Measles Epidemic

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What you need to know | Symptoms | Complications | Prevention | For additional information

According to the California Department of Public Health, the California measles outbreak was declared over on April 17, 2015.


What you need to know

California was one of a number of states that experienced a major measles outbreak. Measles is a highly contagious viral infection that is easily spread from one person to another when an infected individual coughs and sneezes. According to the Centers for Disease Control and Prevention (CDC), "measles is so contagious that if one person has it, 90% of the people close to that person who are not immune will also become infected." Contributing to its infectiousness, the measles virus can live on surfaces and in the air up to two hours after an infected person has coughed or sneezed.

Measles complications, though rare, are serious and can result in life-threatening conditions. Among childhood rash/fever illnesses, measles is the deadliest. Vaccination with two doses of the MMR (measles, mumps, rubella)  or MMRV (measles, mumps, rubella, varicella — for children 12 months to 12 years of age) vaccine is the best way to prevent infection.

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Symptoms

Initial symptoms

Symptoms typically develop 7-14 days after exposure and include:

  • High fever
  • Cough
  • Runny nose
  • Red, watery eyes (conjunctivitis)

Measles rash

  • 2-3 days after symptom onset
    • White spots may appear in the mouth
  • 3-5 days after symptom onset
    • A rash develops that spreads from the hairline of the face to the body, arms and legs feet. The rash initially appears as flat red spots. Red raised bumps may develop on the spots.
    • Fever may spike to 104º F or higher when the rash appears.
    • The rash and fever typically subside after a few days.

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Complications

Complications from measles infections develop in approximately 30% of those infected. Children under 5 years old and adults over 20 years of age are at higher risk for complications, though complications are serious for all age groups. Common complications include ear infections and diarrhea.

Severe complications

Severe complications include:

  • Pnemonia: A lung infection which is the number one cause of death for children with measles.
  • Encephalitis: Swelling of the brain which can lead to convulsions, loss of hearing and mental retardation.
  • Subacute sclerosing panencephalitis: A rare, but fatal, central nervous system disease that develops 7-10 years after a person has had the measles.

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Prevention

Worldwide, of the estimated 20 million people who get infected with measles each year, 146,000 people die — that equals about 440 deaths every day or about 17 deaths every hour, according to the CDC. Yet, measles can be prevented with the MMR (measles, mumps, rubella) vaccination.

Information about vaccination recommendations is available from the Centers for Disease Control and Prevention, the Los Angeles Department of Public Health and vaccines.gov.

CDC Vaccine Recommendations

Children

CDC recommends all children get two doses of MMR vaccine, starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age. Children can receive the second dose earlier as long as it is at least 28 days after the first dose.

Students at post-high school educational institutions

Students at post-high school educational institutions who do not have evidence of immunity against measles need two doses of MMR vaccine, separated by at least 28 days.

Adults

Adults who do not have evidence of immunity against measles should get at least one dose of MMR vaccine.

International travelers

People 6 months of age and older who will be traveling internationally should be protected against measles. Before any international travel—

  • Infants 6 through 11 months of age should receive one dose of MMR vaccine. Infants who get one dose of MMR vaccine before their first birthday should get two more doses (one dose at 12 through 15 months of age and another dose at least 28 days later).
  • Children 12 months of age and older should receive two doses of MMR vaccine, separated by at least 28 days.
  • Teenagers and adults who do not have evidence of immunity against measles should get two doses of MMR vaccine separated by at least 28 days.

Healthcare personnel

Healthcare personnel should have documented evidence of immunity against measles, according to the recommendations of the Advisory Committee on Immunization Practices (48 pages). Healthcare personnel without evidence of immunity should get two doses of MMR vaccine, separated by at least 28 days.

For more information, see measles vaccination recommendations.

For Those Getting Vaccinated

Vaccination recommendations and other useful information about the measles vaccine

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For additional information

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Content Sources: 1) California Department of Public Health. 2) Centers for Disease Control and Prevention. 3) Los Angeles County Department of Public Health. 4) vaccines.gov.