By Sara McCloskey 

Cases of one of the most contagious viruses are being investigated across the country, including in Northern Virginia. 

Measles, a respiratory illness most known for causing a distinct red rash, was considered eliminated in the United States in 2000. However, several outbreaks among primarily unvaccinated populations are currently being tracked by the Centers for Disease Control and Prevention. 

While the majority of these cases are in Texas and New Mexico, a Maryland resident who passed through Washington Dulles International Airport in early March reportedly contracted the virus during a trip abroad. 

Gonzalo Bearman, M.D., chief of the Division of Infectious Disease at VCU Health, notes that the best way to protect against this virus is with the measles, mumps, and rubella (MMR) vaccine. 

“Measles is a significant public health threat, particularly in unvaccinated individuals.  Health departments, physicians, and all people must remain vigilant,” Bearman said. “Vaccination is the best mode of prevention. This vaccine is safe and has been around for years. If you are not yet vaccinated and are eligible to get it, the vaccine is highly recommended.”  

Recognizing the potential public health concerns posed by this illness, Bearman spoke with VCU Health News about the signs and symptoms of measles and the importance of immunizations. 

What are the signs and symptoms of measles? 

Measles is very contagious. Symptoms tend to appear 7 to 14 days after being in contact with the virus.   

Some of the symptoms include: 

• High fever 
• Cough 
• Runny nose 
• White dots inside the mouth (Koplik spots) 
• Red, water eyes or pink eye 
• Red spots or rash  

Measles can lead to serious health problems that could lead to hospitalization, especially for young child 5 and under. Some common complications include ear infections, diarrhea, pneumonia, and encephalitis (swelling of the brain).  

How does measles spread?  

Measles can spread through droplets in the air when a sick person coughs or sneezes. Even if someone with measles has left the room, the virus can stay airborne for up to 2 hours – so you can still get sick. 

When are people most contagious with measles? 

People are considered to be most contagious 4 days before and 4 days after the red rash appears on their skin. To note, sometimes people who are immunocompromised don’t develop a rash.  

Who is most at risk of getting sick?  

Anyone who has not received a vaccine is considered at risk of contracting measles. This virus can cause serious health problems for all age groups, but some people are especially at risk. Those individuals include: 

• Children under 5 years old 
• Adults older than 20 years old 
• Pregnant people 
• Those with weakened immune systems or are immunocompromised 

How is measles treated?  

There is no specific treatment for measles, so care is mostly focused on managing symptoms and preventing other illnesses from developing that could cause more serious health problems. Providers often recommend fluids, rest, antibiotics for secondary infections, and potentially vitamin A supplements. 

If someone has been exposed to measles and it’s not clear if they have received the vaccine or have immunity from previous exposure, then providers can offer them a post-exposure prophylaxis (PEP) to provide some level of protection against the virus.  

The two types of PEP for measles include: 

• MMR vaccine, which can be administered within 72 hours of initial measles exposure. 
• Immunoglobulin (IG), which can be given to a patient within 6 days of exposure. 

According to the CDC, these PEPs cannot be taken together as they would invalidate the treatment. 

Is the MMR vaccine safe?  

Yes, the MMR vaccine is safe and effective. It’s the best way to protect against measles. The CDC and most doctors recommend two doses of the vaccine. According to federal health experts, two doses of the MMR vaccine are about 97% effective at preventing measles; one dose is about 93% effective.  

Children often receive the MMRV vaccine, which protects against measles, mumps, rubella, and varicella (chickenpox), when they are 12 to 15 months old and again between 4 to 6 years old. A new federal guidance says babies who are 6 to 11 months old can get an MMR shot early if they are traveling internationally or are in areas with outbreaks, however, they will still need to get the other shots based on the CDC’s recommended schedule. 

If I already received the MMR vaccine, should I get another? 

If you have received all doses in this vaccine series, you do not need to get any additional shots. 

If I think I’m sick with measles, what should I do?

If you think you are sick with measles, call your health care provider and tell them about your symptoms. They can make special arrangements with others in the office to ensure you are evaluated, without putting others at risk.  

Stay at home if you are diagnosed with measles. This is very important because measles can easily spread to other people. Be sure to talk to your health care provider about when it is safe to stop isolating yourself. 

While at home, you should also consider the following steps to prevent others from getting sick: 

• Cover your mouth and nose when coughing or sneezing. Use a tissue or your elbow. 
• Wash your hands frequently with soap and water. 
• Avoid sharing drinks, food, and utensils.  
• Disinfect frequently touched surfaces.  

If you are concerned about your symptoms or believe you are getting sicker, contact your health care provider. Some complications caused by measles can lead to hospitalization and even death.  

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