Why is measles dangerous?

The recent measles outbreak underscores the need for every child to be vaccinated. Jesse Couk, M.D., a Piedmont infectious disease specialist, explains why measles is dangerous and how it can be prevented.

What makes measles so threatening?

Measles is a virus that is one of the most contagious agents known to man. Case reports describe individuals becoming infected with measles roughly an hour after visiting the same location. The individuals never came into contact. Measles can cause pneumonia and encephalitis, which can be fatal. Pneumonia occurs in 6% of measles cases and is the most common cause of death. Neurologic infection is rare, occurring in about one of every 1,000 measles cases. However, it can cause permanent harm or death.

Following measles infection, there is a loss of immune memory that results in immunosuppression. This increases the risk for mortality for up to three years after measles infection. Rare but potentially fatal complications can occur after infection. Including ADEM about two weeks later and SSPE, which usually develops 7–10 years afterward.

How can people avoid catching measles?

Immunization is very effective. If we can promote global immunization efforts, measles could be eradicated. Still, the anti-vaccination movement has increased measles cases worldwide. Measles has returned to some locations where it had been eradicated.

How does measles spread?

Measles spreads from person to person and is airborne, meaning it can spread without touching surfaces or particles. Measles can remain live in the air for up to two hours after an infected person coughs or sneezes. Individuals are considered contagious from four days before through four days after the rash appears.

Are adults at risk for measles, too?

Adults who are not vaccinated or who have their immune system compromised following organ transplant or chemotherapy are at risk.

When should I be vaccinated for measles?

The measles vaccine is part of a live virus vaccine series called MMR. MMR requires at least two doses; children typically receive it at 12-15 months and 4-6 years. However, doctors can give a second dose earlier if separated by at least 28 days.

Is this measles outbreak concerning? 

Yes. The measles outbreak is particularly concerning given how easily it spreads and is potentially fatal. Even more concerning is the continued anti-vaccination movement. It causes some parents to hesitate about immunizing their children. Doctors see no evidence the movement is shrinking. Research continues to demonstrate the safety of immunization.

Do you expect to contain this measles outbreak? 

MMR is highly effective at containing current outbreaks. Future outbreaks will continue unless global immunization eradicates measles. Doctors are not optimistic at this point, given the hard-line anti-immunization attitudes among a sizable minority of individuals.

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