Jason Kessler, MD, MPH, Chief of Infectious Diseases at Atlantic Health System's Morristown Medical Center answers questions about adults and measles:
Q: What is measles?
A: Measles, or rubeola, is an infectious viral disease that spreads easily from person to person. Before a vaccine for measles was introduced in 1963, measles was a common illness, particularly in children. Thanks to vaccination efforts, by the year 2000 the disease was declared eradicated in the United States. However, recent outbreaks in communities that have lower than the recommended vaccination rates mean the disease is again active in the United States and other countries.
Q: What are the symptoms of measles?
A: High fever, cough, runny nose, and red, watery eyes are among the early symptoms. Two or three days after that, small white spots may appear in the mouth. Three to five days after the beginning of symptoms, the characteristic measles rash appears—flat red spots starting at the hairline and spreading downward onto the face, neck, trunk and limbs. Some of the spots may have raised red bumps on them, and they may be so numerous that they actually join together. The appearance of the rash often coincides with a fever of 104 degrees or higher.
Q: How long after infection do symptoms begin?
A: Generally, one to two weeks after infection is when the first symptoms will appear.
Q: How easy is it to get measles?
A: It’s very easy to get measles if you’re inadequately immunized against it and come into contact with an infected person. It’s spread by coughing and sneezing, and the virus lives in airspace for up to two hours, meaning you can be exposed even two hours after an infected person left the room. People with measles can transmit it anywhere from four days before to four days after their rash first appears. Measles is highly contagious with up to 90% of people who aren’t immune, either because they never had measles in the past or weren’t vaccinated against it, getting measles if they’re close to someone who has it.
Q: How can I ensure that I’m fully immunized against measles?
A: If you had laboratory-confirmed measles in the past, or were born before 1957, you’re considered fully protected against the disease. This is because measles was common in our communities before 1957. People born between 1963 and 1967 may have received a dose of killed measles vaccine which, according to the Centers of Disease Control and Prevention (CDC), is not effective. If you fall into this category, talk to your doctor about getting a booster shot or having your blood tested to ensure that you’re immune.
The CDC considers children to be fully immunized when they receive two doses of MMR vaccine, starting with the first dose at 12 to 15 months of age, and the second dose at 4 through 6 years of age.
Q: I’m not fully immunized against measles. What are my next steps?
A: If you’ve been exposed to someone with measles and you’re not fully immunized, meaning you didn’t receive two doses of the MMR vaccine as a child, getting the measles vaccine right away may help you avoid developing the disease or result in less severe disease.
Certain people at high risk for severe disease may be given a medicine called immune globulin, which can help avoid the disease or, if you do become infected, may have a less severe case. If you don’t get vaccinated or are given immune globulin, you should to stay away from places with large groups of people to avoid infecting them.
Q: What should I do if I’ve been exposed to someone with measles?
A: The first thing you should do is call your doctor. He or she can let you know if it’s necessary for you to be evaluated and how to do that without exposing other patients and medical staff. If they ask you to come in, there may be some additional steps to take to avoid a potential exposure which could include: your medical team having to wear special personalized protective equipment, transport you in a special vehicle, place you in a separate room, or ask you to wear a mask. Again, it’s important not to just show up at your doctor’s office or an emergency department to avoid the risk of exposing others. Call your doctor or the emergency department first.
You should have your immunization record handy, which will help your doctor determine whether you’re at risk.
Q: I’ve had all my measles vaccines. Should I still be worried if I come into contact with someone who has the disease?
A: Although unlikely, it is possible for someone who received the suggested two doses of the measles vaccine to contract the virus. The good news is that the disease will probably be milder than usual and less likely to spread.