Measles 101

Katie MacDonald, MSN, CPNP and Erin Rovelli, RN, BSN serve patients at the Children’s Emergency Room at Inova Loudoun Hospital – Loudoun County’s only emergency facility solely dedicated to caring for children and adolescents. It is also the first and only sensory-friendly ER in Loudoun County.

Katie is also a pediatric nurse practitioner for Inova Urgent Care.  Inova offers specialized pediatric urgent care services at the Dulles South, Reston, Tyson’s Corner, and West Springfield urgent care locations.

From January 1 to May 31, 2019, 981 individual cases of measles have been confirmed in 26 states. This is the greatest number of cases reported in the U.S. since 1994 and since measles was declared eliminated in 2000. 

Here’s what you need to know about this highly publicized and very contagious disease:

Important Disclaimers

• If you are concerned that you or a loved one has been exposed to or has contracted measles, please stay home and call your pediatrician and local health department for further instructions.

• If you are experiencing serious symptoms and need urgent or immediate medical attention, please contact your preferred emergency department for further instructions.  This will allow staff time to prepare for your arrival and take the necessary isolation precautions.  Please do not go to a medical office or urgent care if you have been exposed to or have measles. 

• Most of the people who have contracted measles were not vaccinated against the virus.  This is a stark reminder of the importance of making sure you and your children are fully vaccinated. 

What is measles and what are the symptoms?

Measles (also known as rubeola) is a very contagious respiratory infection.

While some may think of measles as a small rash and fever that clears up in a few days, it can cause serious health complications – especially in children younger than 5 years of age.  For some children, measles can lead to pneumonia, encephalitis (irritation and swelling of the brain), deafness, dehydration and death. Symptoms can include:

• Fever
• Cough, usually dry
• Runny nose
• Watery eyes
• Red, swollen eyes (conjunctivitis)
• White spots inside the mouth (Koplik’s spots)
• A red, spotty rash that starts 3 – 5 days after other symptoms. It typically starts on the face and neck and then spreads to the chest, back and full body. The rash is typically flat but may appear to have larger raised areas. Spots can also often look grouped together.
• High fever (104 – 105) at the same time as the rash

Cold-like symptoms tend to get worse during the first 1 to 3 days of the illness.

How contagious is measles?

When you hear that measles is VERY CONTAGIOUS, it is not an exaggeration.  In fact, 9 out of 10 people who are not vaccinated for measles will get it if they are near an infected person. 

Measles is spread through droplets being sprayed into the air when a person infected with the virus breathes, coughs or sneezes.  You can contract measles from simply being in a room where an infected person has been, up to 2 hours after they leave.   

An infected person can spread the measles to others even before knowing s/he has the virus—from 4 days before developing the measles rash to 4 days afterward.  Those with measles are most contagious while they have the fever, runny nose and cough.  People with a weakened immune system can spread measles until they fully recover. 

Someone exposed to the virus usually develops symptoms 7 – 14 days later. 

Who is at risk?

During an outbreak, those at highest risk include:

• Infants who aren’t old enough to receive the vaccine
• Children under 5 years of age
• Pregnant women
• Individuals with poor nutrition or weakened immune systems 

I am thinking about starting a family, what is my risk?

Measles can put a pregnancy at high risk for complications including miscarriage or stillbirth, premature birth (before the 37^th week of pregnancy) and low birth weight. Women should be fully vaccinated against measles prior to becoming pregnant.

If you are pregnant, not immune to measles and think you have been exposed to the disease, please call your OB/GYN, primary care provider and the Health Department for guidance as soon as possible.

How can I protect my child from measles?

The only protection against measles is the MMR vaccine. The only way to stop the spread of measles is for people to vaccinate against it.

The MMR vaccine is a safe and effective way to prevent measles, mumps and rubella. No vaccine provides 100 percent protection, but adding the second dose of the MMR vaccine increases protection to greater than 95 percent.

Like medications, vaccines can have side effects. Most children do not experience side effects from the MMR vaccine, however they can include: fever, rash, soreness and swelling where the vaccine was administered and temporary pain or stiffness in the joints.

My baby is too young for the vaccine. Is there anything I can do to protect him/her? 

• Wash your hands! Use soap and warm water and scrub for at least 20 seconds. 
• Limit your baby’s exposure to crowds, children and anyone with cold symptoms.  
• Disinfect objects and surfaces in your home regularly.
• Feed your baby breastmilk—it contains unique antibodies to prevent and fight infections. 

How do you treat measles?

Measles is caused by a virus, so there is no specific medical treatment for it.  To help manage symptoms:

• Drink plenty of fluids
• Encourage extra rest
• Give Tylenol (acetaminophen) or Motrin (Advil/ibuprofen) to reduce fever and discomfort.  Monitor your child closely and contact pediatrician if you have any questions or concerns. 

An injection of measles antibodies (called immune globulin) can be administered to at-risk people who are exposed to measles. It’s most effective when given within 6 days of exposure. These antibodies can either prevent measles or reduce the severity of symptoms. 

The measles vaccine can also be administered within 72 hours of measles exposure to women who are not pregnant and people not in an at-risk group. 

What if I am traveling to a high risk area and my child is under 12 months of age?

If you are traveling out of the country or to a high risk area, speak with your pediatrician about getting an early dose of MMR. Your child will still need a dose at 12 months and the booster when they are older, but an early vaccine will give them temporary protection.