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Most of our children have no idea about measles. But as parents, we may remember this highly contagious viral illness associated with fever, cough, and a characteristic rash. The disease is relatively uncommon in the United States thanks to the vaccine, introduced in 1963. Prior to that time, nearly all children caught measles, affecting over 4 million children annually. Today it affects fewer than 100 people in the U.S. each year. The cases that are seen occur largely among students in grades that do not require the immunization for enrollment, in children under age 5 who have not yet been immunized, and in communities with a religious or philosophical objection to the immunization. A number of cases are seen in visitors from other countries who have not been immunized. Measles is spread by the tiny droplets produced when someone sneezes or coughs. Incubation of the virus lasts 10 to 15 days. A person is contagious for about four days before and about five days after the rash appears. It is very contagious; a susceptible individual is practically guaranteed to get measles if exposed. Measles almost always causes symptoms. It starts with a fever, runny nose, barking or hacking cough, muscle aches, and lymph node swelling. These symptoms subside as the rash appears, usually on the fourth day of fever. The rash begins on the face and neck and then spreads to the shoulders, trunk and arms, gradually fading in about five days. Some children develop an eye or ear infection as a result, and others may have a characteristic patch on the inside of the mouth, called Koplik’s spot. A medical professional can usually diagnose measles through the history and physical exam. In the event there is any question, the diagnosis can be confirmed by culturing the throat or blood for the virus, or by a blood test for measles antibodies. There is no cure for measles. Antibiotics will not treat the virus. With plenty of fluids and rest, most children get better on their own. However, severe complications, even death, from measles can occur in one to two out of every 1,000 children infected. One out of every 1,000 children develop encephalitis (inflammation of the brain), which can lead to seizures and mental retardation. The measles immunization is the best way to prevent the illness. It is typically combined with the mumps and rubella vaccines into one shot, abbreviated MMR. The MMR vaccine is usually given in two doses, the first between 12 and 15 months of age, and the second between 4 to 6 years of age. With the vaccine, the incidence of measles in the U.S has dropped dramatically. Sadly, the immunization is still not available to children in many countries around the world. Measles remains one of the leading causes of mortality in children, responsible for about 1.5 million deaths annually worldwide. Efforts are being made to eradicate the virus on a global level. One day soon, measles may be as rare in other countries as it is in ours. Dr. Richelle K. Marracino is a family practice physician at the UC Riverside Campus Health Center. Information: 951.827.3031. |
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