Measles

What is measles?

Measles, also called rubeola, is a serious respiratory disease that causes rash and fever. It is very contagious. People with measles spread the virus by coughing or sneezing into the air. You can catch the disease by breathing in the virus or by touching an infected surface and then touching your eyes, nose, or mouth. Measles can lead to serious complications, even death, especially in babies and young children. The measles vaccine is very effective and the best way to prevent measles.

Why are we concerned?

Measles has been increasing in many locations around the world, including the United States and Canada. In addition, there have been recent cases in New York City, Pennsylvania, and New Jersey. There is concern of continued spread leading to more cases in New York State and locally in WNY.

What is the best way to prevent measles?

Getting the measles vaccine is the best way to prevent measles.

 Measles Vaccine

You are considered vaccinated against measles if you have written proof of 2 valid doses of MMR vaccine, or other live, measles-containing vaccine.

You are also considered vaccinated against measles if you have a lab report of immunity, or you were born before 1957.

Anyone who has not been vaccinated against measles should receive at least one dose of MMR vaccine. Two doses of MMR vaccine are recommended for all children and adults. This includes, in particular, health care personnel, college students, and international travelers. The doses should be given at least 28 days apart.

We recommend that all children get 2 doses of the Measles, Mumps and Rubella (MMR) Vaccine.

Children should get their first MMR shot at 12 through 15 months old (as soon as possible within this time-period). The second dose may be given as soon as one month after the first dose. But it is usually given between 4 and 6 years of age.

An early dose of MMR vaccine is recommended for children 6-11 months of age who will be traveling internationally or in an outbreak setting. These children will still need the 2 routine doses given at 12-15 months and 4-6 years of age to ensure protection. Therefore, they will receive a total of 3 MMR vaccines.

How effective is the measles vaccine?

One dose of the measles vaccine is about 93% effective at preventing measles if exposed to the virus. Two doses are about 97% effective.

Will I need a booster vaccine for measles?

No. CDC considers people who received two doses of measles vaccine as children according to the U.S. vaccination schedule protected for life, and they do not ever need a booster dose.

If you’re not sure whether you are fully vaccinated, talk with your healthcare provider.

Where can I get a measles vaccine?

  • Some physicians and pediatricians offer MMR vaccine to current patients.
  • Many retail pharmacies offer MMR vaccine.
  • You or your child may be eligible for an MMR vaccine from the Niagara County Department of Health Immunization Clinic. Please call (716) 278-1903 to inquire.

How does measles spread?

Measles is a highly contagious virus that lives in the nose and throat mucus of an infected person. It spreads to others through an airborne route (coughing and sneezing).  If other people breathe the contaminated air or touch the infected surface, then touch their eyes, noses, or mouths, they can become infected.

Animals do not spread or get measles.

What are the symptoms of measles?

7-14 days after infection first symptoms begin and usually include:

  • High fever (may spike to more than 104°)
  • Cough
  • Runny nose (coryza)
  • Red, watery eyes (conjunctivitis)
 Baby with Measles - Copy

2-3 days after symptoms begin Koplik spots appear

  • Tiny white spots (Koplik spots) may appear inside the mouth two to three days after symptoms begin.
3-5 days after symptoms begin measles rash appears
  • The rash usually begins as flat red spots that appear on the face at the hairline and spread downward to the neck, trunk, arms, legs, and feet.
  • Small, raised bumps may also appear on top of the flat red spots.
  • The spots may become joined together as they spread from the head to the rest of the body.
  • When the rash appears, a person's fever may spike to more than 104° Fahrenheit.

How contagious is measles?

Measles is extremely contagious – 9 out of 10 unvaccinated people nearby will get infected. You can catch measles by breathing in the virus or by touching an infected surface and then touching your eyes, nose, or mouth. You can also become infected just by entering a room that an infected person was in up to two hours before you.
Measles CDC

How long is a person with measles contagious?

A person with measles can pass it to others from 4 days before a rash appears through the 4th day after the rash appears.

If my child or another family member has been exposed to measles, what should I do?

Immediately call your local health department or your health care provider for advice. You may be able to get vaccinated or receive immunoglobulin to prevent disease.

What are the complications of measles?

Common complications from measles are:

  • Ear infections: 1 in every 10 children with measles
  • Diarrhea: less than 1 out of every person with measles

More serious complications can occur among certain people including: children younger than 5 years, adults older than 20 years, pregnant women, and people with weakened immune systems.  Serious complications include:

  • Hospitalization: 1 in 5 unvaccinated people in the U.S. will be hospitalized.
  • Pneumonia (lung infection): Up to 1 in 20 children with measles gets pneumonia, the most common cause of death in young children.
  • Encephalitis (swelling of the brain): About 1 child in every 1,000 with measles will develop encephalitis, which could lead to convulsions and leave the child with a hearing problem or intellectual disability.
  • Death: Nearly 1 to 3 of every 1,000 children with measles will die from respiratory or neurologic complications.
  • Pregnancy Complications: Measles during pregnancy increases the risk of early labor, miscarriage, and low birth weight infants.

What should I do if I think I or my child has measles?

Stay home and call your health care provider or local health department right away. If you have measles, you could spread it to others. That's why it's best to call your health care provider or emergency room before being seen. They can tell you the best way to get checked without infecting others. Tell your health care provider or local health department if you, or your child, spent time with other people in the days before or after the measles rash began. These people may be at risk of getting measles themselves. Their health care providers or local health department might offer them a vaccine or immunoglobulin (IG) to help prevent them from getting measles.

We have someone infected with measles at home. Can we be around others?

People who are sick with the measles need to stay home until they are no longer contagious. Their close family members are also at risk of getting measles if they are not already vaccinated against measles. If they have not previously been vaccinated against measles, they may be eligible for preventive vaccine or immunoglobulin. They may also need to stay home for up to 21 days after they were exposed to measles. A person can spread measles to others even before they begin to feel sick. If you have measles in your house, please talk to your health care provider or the local health department as soon as possible. They will tell you how long you and your family members should stay home and what to do if anyone else gets sick.

Is there a treatment for measles?

There is currently no treatment for measles, but acetaminophen and ibuprofen may be taken to reduce a fever. People with measles also need bed rest and fluids. They also may need treatment for complications such as diarrhea, an ear infection or pneumonia.

If my child or another family member has been exposed to measles, what should I do?

Immediately call your local health department or health care provider for advice. Never been vaccinated? Get the Measles, Mumps and Rubella (MMR) vaccine within 3 days of being exposed. This may prevent you from getting measles. Some people may need to receive immunoglobulin – antibodies to the measles virus. It should be given within 6 days of being exposed. This may prevent or lessen the severity of measles.

How do I know if I am protected against measles?

Check with your health care provider if you are unsure of your measles immunity status. People exposed to measles may need to be excluded from certain settings (childcare, schools, post-high school educational institutions, healthcare, workplace) until they can provide documented proof of immunity, or up to 21 days after a measles exposure.

Based on CDC guidance, you are protected from measles if you have written documentation of one of the following:

  • You received two doses of measles-containing vaccine, and you are a(n):
    • School-aged child (grades K-12)
    • Adult who will be in a setting that poses a high risk for measles transmission, including students at post-high school education institutions, healthcare personnel, and international travelers.
  • You received one dose of measles-containing vaccine, and you are a(n):
    • preschool-aged child
    • adult who will not be in a high-risk setting for measles transmission
  • A laboratory confirmed that you had measles at some point in your life
  • A laboratory confirmed you are immune to measles (positive serum measles IgG)
  • You were born before 1957

What should I or my family members do to prevent measles if we are traveling out of the country?

Measles is still common in many other countries. Make sure that you and your children are fully vaccinated before traveling out of the U.S.

Children, adolescents, and adults should have two doses of MMR vaccine, at least 28 days apart.

An early dose of MMR vaccine is recommended for children 6-11 months of age who will be traveling internationally or in an outbreak setting. This dose does not count as part of the routine doses given at 12-15 months and 4-6 years of age. These children will need a total of 3 MMR vaccinations.

My child is younger than 6 months. How can I protect them from getting measles?

Babies under 6 months are too young for the measles vaccine. But you can protect them by making sure everyone who lives in or visits your home is vaccinated. Avoid people who are sick with measles. Avoid traveling to locations with measles outbreaks. Talk to your health care provider. Your child may benefit from immunoglobulin (IG), if they have been around someone who has measles.

Additional Resources for Measles

Niagara County

New York State

Center for Disease Control and Prevention (CDC)

Additional Resources for Immunization Records

Healthcare providers now use electronic immunization registries to keep track of children's immunizations.  Finding old immunization records for adults can be difficult or even impossible.  To avoid having to hunt for old records, and possibly repeating vaccinations that cannot be documented, individuals should make sure that all immunization providers give them a written record of their vaccines.  Parents should also keep track of their child's vaccination history.  Consider using this free life-time immunization record card.

If you are unable locate your records, check with the following places:

 

Electronic Immunization Registries

Healthcare providers now use electronic immunization registries to keep track of children's immunizations.

As of January 1, 2008, the New York State Immunization Registry Law requires healthcare providers to report all immunizations administered to persons less than 19 years of age, along with the person's immunization histories, to the New York State Department of Health using the New York State Immunization Information System (NYSIIS). This system can also be used for adult immunizations. All COVID-19 vaccinations given in NY State, regardless of the recipient's age, are recorded in NYSIIS. 

For more information:

For Schools and Community

Measles is more than just a rash. We all have a role to play in protecting against measles, a debilitating and highly contagious disease.  

Measles is easily spread in school settings - buses, classrooms, sports and activities, lunchrooms. Extended absences among school staff and students because of measles exposure or illness are disruptive and something we are all working to avoid. 

If a measles exposure happens within a classroom, sports or school bus setting, people who do not have the protection of the measles, mumps, rubella (MMR) vaccine will be at high risk of infection and illness.

Fortunately, New York State requires MMR (measles, mumps, rubella) vaccine for PK-12 school entry and attendance. This means that there is a low likelihood that a measles exposure in a school setting would lead to large numbers of measles cases among students. That is the power of community immunity - also called herd immunity.

Individuals who are not measles immune are at risk of developing measles disease.

What schools can do to protect their community:

  • Follow NYSDOH regulations around vaccines for school entrance and attendance.
  • Encourage school employees, visitors, parents and vendors to know their measles immunity status.
  • Encourage parents and employees with questions to talk to their doctor about their risks for measles and other vaccine-preventable diseases.
  • Connect families who need help accessing MMR vaccine with local pharmacies or their local department of health.
  • Promote good school hygiene practices - regular hand washing and staying home and away from others when sick. 

Resources for School Nurses and Medical Directors

To report a possible case of measles in Niagara County, please call our Nursing Division at 716-278-1900.