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Measles

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Measles Case Counts

What is measles?

Measles is a serious, highly contagious disease caused by a virus. The virus is spread easily through the air when an infected person coughs, sneezes, or by direct contact with infected nose or throat secretions.

What are the signs and symptoms of measles?

Symptoms of measles include:

  • Fever of 101F (38.3C) or higher
  • Cough, coryza, or conjunctivitis
  • A generalized maculopapular rash lasting three days or more

Initially, a high fever, runny nose, cough, and red, watery eyes develop, followed by the rash. The rash usually starts on the face, hairline, behind the ears, and neck, and then spreads to the rest of the body. The fever typically begins about 10 days (range 7 to 18 days) after exposure, and the rash appears about 14 days after exposure. Infants and adults are usually sicker than children and teenagers.

In the United States, death from measles has occurred at a rate of about 2 to 3 per 1,000 cases in recent years. These deaths occur mainly in children younger than 5 years of age, primarily from pneumonia and occasionally from encephalitis. Other complications include ear problems, diarrhea, and brain damage.

Should a person with measles stay home?

Measles is very contagious. Someone with measles is contagious from four days before the onset date of the rash through the end of the fourth day after the onset of the rash (the onset date of the rash is day zero). During this time, those infected should stay home and not attend work, school, or social activities unless they are seeking medical care. If seeking medical care, patients should call ahead to the medical facility and local health department to make arrangements to minimize exposures.

What is the treatment for measles?

Treatment includes bed rest, fluids, and medicine for fever and headache. Antibiotics do not help and will not cure measles or prevent the disease. There are no antiviral drugs for treating measles.

Can measles be prevented?

The best way to prevent measles is through vaccination. The measles vaccine is recommended for children at 12-15 months of age, with a second dose recommended at 4-6 years of age. The vaccine is called MMR and is given to help protect from measles, mumps, and rubella. Two doses of MMR are required in Illinois for kindergarten through 12th grade children. There is another combination vaccine called MMRV that also helps protect against varicella (chickenpox).

Most adults are recommended to have at least one dose of MMR. Some groups are recommended to have two doses; this includes all persons working in health care and anyone 6 months of age and older who plans to travel internationally.

Persons born before 1957 are likely immune because they may have had measles.

Women should not get the vaccine if they are already pregnant or if they plan to become pregnant within three months after getting the vaccine.

Illinois Vaccine Locator

How do I know if I have immunity to measles?

If you have had two doses of MMR vaccine, the Centers for Disease Control and Prevention (CDC) considers you to have presumptive immunity. Two doses of MMR are about 97% effective in preventing measles. Some adults and preschool children with just one MMR dose are considered to have presumptive immunity if they are not in a high-risk setting, traveling internationally, or in/near an outbreak.

You are also considered immune if you have laboratory testing that shows you have had the disease or testing that shows you have protective antibodies to measles.

Acquired immunity after a measles illness is typically considered to be lifelong.

How do I find out if I have been vaccinated or am immune to measles?

Begin by looking for your vaccination records. Your health care provider may have this information. Another potential source of vaccination records could be your school or college records. If you do not have written documentation of a measles vaccination, you can get a dose of MMR vaccine. CDC recommendations indicate there is no harm in getting a dose of MMR vaccine, even if you are already immune.

While not generally recommended, you can also ask your health care provider to order a blood test for measles antibodies.

Measles Epidemiology

Before the availability of the measles vaccine, around 500,000 cases of measles, 48,000 hospitalizations, and 400-500 deaths were reported annually in the U.S. Measles was declared eliminated in the U.S. in 2000, which means that transmission is not ongoing or endemic in the country. However, non-immune people can still be infected through exposures where measles is actively occurring (i.e., cases or outbreaks in the U.S. or international travel).

Reporting Measles to Public Health

Measles is reportable in Illinois immediately, within three hours, to the local health department and/or Illinois Department of Public Health.

If you suspect measles in a patient:

  1. Call your local health department immediately to report the case and receive guidance. Health care providers can find their local health department contacts for reporting here.
  2. Collect specimens for RT-PCR testing at the state lab and hold the specimens until approval has been received from the local health department or IDPH before shipping to the state lab.
  3. Refer to the laboratory manual of services for specimen collection, storage, and shipment instructions.

Laboratory Testing

Measles PCR testing is the recommended testing method to confirm a measles infection.

Resources

Resources for Health Care Providers