Two cases of measles were reported in Framingham, MA on February 22, 2014. Mark Steven Pasternack, MD, unit chief of the MassGeneral Hospital for Children Pediatric Infectious Disease Program, answers common questions about measles and the current situation.
Measles Q&A with Mark Pasternack, MD
Q: What is measles?
A: Measles is a contagious viral illness that infects individuals who have not been adequately vaccinated. It is highly contagious through the spread of viral particles that occurs when an infected person coughs or sneezes into the air. Someone who has not been vaccinated against measles may contract the illness if those particles get into the eye or are breathed in. Measles is no longer routinely circulating in the United States, but 50-200 cases are reported each year due to measles in returning travelers.
After an incubation period of approximately 10 days, measles initially produces symptoms of a bad cold with runny nose, conjunctivitis, cough, and high fever which is followed by a rash. The rash is a prominent red, spotted rash that typically starts in the face and the head and descends through the body. Doctors always look for white spots on the inner cheeks when examining children with possible measles. People with measles are contagious four days before and four days after the rash appears. Measles vaccine is often given to susceptible individuals within 3 days of exposure in hopes of preventing or minimizing disease following exposure.
The main complications of measles can be pneumonia, (viral or bacterial pneumonia) and, less commonly, very serious forms of neurological or central nervous system infection. There is no direct antiviral treatment for this condition, so major emphasis is put on prevention. Individuals who are ill with measles are treated supportively with fluids and fever control. If they show suspected bacterial pneumonia, they are treated with antibiotics.
Q: Is my child at risk for getting the measles? How can I protect my child against the illness?
A: Children who are over 1 year of age and have been immunized in the routine fashion with measles, mumps, rubella (MMR) vaccine have a very high rate of protection against infection. A second dose routinely given at 4-6 years of age increases the protection rate even higher and improves long term protection. School-age children and adults who have grown up in the United States and been vaccinated should be well protected. Most individuals born before the approval of measles vaccine in 1967 are immune due to childhood infection. Parents should verify their measles immunity status with their primary care providers if they are unsure.
The current Massachusetts measles reports serve as a good reminder that parents whose children may be behind in their immunizations should use this opportunity to make sure they are up-to-date. Prevention is really a key thought process.
For more information about the measles, mumps, rubella (MMR) vaccine visit: http://www.cdc.gov/vaccines/Pubs/vis/downloads/vis-mmr.pdf
Q: What should I do if I suspect my child might have measles?
A: Parents should be vigilant that children who seem to get a cold or flu-like illness with prominent runny nose, conjunctivitis, and cough who develop a rash should alert the pediatrician that the child should be evaluated for possible measles. Parents should recognize that the illness is highly contagious and they should limit contact between their child and other individuals until the child is evaluated by his/her physician.
If children are chronically ill and have a weakened immune system, either because of their underlying disease or medications given to treat their condition, parents should be particularly attentive to make sure their immunizations are up-to-date and to report any illness to their pediatrician.
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