As of March 21, 2024, a total of 64 measles cases were reported by 17 jurisdictions: Arizona, California, Florida, Georgia, Illinois, Indiana, Louisiana, Maryland, Michigan, Minnesota, Missouri, New Jersey, New York City, Ohio, Pennsylvania, Virginia, and Washington. None have been reported in Wisconsin with this current outbreak.
Since 2000, when measles was declared eliminated from the U.S., the annual number of cases has ranged from a low of 37 in 2004 to a high of 1,282 in 2019. The majority of cases in the United States have been among people who are not vaccinated against measles. Measles cases occur as a result of importations by people who were infected while in other countries and from subsequent transmission that may occur from those importations. Measles is more likely to spread and cause outbreaks in communities where groups of people are unvaccinated.
Measles is one of the most contagious diseases. Measles is so contagious that if one person has it, up to 90% of the people close to that person who are not immune will also become infected. It is critical for all international travelers to be protected against measles, regardless of their destination.
- Infected people can spread measles to others from four days before through four days after the rash appears.
- Measles virus can live for up to two hours in an airspace after an infected person leaves an area. Airborne Isolation must be initiated immediately if someone is suspected of having measles.
- Symptoms usually begin 7-14 days after you’ve been infected.
7 – 14 days after a measles infection: first symptoms show
Measles isn’t just a little rash. Measles can be dangerous, especially for babies and young children. Measles typically begins with
- high fever (may spike to more than 104°),
- cough,
- runny nose (coryza), and
- red, watery eyes (conjunctivitis).
- 2-3 days after symptoms begin: Koplik spots
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
Three to five days after symptoms begin, a rash breaks out. It 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.
People and groups at risk of measles complications
Measles can be serious in all age groups. However, there are several groups that are more likely to suffer from measles complications:
- Children younger than 5 years of age
- Adults older than 20 years of age
- Pregnant women
- People with compromised immune systems, such as from leukemia or HIV infection
Severe complications in children and adults
Some people may suffer from severe complications, such as pneumonia (infection of the lungs) and encephalitis (swelling of the brain). They may need to be hospitalized and could die.
What to do if you have a suspected case:
- Immediately mask and isolate the patient in a room with a closed door (negative pressure room if available). Follow AIRBORNE and STANDARD precautions.
- Only allow health care workers with presumptive evidence of measles immunity * to attend the patient. All healthcare providers caring for suspected or confirmed measles patients must wear an N95 mask or PAPR.
- Evaluate the patient and order measles confirmatory testing
- Contact infection control.
- Immediately report this suspected case to our local and/or state health department.
* Ensure that all HCP Have Presumptive Evidence of Immunity to Measles
- Presumptive evidence of immunity to measles for HCP includes:
- Written documentation of vaccination with 2 doses of measles virus-containing vaccine (the first dose administered at age ≥12 months; the second dose no earlier than 28 days after the first dose); OR
- Laboratory evidence of immunity (measles immunoglobulin G [IgG] in serum; equivocal results are considered negative); OR
- Laboratory confirmation of disease; OR
- Birth before 1957.
- Consider vaccinating HCP born before 1957 who do not have other evidence of immunity to measles.
- During a measles outbreak, 2 doses of measles virus-containing vaccine are recommended for all HCP, regardless of year of birth.
- Recommendations on immunization of HCP for measles are maintained by CDC and Advisory Committee on Immunization Practices (ACIP).
Prevention
The MMR vaccine protects against measles, mumps, and rubella. Two doses of the vaccine are about 97% effective at preventing measles.
The Centers for Disease Control and Prevention (CDC) recommends two doses for:
- Children.
- First dose at 12–15 months of age.
- Second dose at 4–6 years of age, before entering school.
- College students.
- Children and adults who Plan for Travel internationally.
- Health care personnel.
The CDC recommends one dose of the measles vaccine for:
- Adults born during or after 1957 who haven’t had measles.
- Adults who haven’t been fully vaccinated against measles.
Treatment
There is no specific antiviral therapy for measles. Medical care is supportive and to help relieve symptoms and address complications such as bacterial infections.
For more information about Measles (Rubeola) please visit:
https://www.cdc.gov/measles/index.html
https://www.dhs.wisconsin.gov/immunization/measles.htm
Measles Fact Sheet_P-42174.pub (wisconsin.gov)
https://publichealthmdc.com/blog/2024-01-19/measles-is-increasing-but-it-doesnt-have-to-be
