FROMLINE: Polly Tita

Newswise — Decades after the highly effective measles vaccine stopped the virus’ continued spread across the United States, measles cases are being reported in Chicago and other parts of the country. We asked the RUSH infectious disease doctor David Nguyen, MDto answer some of the most common questions about the measles virus.

What is measles?

Measles, also known as rubella, is a highly contagious virus that can cause serious illness and, in some rare cases, be fatal. It is very preventable with the measles vaccination. Before there was a vaccine, almost all children contracted measles before the age of 15.

What are the symptoms of measles?

The first symptoms – fever and cough, followed by red eyes – are similar to a common cold. After 7 to 10 days, a measles rash develops, starting on the face and spreading to the arms, back, chest, and legs.

What does measles look like?

The measles rash consists of flat red dots that begin to overlap as the rash spreads. While the rash is bright red on fair skin, it can be a darker brownish red or purple on darker skin. The rash may also have small red bumps, but in most cases this is not the case.

Who is at risk of getting measles?

Anyone who is not vaccinated is at risk. This includes babies, as the vaccine is usually not given before the age of 1 year. People with weak immune systems, for example from HIV or leukemia, may also not be protected.

Can adults get measles?

Adults and anyone of any age can get measles if they are not vaccinated.

How contagious is measles?

Measles is so contagious that up to 90% of those exposed to the virus are not vaccinated. Measles spreads easily through droplets in the air and on surfaces. When someone with measles sneezes, the droplets can remain in the air for up to two hours – even after the infectious person has left the room.

It can be difficult to know whether someone has been exposed to measles or has the disease: it takes one to two weeks after infection for symptoms to appear. And then the measles rash no longer appears almost a week later, so an infected person could spread the disease for several days without knowing they were contagious.

How long are you contagious?

People with measles are contagious from about four days before the rash appears and until about four days after the rash appears. People with weakened immune symptoms may be contagious for longer.

How serious is measles?

While the vast majority of measles cases come and go without serious illness, the virus can be serious and cause significant complications. Infants and young children are particularly vulnerable to serious illness, as are pregnant women and people with weakened immune systems.

For anyone who has it, having measles is torture. The high fever and other symptoms stress children and adults. Some cases may be complicated by ear infections, pneumonia, and inflammation of the brain (encephalitis). Worse, a measles infection can cause the immune system to weaken for weeks or months, leaving patients vulnerable to other infections.

Can you die from measles?

Complications can be very serious and potentially fatal when affecting the very young, the very old, or those with weak immune systems or an existing medical condition. Pneumonia is the most common complication of measles-related deaths.

Is the measles coming back?

In 2000, after nearly 40 years of efforts to vaccinate children, the CDC declared measles eliminated in the United States – meaning that the virus present in the United States was no longer spreading and the only new cases came from people who were exposed to measles in another country. While more than 93% of people in the U.S. are vaccinated, the country sees a number of measles cases each year, ranging from fewer than 100 to more than 1,000.

So far this year, people have been infected with measles in at least 17 states, including Illinois, and it has been seen in Chicago and Cook County.

If so many people are vaccinated, why are there still cases of measles?

While 93% is a high number, the CDC says a 95% vaccination rate is needed to ensure a population is protected from a virus as contagious as measles. While the U.S. has reached that 95 percent rate this century, the rate has been declining in recent years, according to the CDC. Because measles vaccination rates vary from country to country around the world, including in Europe, measles infections continue to occur in other countries.

Does the vaccine work and is it safe?

The measles vaccine provides long-term protection in 95 percent of children who receive one dose and 99 percent of those who receive the second dose. It is rare for an immunized person to develop an infection if exposed to the disease.

Protection from a measles vaccination is lifelong.

How do I know if I am protected against measles?

Your medical record should include vaccinations, or your family may have a medical record. Certain types of employment, such as Some settings, such as healthcare settings, may require you to have a history of or demonstrate immunity to measles. You may be able to verify your vaccination record by visiting the Illinois Immunization Registry.

If you think it is possible that you have not received the vaccine, you can have your immunity tested with a “titer” test – a laboratory test that checks immunity – or you can ask your doctor for a dose of the vaccine.

How quickly are people protected against measles with the vaccination?

After receiving the vaccine dose, it takes about three weeks for protection against measles to begin.

When do people get the measles vaccine?

The CDC recommends that all children ages 12 to 15 months receive a first dose of the combined measles-mumps-rubella vaccine, called MMR, and a second dose between ages 4 and 6 years. For families traveling outside the U.S. For children under 12 months of age or for other reasons who are at increased risk of measles, an early MMR vaccine dose may be given to children 6 months of age and older, but this will not count toward Recommendation Two -Dose series. Children over 12 months and adults traveling should receive two doses, and the doses must be separated by at least 28 days.

You’re never too old to get a vaccination if you haven’t already done so.

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