During the height of the COVID-19 pandemic, the Centers for Disease Control and Prevention warned that 22.3 million babies worldwide missed their first dose of the measles vaccine in 2020, contributing to to the largest annual increase in more than 20 years of unvaccinated children in the US. The concern, the researchers said at the time, was that it would lead to outbreaks of measles and other preventable diseases in the future.
Now, there is a measles outbreak in central Ohio, and most of the affected children are not vaccinated. According to the official website for the city of Columbus, there have been 85 cases of measles since the outbreak began in November 2022, and 34 people have been hospitalized with the virus. Of those affected, 78 were unvaccinated, six had only one dose of the measles-mumps-rubella (MMR) vaccine that works to prevent the disease, and one had unknown vaccination status.
All cases were in children 17 years of age or younger, and the vast majority of patients were 2 years of age or younger.
Columbus Health Commissioner Mysheika Roberts said in an interview last month that the outbreak began with a small group of people who returned from an area where measles regularly occurs. The virus spread rapidly in unvaccinated young children. “The reason so many of our young children have been affected by this measles outbreak is because that is the vast majority of our population that is not vaccinated,” she said.
These aren’t the only measles cases in the US over the past year: CDC data shows there were 118 measles cases in 2022, up from 49 cases in 2021. (2023 data not yet available online).
It’s understandable to have questions about measles after this. Here’s what you need to know.
What is measles?
Measles, which is caused by a virus, is an acute viral respiratory illness that causes a variety of uncomfortable symptoms, including a distinct rash, high fever, and cough, according to the CDC. But it’s not your average disease. “Measles is a dangerous disease that has the ability to cause pneumonia, brain infection, and can wipe out aspects of the immune system,” Dr. Amesh Adalja, a senior fellow at the Johns Hopkins Center for Health Security, tells Yahoo Life. More specifically, a measles infection can damage a person’s immune system by wiping out up to 73% of pre-existing antibodies to other diseases, including influenza.
The virus is also “extraordinarily infectious, even more infectious than COVID,” Dr. Thomas Russo, chief of infectious diseases at the University at Buffalo in New York, tells Yahoo Life.
Dr. Danelle Fisher, chair of pediatrics at Providence Saint John’s Health Center in California, tells Yahoo Life that measles is so contagious that the virus can still make someone sick up to two hours after a person with measles has left the room. “This is very, very contagious,” she says.
How is measles transmitted?
Measles spreads in a “COVID-like” way, Russo says. It is transmitted through direct contact with infectious droplets or respiratory particles that enter the air when an infected person breathes, coughs or sneezes, according to the CDC. And again, the virus can remain airborne for two hours after someone with measles has left the area.
People can also get measles by touching an infected surface and then touching their eyes, nose or mouth, the CDC says.
The CDC notes that measles is so contagious that if one person has it, up to 90% of those around them who are not immune to the virus will also become infected.
Signs of measles to keep on your radar
Measles symptoms usually appear seven to 14 days after someone has been infected, according to the CDC, and symptoms tend to appear in stages.
In the first stage, a child will typically experience these symptoms:
Red and watery eyes.
“Usually you get these cold-like symptoms first,” Fisher says. From there, a patient may experience small white spots (called Koplik’s spots) inside the mouth, according to the CDC. Three to five days after symptoms begin, a rash usually appears, beginning as flat red spots that appear on the face and spread to the rest of the body. Measles can also cause serious complications, including pneumonia and brain swelling, according to the CDC. “It’s not a very fun disease to have,” says Russo.
How to prevent measles
Measles is prevented with the two-dose MMR vaccine. The CDC recommends that children receive the first dose of the vaccine between 12 and 15 months of age and the second between 4 and 6 years of age. One dose of the vaccine is about 93% effective in preventing measles, while both doses are about 97% effective, the CDC says.
It is important to note that most of the children affected by the Ohio outbreak were less than 2 years old and therefore ineligible to receive the full measles vaccine. However, those older than 12 months, the largest group affected, were eligible to receive the first vaccine in the series. Still, only six of the 85 people affected by the outbreak had received an injection.
Herd immunity, which is when a sufficient portion of a population is immune to a disease that even people who are not vaccinated are afforded some protection because the disease has little opportunity to spread in the community, is important in protecting those who are not vaccinated. Not yet vaccinated, those who are not fully vaccinated, and those who are immunocompromised and will not have an optimal response to the vaccine, Russo says.
“The only means of protection is a vaccine,” says Fisher. “I can’t believe we’re here again. This is directly related to the decline in vaccinations.”
How is measles treated?
There is no specific treatment for measles. Instead, children can be given acetaminophen or ibuprofen for aches or fever, and encouraged to drink plenty of fluids, Russo says.
“We really don’t have much in the way of treatment,” he says. “The key with measles is prevention.”
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