What You Need to Know About Measles

Called “one of the most contagious diseases humans ever faced,” the United States declared the measles eliminated in 2000 thanks to a vaccine that was introduced in 1963. Before that, 3 to 4 million people got measles each year. Among reported cases in that group, 400 to 500 died, 48,000 were hospitalized and 1,000 developed encephalitis (brain swelling).

“This is not a disease that should be underestimated.” - Alex Benjamin, MD, Chief Infection Control and Prevention Officer with Lehigh Valley Health Network

Recently, measles has reappeared. News outlets have been following an outbreak concentrated in Texas where more than 200 people have become sick. It’s worth taking a look at what is happening and why.

There have been outbreaks of measles in the United States since 2000, including a large one in Disneyland in 2014 and another in New York in 2019. According to experts, we can experience additional outbreaks even after the disease is declared eliminated.

“Measles still exists in other countries. So, when people who are not immunized travel and become infected, they can bring the disease back to the United States,” says Alex Benjamin, MD, Chief Infection Control and Prevention Officer with Lehigh Valley Health Network (LVHN). “Also, when people or children are unvaccinated, they can get the disease and spread it. Not only is measles extremely contagious, it can be spread before people even realize they have symptoms. They may spread measles to people who cannot get vaccinated because they are too young or have specific health conditions where they cannot be given a live vaccine.”

The Centers for Disease Control and Prevention (CDC) reports that there are clusters of people who delay or decline vaccines in certain communities. When measles gets into communities with pockets of unvaccinated people, outbreaks can occur. This makes it difficult to control the spread of the disease and makes Americans vulnerable to having the virus reestablish itself in our country.

Measles is transmitted by direct contact with infectious droplets or by airborne spread when an infected person breathes, coughs or sneezes. People who are infected will begin to have symptoms within a week or two after exposure. Early symptoms include high fever, cough, runny nose and red, watery eyes. A few days later, the telltale rash breaks out as flat, red spots starting on the face and then spreading down the neck to the chest, trunk and arms.

A person is contagious from four days before the rash starts to four days after the rash appears. Measles virus can remain infectious in the air for up to two hours after an infected person leaves an area.

The CDC considers you protected from measles if you fall into the one of the following categories:

• A preschool-age child with one measles vaccine (measles-mumps-rubella or MMR)
• A school-age child (K-12) or adult with two measles vaccines (MMR)
• You were born before 1957
• You were diagnosed as having had measles by a doctor or blood test
• You had a titer test that shows you are immune (see below)

If you received two doses of measles vaccine as a child according to the U.S. vaccination schedule, you are protected for life and do not ever need a booster dose, says the CDC. If you were born after 1957, you’re considered protected with one dose of measles vaccine. Certain adults may need two doses. Those who are going to be in a setting with a high risk for measles transmission (health care workers, for example) should make sure they have had two doses separated by at least 28 days.

If you’re not sure whether you are fully vaccinated, talk with your clinician. Your clinician can order a blood test called an MMR titer that will show whether you have antibodies to measles.

As we watch the progress of the current outbreak of measles, we are reminded that the measles (MMR) vaccine is essential to continue to control the disease. 

“The United States eliminated measles because it has a highly effective measles vaccine, a strong vaccination program that achieves high vaccine coverage in children and a strong public health system for detecting and responding to measles cases and outbreaks,” Dr. Benjamin says. “This is not a disease that should be underestimated.”

Specific LVHN ExpressCAREs have been designated as sites for giving the measles, mumps, rubella (MMR) vaccine as post-exposure prophylaxis (medicine taken very soon after a possible exposure to prevent the virus from taking hold in your body). Non-immune individuals may receive MMR vaccination within 72 hours of exposure, unless they have a contraindication to MMR.

People should coordinate getting the MMR vaccine with their primary care clinician. Your clinician will notify the ExpressCARE to ensure you are brought into the facility safely and with minimal exposure to others.

MMR vaccine sites:

• LVHN ExpressCARE-Airport Beltway: 384 Airport Road, Hazle Twp., PA 18202 (570) 501-7700 
• LVHN ExpressCARE-Palmerton: 528 Delaware Ave., Palmerton, PA 18071 (610) 900-4950 
• LVHN ExpressCARE-Muhlenberg: 2649 Schoenersville Road, Suite 100, Bethlehem, PA 18017 (484) 884-8146 
• LVHN ExpressCARE-Macungie: 6451 Village Lane, Macungie, PA 18062 (835) 222-4291 
• LVHN ExpressCARE-MacArthur Road: 2741 MacArthur Road, Whitehall, PA 18052 (610) 434-9561 
• LVHN ExpressCARE-Pocono: 200 East Brown St., East Stroudsburg, PA 18301 (570) 476-3700