What is measles?
Measles is a virus that typically causes high fever, cough, runny nose, conjunctivitis (“pinkeye”), and rash. Symptoms typically develop 1-2 weeks after exposure. While most cases are uncomplicated, 20% – 30% of persons with measles may experience complications, most commonly in children under 5 years of age and adults. The most common complications include ear infection (7 out of every 100 cases), pneumonia (6 out of every 100 cases), diarrhea (8 out of every 100 cases), brain swelling (1 out of every 1000 cases) and death (1 to 3 out of every 1000 cases) A rare, progressive, and devastating neurologic disorder known as subacute sclerosing panencephalitis (SSPE) may occur in 1 out of every 100,000 persons who have recovered from measles.
How is measles spread?
Measles is spread person-to-person by small respiratory droplets that hang in the air (i.e. airborne). It is so highly contagious that persons can be infected by measles virus that remain in the air up to two hours after a contagious person has left the area. Over 90% of all exposed individuals without immunity to measles may become infected. An individual infected with measles may be contagious starting 4 days before the rash appears to 4 days after rash onset. “Homegrown” measles in the U.S. has been eliminated since 2000 due to the recommendation for a second dose of MMR vaccine in addition to high immunization rates. However, imported cases continue to cause outbreaks in the U.S., particularly in communities with low immunization rates. In 2014, the U.S. had over 600 cases of measles, the highest number since the 1990’s.
How can measles be prevented?
The measles-mumps-rubella (MMR) vaccine is 95% effective after one dose and 99% effective after two doses, in preventing measles infection. The first dose is recommend to be given between 12 to 15 months of age while the second dose is recommended at 4 to 6 years of age. Children as young as 6 months old may safely receive the MMR vaccine prior to travel outside the U.S. However, if given before 12 months of age, the MMR vaccine must be given again at 12 months of age.
I have an infant less than 12 months of age. Given the current outbreak situation, should my child be immunized early?
The current recommendations are for healthy children to receive their first MMR vaccine at 12 months of age, given that this is the earliest age at which the majority of children would typically be expected to have the most effective immune response from the MMR vaccine. If your infant has been exposed to someone with measles or if international travel is planned, the MMR may be given early (see “How can measles be prevented?”). If a large outbreak occurs locally, the Department of Public Health will provide guidance as to when to implement early MMR immunization. We are closely watching the current measles outbreak and any related public health advisories, and will notify our CCP patients if the recommendations change. Routine early MMR vaccine administration is not being recommended at this time.
Does Center City Pediatrics accept patients who choose to be unvaccinated?
For the health and safety of the children we provide care for, CCP does not accept unvaccinated patients.
Prepared on February 10, 2015 by Grace E. Lee, MD MSCE