Facts About Measles

Measles cases continue to pop up throughout the United States and have been diagnosed in people as close to home as Pittsburgh.

At Penn Highlands Healthcare, we want you to know the facts about measles, and we want you to take precautions when you can.

What are measles?

“Measles is an illness caused by a virus,” Sue Stiner, MSN, RN, CIC, Infection Prevention and Control Department Director at Penn Highlands DuBois, said. “Measles is spread from person to person through the air by infectious droplets from coughing. It is highly contagious.”

“It takes an average of 10–12 days from exposure to the first symptom, which is usually fever,” Rhonda Chilson, RN, Quality/Infection Control Director at Penn Highlands Elk, said. “The measles rash doesn’t usually appear until approximately 14 days after exposure, two to three days after the fever begins.”

Symptoms include fever, runny nose, dry cough, loss of appetite, pink eye and a rash. “The rash – which shows up as flat red blotches - usually lasts five to six days and begins at the hairline, moves to the face and upper neck, and proceeds down the body,” Beth Keth RN, BSN, Organizational Performance Improvement/Patient Safety Officer at Penn Highlands Brookville, said. The person could also have Koplik spots in the mouth. Koplik spots are tiny grayish-white spots that look like grains of sand with a reddish ring around them.

How serious is measles?

“Very, with 30 percent of reported cases experiencing one or more complica¬tions. Death from measles occurs in 2-3 per 1,000 reported cases in the United States. Complications from measles are more common among very young children - younger than five years - and adults older than 20 years,” Diane Bengtson, RN-BC, MS, CCHC, Director of Quality and Patient Safety at Penn Highlands Clearfield, said.

Diarrhea is the most common complication of measles occurring in 8 percent of cases, especially in young children. Ear infections occur in 7 percent of reported cases. Pneumonia, occurring in 6 percent of reported cases, accounts for 60 percent of measles-related deaths.

“Approximately one out of one thousand cases will develop acute encephalitis, an inflammation of the brain,” Chilson said. “This serious complication can lead to perma-nent brain damage.”

“Measles during pregnancy increases the risk of premature labor,” Keth said. “Miscarriage and low-birth-weight infants are also a risk, although birth defects have not been linked to measles exposure.”

Measles can be especially severe in persons with compromised immune systems. Measles is more severe in malnourished children, particularly those with vitamin A deficiency. In developing countries, the fatality rate may be as high as 25 percent.

“Measles is diagnosed by reviewing a patient’s symptoms and performing a lab test,” Stiner said. The test is done outside of a hospital lab by the state, so it takes 24 hours to get lab results.

Treatment is usually bedrest, fluids and control of the fever. The virus must run its course.

“Measles viruses are highly contagious and can be transmitted from four days before the rash appears until four days after it appears,” said Bengtson.

“Anyone exposed to measles should contact their doctor,” she said. “It is possible to receive the vaccine within a short window after being exposed. This may lessen the severity of the symptoms.”

Any children, adolescents and adults born in 1957 or later can still be vaccinated if they are not already. It is a two dose with each vaccine injected weeks apart.

Adults who do not know if they have had the vaccine should get at least one dose of the vaccine. Proof of vaccinations is documented for children in their medical records and duplicate records are kept by parents. If those records are lost, a blood test can confirm evidence of past immunization or even having a case of the measles.

Adults born before 1957 are likely to have had measles or have been exposed to the virus and generally are considered immune already. Those adults should talk to their doctors if they are concerned.

For those who received a measles vaccine in 1963-1967, they should consider a blood test. The killed-virus measles vaccines was not as effective as originally thought.

How safe is the current vaccine?

“Hundreds of millions of doses of this vaccine have been given in the United States, and its safety record is excellent,” Stiner said. “The Centers for Disease Control and Prevention, the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists and the American College of Physicians have all recommended this vaccine.”

As always, if you have questions, call your healthcare provider. If you don’t have a provider, go to www.phhealthcare.org/doctor for a list of our providers or call the Family Medicine Continuity Clinic at 814-503-4305. The Continuity Clinic sees patients of all ages.