Measles is spreading. Here’s what to know
In his 34 years as a pediatrician, Kenneth Colmer, MD, has never seen a case of measles, which he attributes to the vaccine that he routinely administers to his young patients.
“The vaccine's been around since 1963, so measles was pretty much eradicated in the United States,” said Dr. Colmer, who practices at Bass River Pediatric Associates in South Yarmouth. “The vaccine has made a big difference.”
But recently, the viral disease is spreading in the United States.
As of March 13, there were 301 recorded U.S. measles cases, most of them among children in Texas and New Mexico, according to the U.S. Centers for Disease Control. A 7-year-old girl in Texas died of measles. And an adult male who died in New Mexico also tested positive for the disease. Cases also have been reported in 27 other states, including Massachusetts and New Hampshire, according to the U.S. Centers for Disease Control.
The standard protocol is for children to receive the first dose of the measles-mumps-rubella vaccine at age 12 to 15 months; and the second at age 4 to 6 years, according to the CDC. The recent outbreak has been centered on counties in Texas where the vaccination rate is below the CDC-recommended rate of 95 percent. In Barnstable County, the CDC estimates 96.3 percent of kindergartners had received both of the MMR inoculations in the 2023-2024 school year. But the agency also warns that pockets of low vaccination rates exist throughout the country.
With so much recent discussion of measles in the media, we asked Dr. Colmer to answer some questions about measles and the vaccine. His answers, edited for length, are below.
What does measles look like?
It’s similar to most other viral illnesses – fever, cough, nasal congestion, conjunctivitis. And then the rash breaks out. It starts on the face and progresses down the body. Once the rash shows up, then it is probably easier to diagnose. But it's tricky because it's contagious before the rash, so somebody with the measles could be seen in a clinic or the hospital and they could be diagnosed with a viral illness, not knowing that it's measles.
How are measles passed from person to person?
It's an airborne contagion, and it's probably the most contagious disease on the planet. So, if anybody coughs or sneezes, then it's in the air. If an unimmunized person is exposed to someone with measles, the chances are 90 percent that they will get it.
What's the difference between measles and German measles or rubella?
They are different viruses. When people get vaccinated, they get the MMR, which is measles, mumps and rubella, but they're all separate viruses that they lump into one vaccine.
How does the vaccine work?
It’s an attenuated (weakened) strain of the live virus. The person then develops an antibody to measles. Babies from birth to 6 months have some protection as long as the mother was immunized. The high risk is for infants 6 months to one year where the maternal antibody has waned, and the infant is not old enough to be vaccinated.
What does the research say about the vaccine’s safety?
It’s a very safe vaccine. There was a study years ago that came out in England where they thought that the measles vaccine increased the risk of autism. But it was one study, and it was found to be a flawed study. And there have been multiple studies since then that show there’s no association between the measles vaccine and autism. In general, it's a very safe vaccine. You could get soreness at the injection site, and some people get a fever and a rash after the vaccine.
Are there situations where adults should be revaccinated?
It depends if the person is at high risk. A person can have a blood test to determine their immunity and if they're not immune, and if they're at high risk, then they should definitely be vaccinated. But most people, if they get those two doses, then they're immune. If you've had measles, you don't need to be vaccinated.
What are the dangers of getting measles?
If it becomes invasive, it can cause pneumonia and then other illnesses, such as encephalitis, which is inflammation of the brain. It is a serious disease and can lead to death.
Is there a treatment for measles?
There's no treatment for it. Treatment is basically supportive. So, if somebody has measles and they end up in the hospital, clinicians do the best they can, such as put them on a respirator. In other countries, where a lot of kids are malnourished, they'll have low vitamin A levels, and they find that if they're given vitamin A, they might not have as severe an illness. So, what they recommend now is that everybody who has measles gets vitamin A. But it’s not a treatment like an antibiotic is for strep throat.
What happens if people don’t get vaccinated?
You can sort of get away with that to a point because if a few people aren’t vaccinated, we're still going to have a high level of immunity in the community. But if a lot of people decide not to be vaccinated, then that herd immunity is going to drop. And then we're going to see more cases of measles and other diseases that people are not vaccinating against.
