Also called rubeola, measles can be serious and even fatal for small children. While death rates have been falling worldwide as more children receive the measles vaccine, the disease still kills several hundred thousand people a year, most under the age of 5.
Measles has an incubation period of 10 to 12 days after an unvaccinated person is exposed. It starts with a fever, dry cough, inflamed eyes, sore throat and runny nose. Within 48 to 72 hours, red spots with bluish white centers appear in the mouth. The skin rash usually begins at the same time, starting on the face and spreading down the body to the feet.
The rash is usually somewhat itchy, and will go away in the same order that it appeared as the disease runs its course over a two-week period. Fever goes from mild to more severe, usually spiking at 104 to 105 degrees F.
Measles can be prevented by the combination MMR (measles, mumps, and rubella) vaccine. In the decade before the measles vaccination program began, an estimated 3–4 million people in the United States were infected each year, of whom 400–500 died, 48,000 were hospitalized, and another 1,000 developed chronic disability from measles encephalitis.
Widespread use of measles vaccine has led to a greater than 99% reduction in measles cases in the United States compared with the pre-vaccine era, and in 2009, only 71 cases of measles were reported in the United States. However, measles is still common in other countries. The virus is highly contagious and can spread rapidly in areas where vaccination is not widespread. It is estimated that in 2008 there were 164,000 measles deaths worldwide—that equals about 450 deaths every day or about 18 deaths every hour.
The cause of measles is a very contagious virus, which lives in the mucus in the nose and throat of an infected child or adult. That child or adult is contagious from four days before the rash appears to four days after. When someone with measles coughs, sneezes or talks, infected droplets spray into the air, where other people can inhale them. The infected droplets may also land on a surface, where they remain active and contagious for several hours.
Most measles-related deaths are caused by complications associated with the disease. Complications are more common in children under the age of five, or adults over the age of 20. The most serious complications include blindness, encephalitis (an infection that causes brain swelling), severe diarrhea and related dehydration, ear infections, or severe respiratory infections such as pneumonia.
As high as 10% of measles cases result in death among populations with high levels of malnutrition and a lack of adequate health care. People who recover from measles are immune for the rest of their lives.
Some parents do not let their children get vaccinated because of unfounded fears that the MMR vaccine, which protects against measles, mumps, and rubella, can cause autism. Large studies of thousands of children have found no connection between this vaccine and autism. Not vaccinating children can lead to outbreaks of a measles, mumps, and rubella -- all of which are potentially serious diseases of childhood.
Measles-containing vaccine is recommended for anyone born on or after January 1, 1957, who does not have a history of physician-diagnosed measles or a blood test confirming measles immunity. Individuals should receive 2 doses of MMR (measles, mumps, rubella) vaccine for maximum protection. The first dose should be given at 12 to 15 months of age. The second dose should be given at four to six years of age (age of school entry) at the same time as the DTaP and polio booster doses.