Measles — No Mickey Mouse!

If you’ve seen the news lately, you know that Measles (also called rubeola) is trying to make a comeback! The latest outbreak began in Disneyland in California, among unimmunized people. Measles is a highly contagious respiratory illness caused by a virus. Prior to the development of an effective vaccine in 1963, 500,000 cases of Measles were recorded in the U.S. annually, with many hospitalizations and about 500 deaths. Measles is contracted from infected persons via droplet transmission, i.e. from the person’s nose, mouth, or throat via direct contact, cough, or sneeze. Measles can be “caught” up to 2 hours after an infected person leaves a room. Measles begins like many similar respiratory illnesses with a fever — but eventually includes the “3 Cs” — Cough, Coryza (runny nose), and Conjunctivitis (red eyes). Finally a rash develops about the 4th day. The rash starts as flat red spots on the face and spreads downward to the neck, trunk, legs, and feet. The fever usually spike to about 104 degrees F about the time the rash first appears. A person is infectious and can spread the disease between 4 days before the rash until 4 days after the rash.
The first measles vaccine was developed in 1963. This was a “killed vaccine” made from dead virus. However, it was determined that this initial vaccine was ineffective in preventing the spread of measles. In 1967 the first effective vaccine was developed, and this was an “attenuated vaccine” meaning it contains a small amount of live virus; enough to stimulate an immune response, but not enough to cause the disease. The most common way to receive a measles vaccine today is via the measles-mumps-rubella (MMR) vaccine.
Are you in danger of getting Measles? Although Measles was declared eradicated in the U.S. in 2000, it continues to arrive from other countries to infect those who are not immune. Since 2000, case numbers have ranged from 37 in 2004 to 644 in 2014. So far this year through February 6th, there have been 121 cases in 17 states and the District of Columbia, but none yet in Indiana. The recommended childhood immunization schedule calls for a Measles vaccine at age 12-15 months and a second dose at age 4-6 years. Adults who didn’t receive 2 doses as a child should have at least 1 dose or prove immunity via a lab test. College students and adults working in high risk areas like heath care should have 2 doses separated by at least 28 days. Measles vaccine is extremely effective — 93 percent from one dose and 97 percent from 2 doses. You are considered safe from Measles if you were born before 1957 (assumes you had and survived the disease).
There are concerns about a growing number of people who are not immunizing their children, leaving them vulnerable to Measles and other morbid or deadly childhood diseases. These pockets of unimmunized people (mostly children) are not only at risk themselves, but increase the risk of measles making a comeback and reestablishing itself in our country. If you have questions about immunizations, please discuss with your primary care physician (PCP). You can just say “No” to Measles and help keep it out of Indiana — and America.

Dr. Fleming is the Medical Director of The Jane Pauley Community Health Center (closely affiliated with Community Health Network). Ideas for this column can be e-mailed to Dr. Fleming at Or you can write your medical questions to Dr, Fleming at AskDrFleming, 8931 E. 30th Street, Indianapolis, IN 46218. On written correspondence, please include your name and city (names will not be published).