Measles

Measles is very contagious and can cause serious illness. Measles is caused by a virus and spreads very
easily when an infected person breathes, coughs or sneezes. Measles spreads so easily that anyone
who is exposed and not immune (either by being immunized or having had measles in the past) will
probably get it.

• Fever
• Runny nose
• Cough
• Pink eye (red, watery eyes)
• Rash all over the body starting on the face and spreading throughout the body
  
  People can spread measles before they show symptoms. Symptoms usually last 7-10 days.

Measles is diagnosed by a combination of the patient’s symptoms and by laboratory tests.

It takes an average of 10–12 days from exposure to the first symptom, which is usually fever. The
measles rash doesn’t usually appear until approximately 14 days after exposure, 2–3 days after the
fever begins.

The measles, mumps, and rubella (MMR) vaccine is very safe, effective and the best protection against
measles. Two doses of MMR vaccine are about 97% effective at preventing measles. One dose is about
93% effective.

Measles can be a serious disease, with 30% of reported cases experiencing one or more complications.
Death from measles occurs in 2 to 3 per 1,000 reported cases in the United States. Complications from
measles are more common among very young children (younger than five years), adults (older than 20
years), pregnant people, and people with weakened immune systems.

Diarrhea is the most common complication of measles (occurring in 8% of cases), especially in young
children. Ear infections occur in 7% of reported cases. Pneumonia, occurring in 6% of reported cases,
accounts for 60% of measles-related deaths. About 1 out of 1,000 cases will develop acute encephalitis,
an inflammation of the brain. This serious complication can lead to permanent brain damage. Measles
during pregnancy increases the risk of premature labor, miscarriage, and low-birth-weight infants,
although birth defects have not been linked to measles exposure.
Measles can be especially severe in persons with compromised immune systems. Measles is more
severe in malnourished children, particularly those with vitamin A deficiency. In developing countries,
the fatality rate may be as high as 25%.

Pregnant women should not get the MMR vaccine. Pregnant people who need the vaccine should
wait until after giving birth. Women should avoid getting pregnant for four weeks after getting the
MMR vaccine.

Research has shown that the measles vaccine (MMR) is safe and very effective. Getting vaccinated
is much safer than getting any of the diseases the vaccine protects against.

Like any medication, the measles vaccine (MMR) may cause side effects, most of which are mild:

• Pain at the injection site
• Fever
• Mild rash
• Swollen glands in the cheek or neck

Vaccines do not cause autism. In fact, studies have shown that there is no link between receiving
vaccines and developing autism. Scientists have carefully studied the MMR shot and no studies
have found a link between autism and the MMR vaccine.

Isolation separates people who are sick with a contagious disease from people who are not sick to
prevent further spread of disease. People who have measles infection, or who are suspected of
having measles infection, must be isolated until 4 days after their rash appeared to prevent
infecting other people. Isolation is an important part of stopping measles spreading in the
community, especially to high-risk people.

Quarantine means staying at home and away from daycare/school/work, group and social
activities, sports and recreation events and public places like cinemas and shopping malls.
Quarantine separates people who were exposed to a contagious disease and are in the time period
where they could still get sick from it. People who were exposed to measles may spread measles
to others even before they have symptoms themselves. Quarantine helps prevent measles from
spreading in the community. For measles, quarantine is 21 – 28 days from exposure to a person
with measles

No. The processes of quarantine and school exclusion are different and administered
separately.

Quarantine is a Health Department requirement that separates and restricts the
movement of people, of any age, who were exposed to a contagious disease and are in the
period where they could still get sick from it. Public health authorities help determine the
need for quarantine and the appropriate dates. For measles, quarantine is 21 -28 days from
exposure to a person with measles.

School Exclusion is a State of Ohio rule that applies to School Districts that requires
their individual K-12 schools to exclude unvaccinated students from school for 21 days from
the last reported case of measles in that school. The exclusion period is done for the
protection of the unvaccinated student, is required by the State of Ohio, and is not optional
for the school or the students. School exclusion does not apply to unvaccinated staff or
faculty, but the quarantine period does apply. It should be noted that if there are multiple
cases of the measles at a particular school, the student’s exclusion might be significantly
extended beyond 21 days, since the 21-day time period would reset with the identification of
each individual new case. When a student is excluded from school, this exclusion also
includes all before and after school activities including childcare, clubs, and sports.

If you’re unsure whether you’re immune to measles, you should first try to find your
vaccination records or documentation of measles immunity. If you are not able to locate you
records, you may receive a dose of MMR if you are not currently required to quarantine and do
not have a contraindication to vaccination with a live virus vaccine (such as pregnancy or a
severe immune disorder). Another option is to have a doctor test your blood to determine
whether you’re immune, but this option is likely to cost more and it may take some time to
get the result.

Contact your health care provider regarding your past immunization history. Schools,
colleges, prior employers, or the military (if you were enlisted) may also have records of your
immunization history. If you are, or have been, pregnant your obstetrician’s office may have
also tested you for immunity to measles when they tested you for immunity to rubella. You
may also be included in your state’s immunization registry. Please visit the CDC website for
additional suggestions on how to locate your vaccination records:
http://www.cdc.gov/vaccines/adults/vaccination-records.html

Everyone should be vaccinated with the MMR vaccine.

Children – Children should receive two doses of MMR vaccine, starting with the first dose at
12-15 months of age and the second dose at 4-6 years of age or at least 28 days following the
first dose.

Students at Post-High School Educational Institutions – Students at post-high school
educational institutions without evidence of measles immunity need two doses of MMR
vaccine with the second dose administered no earlier than 28 days after the first dose.

Adults – People who were born after 1957 who do not have evidence of immunity against
measles should get at least one dose of MMR vaccine.

International Travelers – People 6 months of age or older who will be traveling
internationally should be protected against measles.

Anyone who has not been immunized or had measles in the past is at risk. Babies younger
than 12 months are at risk because they are too young to have been vaccinated.

Newborns have some natural immunity from their mothers, if the mother was vaccinated, for
the first few months of their life. If parents or caregivers have not gotten the MMR vaccine or
had measles in the past, they should get vaccinated. It is important to make sure people who
are around your new baby do not expose your baby to measles.

They should stay isolated from you and others for 4 days after their rash first appeared. It is
best to limit contact with others in your household and all family members should review
their immune status.

There is no specific treatment for measles. People with measles need bed rest, fluids, and
control of fever. Patients with complications may need treatment specific to their problem.

Measles is highly contagious and can be transmitted from 4 days before the rash becomes
visible to 4 days after the rash appears.

No