Stay safe: What you need to know about measles outbreaks
Los Angeles is the latest metropolitan area affected by a measles outbreak — the L.A. County Department of Public Health is investigating five cases. Below are answers to commonly asked questions to help you better understand measles, and more importantly, whether you or loved ones are at risk:
What is measles?
Measles is a very contagious respiratory disease spread by breathing, coughing and sneezing. You are contagious before symptoms appear. Without vaccination, you are highly likely to contract the disease when exposed to the virus.
Measles-associated symptoms include:
- Fever: Measles often starts with a mild-to-moderate fever, which can spike to more than 104 degrees when the rash appears.
- Rash: A raised rash that feels like sandpaper will usually start on the face and spread down the body to the feet.
- White spots inside the mouth: Several days after symptoms begin, small white spots (Koplik spots) may appear inside the mouth.
- Cold- and flu-like symptoms: Cough, runny nose, red eyes and sore throat are common.
- Ear infection: One out of every ten children with measles will get an ear infection.
More than 25 percent of kids age 5 and under who get measles need hospitalization. In some cases, the disease causes:
- Brain damage
Why do measles outbreaks occur?
Measles was declared eliminated from the United States in 2000. Yet outbreaks are now on the rise across the country, in part due to international travel. Unvaccinated travelers can contract the disease and unintentionally bring it into the United States. They may have the disease for weeks before they have any symptoms and unknowingly spread it to other unvaccinated people.
Non-vaccination, whether from refusal or forgetfulness, can be problematic. Unvaccinated people who contract measles can easily spread the disease to others who are vulnerable in the community.
What makes someone more vulnerable to measles?
Children who aren’t old enough to receive the vaccine are particularly vulnerable to measles. Public health officials are also concerned about:
- People who have a weakened immune system from disease or medications
- The elderly
- Pregnant women (contracting measles may cause a woman to miscarry or give birth prematurely)
Two doses of the vaccine are required for adults (beyond 12th grade) who are at a higher risk for transmission when they:
- Study in a post-secondary educational institution (college or trade school)
- Work in a health care environment
- Travel internationally
Am I immune to measles?
One dose of a measles-containing vaccine is 93 percent effective at protecting you from measles, whereas two doses are 97 percent effective. According to TheU.S. Centers for Disease Control and Prevention (CDC), you are protected from measles if you:
- Are a preschool-aged child who has one dose of a vaccine
- Are an adult in a low-risk environment for measles transmission who has had one dose of a vaccine
- Are a school-aged individual (K through 12th grade) who has had two doses of a vaccine
- Are a post-high school adult at a higher risk for transmission with two doses of a vaccine
- Were born before 1957 (most people born before this year are immune because they previously had the disease)
Have a laboratory confirmation that you have had measles before or are immune to measles.
Can I get the measles even if I’m vaccinated?
Only three out of 100 individuals who have two doses of the vaccine will get measles. It is unclear why they remain susceptible after vaccination. Fortunately, if you were vaccinated and contract the disease you:
- Will probably experience milder symptoms
- Are less likely to spread the disease to others
With all the outbreaks, should I be re-vaccinated?
Talk with your provider if you’re concerned about your immunity. You do not need to be re-vaccinated or have a booster dose of the vaccine if you received:
- Two doses as a child
- One dose as an adult
- Two doses separated by at least 28 days if you are an adult who has high-risk exposure to measles
If you cannot recall whether you were vaccinated, you should try to find your childhood vaccine records. If you cannot locate these records, talk with your provider. You and your provider may elect to get a blood test to see if you are immune, or receive a dose of the vaccine. There is no harm in receiving another booster dose even if you previously received one.
What can I do to protect my kids from measles?
The best approach to protect your kids from measles is to have them vaccinated. While no federal laws exist, all 50 states and the District of Columbia have laws requiring vaccinations for children entering a childcare setting or a public school.
The CDC recommends these vaccination guidelines:
- Avoid the MMR vaccine if you are pregnant.
- Wait at least one month after being vaccinated to become pregnant.
Under 12 months
- Breastfeeding mothers may safely receive the vaccine without harming their infant.
- The best protection for infants is to vaccinate family members.
- If your child is under 12 months of age and you have international travel plans, they should receive one dose of the measles, mumps and rubella (MMR) vaccine. They will then need two more doses after their first birthday. Speak with your healthcare provider about whether your child should be vaccinated early due to international travel.
12 months to 12 years
- Give your child their first dose of the MMR vaccine when they are between the ages of 12 and 15 months.
- Give the second dose between ages 4 and 6.
Age 13 and older
- If your child did not receive the vaccine before they turned 13, they will need one dose of the MMR vaccine.
- If they plan to study at a college or trade school, they will need two doses, separated by at least 28 days.
What should I do if I’ve been exposed to measles?
After exposure, you may be contacted by the Public Health Department. They would give you specific instructions on what to do and what to watch out for. If you are exposed, your first call should be to your doctor who can help you determine if you are immune or if you need an evaluation. If you are not immune, your doctor may recommend vaccination andyou may potentially have to stay home to monitor your symptoms.
Your provider will also monitor you for any symptoms. If you do have measles, you’ll need to stay home for four days after the rash clears up to avoid infecting others. Your doctor will let you know when it is safe to return to normal activities.
The providers in UCLA Health’s primary care practices can help answer all of your questions about measles. Call us at 1-800-UCLA-MD1 (800-825-2631) to schedule an appointment.