Do Measles Still Exist?

An outbreak is an increase in the number of endemic cases that is larger than expected. It could be a single instance in a new field. An outbreak can rapidly become an epidemic if it is not contained.

Outbreaks of measles are recently seen among countries where the virus was believed to be eliminated. The possible causes for measles to resurface include:

• Increase of anti-vaccination attitude among the population in recent years
• Reintroduction of measles infection by foreign visitors who are infected or not vaccinated
• Countries with poor health infrastructure and low resources may not be able to provide vaccines and other healthcare support to the population
• Natural disasters may spike infection rates as healthcare facilities are destroyed and healthcare providers are unable to do their duties, especially the duties related to immunization will be disrupted

Overall, the main cause for the rapid increase in measles in recent years is the failure in providing immunization or the idea of anti-vaccination.

Measles, also called rubeola, is a highly infectious respiratory illness caused by a virus that creates a full-body skin rash as well as flu-like symptoms.

Because of extensive immunization, measles is now uncommon in the United States. However, millions of instances occur each year throughout the world.

In an incidence in September 2019, the United States was at risk of losing measles elimination status due to several large-scale outbreaks resulting in more than 1,200 confirmed cases across 31 states.

Measles is extremely contagious and may infect 9 out of 10 people who are not vaccinated for the virus if they meet an infected person.

The spread of measles is through direct contact with body fluids or inhaling virus-infected droplets from an infected person. It can spread by droplets blasted into the air when a measles patient sneezes or coughs.

When a person is exposed to the virus, symptoms generally appear 7 to 14 days later. 

• People infected with measles can spread the disease from four days before the rash appears until four days after the rash appears.
• They are most infectious when they have a fever, runny nose, or cough.
• Those with weakened immune systems because of other illnesses, such as human immunodeficiency virus and acquired immunodeficiency syndrome, can spread the measles virus until they recover.

The symptoms of measles include:

• A high fever that may go beyond 104°F
• Cough
• Runny nose
• Watery eyes
• Conjunctivitis (inflammation of the conjunctiva)
• Koplik’s spots: Tiny white spots may be seen in the mouth two to three days after symptoms begin.
• Measles skin rash: Small, raised, red spots appear on the skin three to five days after symptoms begin. The rash first appears on the face and hairline and spreads to the neck, trunk, arms, legs, and feet.
• Complications from measles include ear infections, pneumonia, diarrhea, and panencephalitis, leading to deafness or intellectual disability

There is no medical therapy for measles. The infection must be allowed to take its course.

Isolation

• To avoid spreading the virus, a sick child should drink enough fluids, get plenty of rest, and take prescribed or over-the-counter medications to ease symptoms.
• The most important step to follow is to keep the infected child isolated at home. 
• Unvaccinated children should be kept in the house away from the infected child in case of an outbreak.

Vaccination

• Vaccination is the only way to prevent the risk of being infected with measles. It is essential to provide complete immunization to everybody, especially to children who are at risk of getting infected.
• The Centers for Disease Control and Prevention recommends all children get two doses of measles-mumps-rubella (MMR) vaccine, with the first dose between 12 and 15 months of age followed by the second dose at four or six years of age.