and progress in stages:
1. Early Symptoms (Prodromal Stage, ~2-4 days)
• High fever (often > 104°F or 40°C)
• Runny nose
• Cough
• Red, watery eyes (conjunctivitis)
• Fatigue
2. Koplik’s Spots (~2 days before the rash appears)
• Tiny white spots with a bluish center inside the mouth (on the inner cheeks).
3. Rash Stage (~3-5 days after symptoms start)
• Red, blotchy rash that starts at the hairline, spreads to the face, and then down the body.
• Rash lasts about 5-6 days before fading in the same order it appeared.
How Contagious Is Measles?
• Extremely contagious – one of the most infectious diseases.
• R₀ (Basic Reproduction Number): 12-18, meaning one infected person can spread it to 12–18 others in an unvaccinated population.
• Virus can live in the air and on surfaces for up to 2 hours after an infected person has left an area.
• People are contagious 4 days before and 4 days after the rash appears.
Complication Rates & Risks
• Mild complications (common): Ear infections (~10%) and diarrhea (~8%).
• Severe complications (more likely in young children, pregnant women, and immunocompromised individuals):
• Pneumonia (~1 in 20 cases, leading cause of measles-related death).
• Encephalitis (brain swelling, ~1 in 1,000 cases, can cause seizures and brain damage).
• Death (~1-3 in 1,000 cases).
• Long-term risk: Subacute sclerosing panencephalitis (SSPE) – a fatal, delayed brain disease that can develop years after measles infection (~1 in 10,000 cases).
Prevention
• MMR vaccine (Measles, Mumps, Rubella)
• 1st dose: 12-15 months
• 2nd dose: 4-6 years
• ~97% effective after both doses.
**if needed an early dose of MMR can be given at 6-11 months of age