Measles on the rise in the U.S. Here’s why and how to prevent it.

Measles is disease that, on a global basis, has been in decline for decades says Kenneth Sands, MD, HCA Healthcare’s Chief Epidemiologist. However, in the United States, cases of measles are on the increase.  As of August 22, there have been 124 confirmed cases of the disease reported in 22 states and Washington, D.C. That’s more than the 118 in 2017, and the most since 2015, when there were 188 cases.

Naturally, this raises the question: Are we facing an outbreak?

“The Centers for Disease Control and Prevention (CDC) has been careful to say this is not an outbreak,” Dr. Sands said. “It’s an observed increase in the number of cases of measles on a national basis certainly, but that’s different from saying there’s an outbreak. It’s an important distinction,” he added.

Dr. Sands further explained that an outbreak is “when one sees an increase of events in a specific community or geographic region.”

Semantics aside, here’s what else you should know about measles.

What is measles?

Measles, also known as rubeola, is an infection caused by a highly contagious virus. It was a common childhood disease many decades ago. However, the creation of the measles vaccine in 1963 drastically reduced the number of cases.

How does it spread?

Measles is so contagious that the CDC says 90 percent of people who are near a person with the disease and are not immune will also become infected. It can travel by air so even a small amount of particles released from an individual who either has measles or is carrying the virus can lead to exposure. People who are exposed to that environment or haven’t been vaccinated can easily become infected themselves.

Who’s most at-risk for getting measles?

Unvaccinated individuals are most at-risk for contracting measles. The vast majority of people who live in the United States will receive vaccinations as part of their routine pediatric care. However, there are some who actively resist getting their child vaccinated and that population is at risk of both getting measles and spreading the disease to other unvaccinated individuals.. Also, individuals who travel to the United States from countries where measles is still common and where they don’t routinely vaccinate similarly are at risk for both the disease and being a source of transmission.

What are the symptoms?

The symptoms, which may appear 7-10 days after infection, typically include:

• high fever
• cough
• runny nose
• red eyes
• potentially abdominal pain, and
• a distinctive rash on the face, body and in the mouth.

How do you prevent measles?

Vaccination is the only effective way to prevent measles. According to the CDC, two doses of the vaccine is about 97 percent effective at preventing the disease. Other than that, it’s difficult to prevent exposure to measles. It’s really all about vaccination. The vaccination is very effective and very safe.

The concept of “herd immunity” becomes important in the cases where people choose not to get vaccinated. Herd immunity is achieved when an individual, especially a child, has not been vaccinated, but everyone (at least 95 percent) of their community has been vaccinated. This will protect the unvaccinated individual.

When do people receive this vaccination?

It’s a part of a standard vaccination called MMR, or measles, mumps and rubella vaccine. It’s administered in multiple doses during childhood. The first dose is recommended around 1 years old and the second dose is expected around school-age (4-6).

How is measles treated?

It is not a condition that you can treat with antibiotics because it’s a virus. It’s about helping individuals through the initial disease, which most people recover from. In some circumstances, it can cause significant long-term complications or even death, especially for infants, elderly or individuals with underlying conditions that affect the immune system, such as  AIDS.

What to do if you’ve been exposed to measles? 

Exposure to measles is still a rare event.   The most important action for anyone is to confirm that they have received the MMR vaccination.  If exposed, the best thing to do is to contact your healthcare provider for guidance. The caregivers are likely to ask questions about where the exposure may have occurred because they will be very interested in controlling that source, in addition to understanding your illness.

Dr. Kenneth Sands serves as HCA Healthcare’s chief epidemiologist and leads enterprise-wide initiatives in health services research, infection prevention, and patient safety.

HCA Healthcare 50th Anniversary
In 1968, HCA Healthcare was conceived by two physicians and an accomplished business leader — Dr. Thomas Frist Sr., Dr. Thomas Frist Jr., and Jack Massey. This year, HCA Healthcare celebrates its golden anniversary and the culture of caring established by our three founders 50 years ago. To help us celebrate our 50th year, we’ll share stories here that reflect HCA Healthcare’s mission – above all else, the care and improvement of human life – and our pledge to improve life and make history for the next 50 years and beyond.