Q: Why do we care about the measles outbreak?
A: Measles is more than just a rash-- it is caused by the most contagious virus known to man.Measles causes a respiratory illness with high fevers, tiredness, painful runny nose, cough, andred eyes, followed a characteristic rash. If not immune, 90% of people exposed to measles wil get sick from the virus. Measles can be especially severe in young infants and the immune compromised, as a measles infection can lead to a bacterial pneumonia, low oxygen levels of oxygen that require care in the hospital and brain inflammation. Six percent of infants with measles pneumonia can die. Years after a measles infection, a fatal neurologic disease called subacute sclerosing panencephalitis (SSPE) can develop, and there is no cure for this devastating neurologic disease. Pregnant women infected with measles can cause their baby to be stillborn, and pregnant women also can become severely ill or die from measles. Those exposed to or infected with measles need to quarantine at home given the risk of spreading this virus to others.
Q: Why do measles outbreaks occur?
A: Measles is a highly contagious respiratory virus that is spread via through the air, meaning that it can linger in air for hours after an infected person has been in a given space. Given the high infectivity and contagious nature of measles, a single person can infect up to 18 unvaccinated persons who have been in the same location as the infected person. Because this virus is so contagious, having strong population-based immunity to measles is critical to preventing outbreaks of measles. In areas where measles immunity (e.g. complete vaccination) drops below 95%, measles outbreaks can occur. The most recent large outbreak of measles is due to measles vaccination rates dropping below 95%.
Q: Is measles preventable?
A: Measles is vaccine preventable. In the US, the measles vaccine is included in the measles- mumps-rubella (MMR) vaccine or MMR plus varicella (MMR-V) vaccine. Healthy individuals (children and adults) who have received 2 doses of the measles vaccine, spaced by at least 4 weeks between doses, need not worry about contracting measles or passing this virus on to others. Children who have received at least 1 dose of the measles vaccine, who are not yet due for their 2 nd dose, are also protected from measles. People who received 1 dose of the vaccine and are over-due for the 2 nd dose may be at increased risk for contracting measles, and receiving their 2 nd dose of the vaccine is advised.
Q: What are the best ways to protect yourself from measles?
A: Vaccination is the most effective and complete way to protect yourself, your loved ones and your community from measles. Very young infants and those with immune compromise may be eligible for measles antibody (immune globulin) injection to protect them, but this antibody is not widely available.
Q: Is the MMR vaccine safe for all children and adults?
A: The MMR vaccine is safe and effective for healthy individuals older than 6 months of age. The vaccine is not safe for those with certain types of immune compromise, including advanced HIV/AIDS, certain primary immune deficiencies, cancer undergoing certain types of chemotherapy, those receiving certain immune suppressants for autoimmune diseases, and those who have undergone organ transplantation. The MMR vaccine can cause side effects just as any vaccine (fever, localized pain/redness), and also rarely can cause a measles-like rash; these side effects are not reasons to forego receiving the MMR vaccine.
Q: How early can someone receive the MMR vaccine?
A: The MMR vaccine is safe from 6 months of age onward. MMR is recommended for individuals 6 months and older when traveling internationally. Infants aged 6-12 months have high levels of maternal antibodies in their bloodstream, and MMR vaccine is a weakened live virus that can be neutralized by these maternal antibodies; therefore MMR vaccines given before 12 months of age may not have long-term efficacy. If a patient is vaccinated with MMR prior to 12 months of age, they should receive 2 doses of MMR vaccine after they are 12 months old (e.g. continue with the routine childhood MMR schedule) which is standard to receive between four and six years of age.
Q: Can you still get measles despite being fully vaccinated?
A: The MMR vaccine is extremely effective, with a vaccine efficacy of 97%. If you are fully vaccinated against measles, you can rest assured that you are very unlikely to contract measles; but if you contract the virus, you are very unlikely to get very ill from the infection.
Q: If I had 2 doses of MMR vaccine, do I need a booster?
A: Most people who received both doses will not need a booster. Some specific populations may need their antibody levels measured, for example healthcare workers, or those who are immune compromised. People who had documentation of having received MMR vaccine with an inactivated measles vaccine (or unknown vaccine type) between 1963 and 1967 should receive at least 1 dose of live attenuated MMR. Healthcare workers who received inactivated measles vaccine (or unknown vaccine type) between 1963 and 1967 should be vaccinated with 2 doses of MMR, separated by at least 4 weeks.
Q: What if someone is less than 6 months of age and may come in contact with measles?
A: Measles can be dangerous for young infants. If the community has >95% immunity to measles, it is very unlikely that the youngest infants will be exposed to the virus, because there is excellent “herd immunity” to measles. If an infant has an increased risk of exposure (e.g. will be traveling to an area with a known outbreak, or traveling via airplane), they can receive an antibody (immune globulin) injection that provides short-term passive immunity to the child. This injection provides protection for 4-6 months and is not a substitute for vaccination. The measles antibody (immune globulin) injection is available in select sites, including some Health Departments and Emergency
Q: How should a measles exposure be handled?
How you should respond to a measles exposure depends on the vaccine and health status of the exposed person. -Healthy individuals who have received 2 doses of MMR do not need to take any further measures -Healthy individuals who have received 1 dose of MMR and are due or overdue for their 2nd dose should receive their 2 nd dose of vaccine as soon as possible -Healthy individuals who have received no doses of MMR should be vaccinated as soon as possible -Healthy individuals who are too young to receive the MMR vaccine, or those who are severely immune compromised (with or without prior complete vaccination) should be considered for treatment as soon as possible with measles immune globulin
Q: What is the current status of the measles outbreak in the United States?
A: Measles had been previously eliminated in the US, however there have been outbreaks of measles in the US over the past decade. There is a growing outbreak of measles cases in Texas, which is growing quickly. Please visit this link for the current status of measles cases in the US.
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