Measles — more than a little rash

Published: Wednesday, June 5, 2019

By KIM HORTON
Times-News Columnist

What’s the big deal about measles? With the almost daily news coverage of measles outbreaks, you might be asking yourself this question. Didn’t we get rid of it years ago? 

Even though measles was declared eliminated from the United States in 2000, due to a highly effective vaccination program, it’s still showing up each year. The disease is brought into the United States by unvaccinated travelers (Americans or foreign visitors) who get measles while they are in other countries.

In addition, even in states with high vaccination coverage, measles susceptibility exists at some local levels because of variable vaccination coverage rates and pockets of unvaccinated people. Basically, anyone who is not protected against measles is at risk.

The current measles outbreak of 940 individual cases in 26 states as of May 24 is the highest number since 1994. As I’m writing this column, there are no known cases of measles in Henderson County or North Carolina.

However, what is of concern to public health is that measles has spread to several states close to our community, especially East Tennessee. In addition, Henderson County is surrounded by counties with lower vaccination rates.

Measles is more than a little rash. It’s one of the most contagious diseases known, and it can come with serious complications:

• 1 of 4 people with measles will be hospitalized.
• 1 of every 1,000 people with measles will develop brain swelling (encephalitis).
• 1 or 2 of every 1,000 people with measles will die, even with the best of care.

Measles is most dangerous for those who have a compromised immune system and young children and infants. The disease also poses risks for pregnant women, including miscarriage and premature birth. Some people, particularly children less than five years of age, may suffer from severe complications, such as pneumonia (infection of the lungs) and encephalitis (swelling of the brain).

This respiratory disease is easily spread through the air by coughing and sneezing. According to the Centers for Disease Control and Prevention (CDC), the measles virus can live for up to two hours in an airspace where an infected person coughed or sneezed. If other people breathe the contaminated air or touch the infected surface, then touch their eyes, noses, or mouths, they can become infected.

In fact, measles is so contagious that if one person has it, up to 90 percent of the people close to that person who are not immune will also become infected.

It’s not always easy to tell who has the measles, especially early in the illness when symptoms mimic other respiratory illnesses. But infected people can spread measles to others from four days before the telltale red rash appears up to four days after.

Symptoms generally appear about seven to 14 days after a person is infected and begin with high fever, cough, runny nose and red, watery eyes. Two or three days after symptoms begin, tiny white spots may appear inside the mouth. Three to five days after symptoms begin, a rash breaks out that usually begins as flat red spots that appear on the face at the hairline and spread downward to the neck, trunk, arms, legs and feet.

Fortunately, the disease can be prevented by the highly effective and safe MMR vaccine, which protects against measles, mumps and rubella. Two doses of measles vaccine are about 97 percent effective at preventing measles if exposed to the virus. One dose is about 93 percent effective. People are usually fully protected after about two or three weeks.

All children should receive two doses of MMR vaccine, with the first dose beginning at 12 months of age and a booster at four to six years of age. Adults born in 1957 or later who have not already been vaccinated should get at least one dose of MMR vaccine. Adults born before 1957 are considered immune. Certain adults should get two doses, including college students, healthcare workers and people who travel internationally.

When you get vaccinated, you’re protecting yourself and your community. When enough people are vaccinated against measles, then the entire community is less likely to get the disease. But some people can’t get vaccinated because of age or they have serious allergies or weakened or failing immune systems (for example, infants, people with cancer, HIV/AIDS, type 1 diabetes or other health conditions). They depend on others to be vaccinated to help protect them from disease.

If you have questions about the vaccine or your immunization records, check with your healthcare provider. The Health Department offers MMR vaccine in the Immunization Clinic on Mondays, Tuesdays, Thursdays and Fridays from 8:00 - 11:30 a.m. and 1:00 - 4:00 p.m. On Wednesdays, it’s open 1:00 - 4:00 p.m. No appointment is necessary. Call 828-694-6015 for more information or visit hendersoncountync.gov/health.

For more information about measles, click here.

Kim Horton is the communications manager for the Henderson County Department of Public Health. She can be reached at khorton@hendersoncountync.gov.

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