Measles outbreaks are in the news. Here's what you need to know

Minnesota is experiencing an outbreak of measles. The disease is so contagious that about one person in five who is infected will be hospitalized. Because measles spreads easily, experts are urging people to get vaccinated. Minnesota has seen 18 cases of measles this year. 

A child who gets measles can have a high fever over 103 degrees Fahrenheit and a rash that begins at the hairline and spreads down to the feet. At the same time, they’re likely to experience symptoms like a runny nose, cough, and red, crusty eyes. Meanwhile, their parents might have to take time off work to care for the sick child while trying to keep other family members from getting sick.

And those are the lucky ones who don’t have a severe case of the disease.

In the U.S.:

• 1 in 5 people who catch measles will be hospitalized. They might need treatment for severe dehydration or lung infection. Children with pneumonia might need to be placed on ventilators to help them breathe.
• 1 out of every 1,000 people with measles will develop brain swelling, which could lead to permanent brain damage.
• 1 to 3 out of 1,000 people with measles will die.

The long-term effects of a measles infection can be devastating. In the early 2000s, Jordan Marmet, MD, a hospitalist at M Health Fairview Masonic Children’s Hospital and an associate professor of pediatrics at the University of Minnesota Medical School, cared for a teenage patient who experienced seizures, abnormal muscle movement, intellectual disability, and vision impairment. The teenager’s condition, called subacute sclerosing panencephalitis (SSPE), was a delayed complication stemming from a measles infection he’d acquired abroad early in life.

“It’s a terrible complication,” Marmet said. “When children under 2 get measles, they’re more susceptible to SSPE even up to seven to ten years after their infection.”

SSPE begins with cognitive decline, such as difficulty focusing and memory loss. Then uncontrollable jerking movements which can affect the head, arms, legs, and trunk. In later stages, people with SSPE lose the ability to walk and enter a comatose state. SSPE is usually fatal within three years. There is no treatment for measles or SSPE, which is why prevention is so important.

Thankfully, there’s a way to cut the risk of getting measles by 97%: Vaccination. Because of safe and highly effective vaccinations, measles was considered to be eliminated from the United States in 2000. It’s been so successful that very few M Health Fairview healthcare providers have seen a case of measles or SSPE through their whole medical careers.

But measles is still active in many parts of the world, and it’s becoming increasingly common in the United States once again – caused in part by a decline in measles vaccination rates among children. About 90% of people who are unvaccinated will get the measles virus if they are around someone who has it. It’s so contagious that an unvaccinated person can get the disease even if they enter a room after an infected person leaves it.

“Measles is one of the most contagious viruses out there,” Marmet said. “It transmits from respiratory droplets. It’s far more contagious than COVID-19, flu, or any other virus. It just takes a couple of particles floating around.”

The COVID-19 pandemic delayed some people from getting recommended vaccines. There has also been an increase in vaccine hesitancy as some parents question the safety of vaccines.

But the measles, mumps, and rubella (MMR) vaccine has been given since the 1960s. So more than five decades of experience tells us that it is safe and effective, according to the CDC.

A 95% vaccination rate is necessary for herd immunity. That would mean that enough people in an area are protected against the disease that it’s unlikely to spread. This helps protect people who can’t be vaccinated due to age or may be susceptible because of a weakened immune system. Minnesota is falling short. Of children born in 2020, just under 93% have gotten at least one dose of the vaccine.

What to do if you were exposed to measles

For people who are vaccinated, the risk of measles infection is very low. People with measles are encouraged to stay home, rest, and take over-the-counter medicine to ease symptoms.

If you or your child have been exposed, watch for the following symptoms:

• Cough 
• Runny nose
• Pink eye
• High fever 
• Rash that usually begins at the hairline and spreads down the body

If you need to seek medical care, call your healthcare provider’s office before going in. That way they can prepare and give you special instructions. If you have measles, they might want you to avoid the regular entrance and waiting area where other patients could be exposed.

There is no cure for measles. You can help prevent the spread of measles by getting vaccinated, if you are able. Children should get their first dose of the MMR vaccine between 12 and 15 months of age and the second between ages 4 and 6. Adults who have not been vaccinated and were born after 1957 should get one dose of the vaccine to be considered immune. People born before 1957 are presumed to be immune based on the high likelihood that they were exposed before vaccines were widely used.

If you’re unvaccinated and were exposed, you can receive the MMR vaccine within 72 hours to reduce your risk of complications. If you’re not sure if you were vaccinated, there’s no risk to getting extra doses of the vaccine. Learn how to find your vaccine records.