Q. I am the mother of a 9-month-old and a 3-year-old. What do I need to know about the measles? The recent outbreak has me worried about traveling.
A. Although measles is rare in the United States, it continues to be common in other parts of the world, where there are about 20 million cases and 146,000 related deaths each year.
In the United States this year, there have been 121 cases in 17 states as of Feb. 6. The majority of these cases are linked to Disneyland in California.
Measles is an extremely contagious viral illness. It is airborne and transmitted by coughing or sneezing. Infected individuals are contagious for four days before and four days after the rash appears. The incubation period – the time of exposure until symptoms develop – is typically one to two weeks.
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Symptoms during the first two to three days are nonspecific: fever, runny nose, cough, conjunctivitis (red eyes), diarrhea and sore throat. During this phase, tiny white spots (Koplik spots) may appear along the mucosal surface of the cheeks.
Next, a raised, red rash on the body will appear. The rash starts on the face and spreads down the body to the legs and feet over the next few days. As it recedes, it clears from the head and neck first and the lower extremities last. Once the rash is present, temperatures begin to spike higher, reaching 104-105 degrees.
Potential complications include ear infections, pneumonia and encephalitis. About one in 20 children with measles will develop pneumonia, and pneumonia is the most common cause of death related to measles. Encephalitis is inflammation of the brain and can have devastating consequences, including deafness and brain damage.
The best way to prevent measles is vaccination. Children are immunized at 12 months of age and then again at age 4. The measles vaccine is 97 percent effective when both doses are given.
The MMR vaccine is a live virus vaccine and cannot be given to children who are immunocompromised; therefore, these children are the most vulnerable. Adults should check their vaccine records to confirm they have received two doses of MMR. Over half the affected individuals in the current outbreak are adults.
For the most up-to-date information about the measles outbreak, visit cdc.gov.
Rhonda Patt is a pediatrician with Charlotte Pediatric Clinic. Email email@example.com; put “pediatrician” in the subject line.