Measles, it’s back!


Measles, it’s back!
I think I may have Measles, what should I do?

Immediately call your doctor and let them know about your symptoms so that they can tell you what to do next. Your doctor can make special arrangements to evaluate you, if needed, without putting other patients and medical office staff at risk.

Measles is a serious viral illness. It is characterized by a fever (as high as 105°F) and malaise, cough, nasal inflammation, and pink eye, followed by a diffuse rash. The rash usually appears about 14 days after a person is exposed and starts on the head, spreading to the trunk then to the lower extremities. Patients are considered to be contagious from 4 days before to 4 days after the rash appears. Of note, sometimes people with weak immune systems do not develop the rash.

In 2000, measles was declared eliminated from the U.S. However, since 2000, when measles was declared eliminated from the U.S., the annual number of cases has ranged from a low of 37 in 2004 to a high of 667 in 2014. The 2019 case count exceeded 2014 levels as of April 26, 2019, and continues to climb. The majority of cases have been among people who are not vaccinated against measles. Measles cases in the United States typically origin as a result of travel by people who were infected while in other countries. Measles is more likely to spread and cause outbreaks in U.S. communities where groups of people are unvaccinated.

Transmission
Measles is one of the most contagious of all infectious diseases; up to 9 out of 10 susceptible persons with close contact to a measles patient will develop measles. In contrast the Flu, which is also a very contagious virus, infects 2.5 out of every 10 people with close contact. The Measles virus is transmitted by direct contact with infectious droplets or by airborne spread when an infected person breathes, coughs, or sneezes. Measles virus can remain infectious in the air for up to two hours after an infected person leaves an area.

Prevention
Measles can be prevented with measles-containing vaccine, which is primarily administered as the combination measles-mumps-rubella (MMR) vaccine. One dose of MMR vaccine is approximately 93% effective at preventing measles; two doses are approximately 97% effective. Almost everyone who does not respond to the measles component of the first dose of MMR vaccine at age 12 months or older will respond to the second dose.

If you are not sure if you received the Measles vaccine, you doctor can do a simple blood test called a Measles titer to test for antibodies. If you have adequate antibodies you are immune to the Measles.

Treatment
There is no specific antiviral therapy for measles. Medical care is supportive and to help relieve symptoms and address complications such as bacterial infections.
Severe measles cases among children, such as those who are hospitalized, should be treated with vitamin A. Vitamin A should be administered immediately on diagnosis and repeated the next day.

In conclusion there has been a significant increase of measles in 2019 due to increase in non vaccinated people and due to travel amongst countries where measles is still prevalent. The best way to prevent measles is through vaccination.

If you have symptoms of the Measles you should go to the emergency room or call the health department. If your symptoms are milder and you are not sure if it is the Measles, you may see our Physicians and P.A.s at Doctors Urgent Care for the highest quality medical evaluation and treatment. We are familiar with Measles symptoms and diagnosis.

David B. Dean, MD

Medical Director

Doctors Urgent Care