LOS ANGELES (Feb. 23, 2024) — A highly contagious childhood disease once eradicated by vaccination has made a comeback.
Globally, measles cases increased by 79% in 2023, according to the World Health Organization. In 2022, WHO estimated that measles killed more than 130,000—most of them children.
In the U.S., during the first two months of 2024, nearly two dozen cases have been reported in California, Arizona and nine other states.
“Measles is a huge concern and directly related to declining measles vaccination rates,” said Priya Soni, MD, a pediatric infectious disease specialist with Cedars-Sinai Guerin Children’s. “Vaccine hesitancy, fueled during the pandemic by the anti-vaccine movement, has affected vaccination rates nationwide. In addition, because children were quarantined during the pandemic, many missed out on well-child visits and didn’t catch up on their vaccines. That has meant 61 million fewer doses distributed nationwide between 2020 and 2022.”
Measles is a contagious infection—even more infectious than COVID-19. While one person with COVID-19 can infect one to three others, one person with measles can infect as many as 18 other susceptible individuals. This airborne virus remains infectious for up to two hours after an infected individual leaves an area.
“The big danger with measles is that it is one of the most unpredictable infections,” Soni said. “There is a very real risk of hospitalization, death or serious damage to the immune system. Even after you’ve recovered from measles, your immune system can be altered for up to three years and you become at risk for many other infections.”
Other potential complications include bacterial pneumonia and encephalitis, an inflammation of the brain. Measles carries the highest risk of complications in children 5 and younger and in adults 30 and older.
The measles vaccine, given as part of the MMR (measles, mumps and rubella) vaccine, is extremely effective, giving those vaccinated with just one dose up to 93% protection. The second dose confers up to a 97% lifetime protection rate.
Although the first dose of the MMR vaccine is traditionally given to infants 12-15 months of age, and the second around a child’s fifth or sixth birthday, Soni said infants as young as 6 months can receive the first vaccine if they are traveling to areas where the measles infection rate is high.
For parents worried their child may have been exposed to measles, there are several telltale signs. One of the first is small white spots that appear inside the cheeks. Those spots—called Koplik spots—are unique to measles. Children also can develop a diffuse rash of small, red bumps that erupt on the face but then spread down the rest of the body, along with a high fever.
“Unfortunately, there are no antivirals or treatments for measles other than rest, staying hydrated and fighting the fever with cool baths and fever-reducing medications,” Soni said.
The good news about measles is that it is preventable with the vaccine, Soni said. But when collective MMR vaccination rates drop below 95% in a population, our “herd immunity” diminishes and this can lead to pockets of outbreaks with measles in certain communities and populations.
“There is no scenario where getting the actual measles infection is somehow better for your child then getting the vaccine,” Soni said. “You are doing an incredible thing for your child and your family by getting them vaccinated.”
Read more on the Cedars-Sinai Blog: COVID-19 and Flu Shots Provide a Double Dose of Protection
