Summit Pediatrics

750 Round Valley Drive, #102

435-655-0926
435-649-3748 fax

Measles



There have been 9 confirmed cases of measles to date in Salt Lake County, none in Summit or Wasatch county.  Never having seen a case of measles, I had to brush up.  Here's what I learned.

Symptoms
Measles is a very contagious respiratory viral infection.  It starts out with cold-like symptoms for 2-4 days:  cough, runny nose, fevers, body aches, and sometimes red, watery eyes or diarrhea.  Then a red, bumpy rash develops and lasts for about 5-6 days.  It begins on the face and spreads to the trunk, arms and legs.  The bumps grow and can merge to form larger spots.  These larger spots typically do not blanch (lose color) with fingertip pressure.  The skin on more severely affected areas may peel.  The rash fades first on the face and head, then disappears from the rest of the body.  Blue-white spots may develop on the inside of the mouth.  These oral lesions are very characteristic of measles, and can appear before or after the rash.

Here's the problem:  the symptoms don't develop until 10-14 days after initial exposure.  By the time a person realizes that they have measles, they could have exposed scores of others.  Furthermore, a person with measles is contagious for four days prior to developing the rash and until four days after the rash appears.  Again, lots of opportunity to infect others before realizing it.

How is measles spread?
Measles is highly contagious.  When an infected person breathes, coughs or sneezes, droplets containing the virus spray into the air and can be inhaled by another person.  Droplets can also land on surfaces, where the virus can live up to 2 hours and infect anyone who touches the contaminated object.  It's so contagious that if one person has measles, 90% of all non-vaccinated contacts will also be infected with the measles virus.

Complications
Measles tends to hit children under 5 hardest.  Potential complications include encephalitis (brain infection), seizures, pneumonia, and death.

Prevention
The best way to protect yourself and your family is through the MMR vaccine.  It is routinely given twice: first at 12-15 months of age, and again before entering kindergarten at age 4-5.  If a person starts the series later, the second dose can be given as soon as 4 weeks after the first dose.  In an outbreak, the vaccine can be given in infants as young as 6 months for protection against disease.

Vaccination within 72 hours of exposure in a non-vaccinated person can protect that person from getting measles.  There is also a treatment called IgG, which is an IV infusion that can help prevent measles if given within 6 days after exposure.

Pregnant women cannot receive the MMR vaccine, but nursing women can.  Immunosuppressed patients (those receiving chemotherapy or those with HIV, for example) should not receive it either.

Risks in Pregnancy
Measles infection during pregnancy can cause miscarriage, preterm labor, and stunted growth.

Diagnosis
Measles is diagnosed through blood testing.

Quarantine
Patients diagnosed with measles should isolate themselves at home until 7 days after the rash begins.  Contacts should have their vaccine records reviewed to be sure that they have had 2 doses of MMR administered at least one month apart.

Does the MMR vaccine cause autism?
NO, NO, NO, NO, NO.  The only study linking MMR with autism was retracted due to lack of good scientific method, and the author was found guilty of fraud.  Numerous subsequent studies have shown no association between MMR and autism.  It's tragic how many children have been put at risk, all because one crook wanted fame and fortune.