February 16, 2015

Measles update

Measles update

As many of you probably know, there has been a recent outbreak of measles in the United States. For people who will be traveling in the future, it is important to know about the seriousness of measles infection and to take the proper precautions.

Measles is one of the most contagious infectious diseases that we know about with at least a 90% secondary infection rate in susceptible domestic contacts. It can affect people of all ages. Worldwide, measles is one of the leading causes of death in young children. Child mortality rates in the US are 0.1-0.2%. The most common causes of death with measles are croup, encephalitis and pneumonia but nonfatal complications such as otitis, pneumonitis, diarrhea, sinusitis, stomatitis, hepatitis, lymphadenitis and keratitis (which can lead to blindness) are not uncommon.

The first sign of measles is usually a high fever that lasts about 4-7 days. Spots in the side of mouth show up about a day before the body rash. The rash is a red rash usually starting on the face, neck and ears and then spread down the trunk. The rash lasts 5-7 days. Sleepiness, fever, poor appetite, conjunctivitis, cough and runny nose are common. Some people have light aversion, swelling around their eyes and muscles aches.

Measles usually occurs 7-14 days after being exposed.

Diagnosis can be made with a blood test.

Treatment is usually just to give lots of fluids due to diarrhea and the poor drinking. Some doctors advocate supplementation with Vitamin A.

All children over age 12 months should have their vaccinations up to date before traveling to an area with measles. Measles vaccine (MMR) is given at 12 months and at age 6 years in Israel. The Ministry of Health will sometimes give infants MMR at 10 months if they are traveling to endemic areas. One immunization is 95% protective, 2 immunizations is 99% protective. All cases in the US occurred in people who where unvaccinated.

Occasionally fever, cough and rash can occur 10 days after the immunization . There is NO medical evidence that the MMR shot is associated with autism or other serious complications. Large, international trials have looked at this question in detail.