What parents need to know about measles

Measles is a serious respiratory illness that is highly contagious. Thankfully, no cases have been reported in the Rochester Community School District or the Caring Steps community. With the current measles outbreak in the Metro Detroit area, however, parents may have questions about protecting their families.
 
The Michigan Department of Health and Human Services (MDHHS) has confirmed more than 40 cases in Oakland, Washtenaw and Wayne counties. Infected individuals range in age from 8 months to 63 years, according to health officials.
 
Measles is a highly contagious, vaccine-preventable disease that is spread by direct person-to-person contact, and through the air. The Centers for Disease Control and Prevention (CDC) reports measles is so contagious that if one person has it, 9 out of 10 people around him or her will also become infected if they are not protected. Your child can get measles just by being in a room where a person with measles has been, even up to two hours after that person has left. An infected person can spread measles to others even before knowing he/she has the disease—from four days before developing the measles rash through four days afterward.
 
Parents are urged to review this information provided by the Oakland County Health Division to help address many of your concerns. If you have questions, please contact the Oakland County Health Division’s Nurse On Call at 800-848-5533 or noc@oakgov.com. For information about the measles outbreak, visit www.oakgov.com/health or Michigan.gov/MeaslesOutbreak.
 
What is measles?
Measles is a respiratory illness with rash caused by the rubeola virus.
 
Who can get measles?
Anyone who has not received two documented doses of MMR or has not had a confirmed case of measles can get measles. If exposed, approximately 90 percent of people who have not been vaccinated or previously had measles will develop the disease.
 
What are the symptoms of measles?
Measles starts with a fever and at least one of the "three Cs": cough, coryza and conjunctivitis. It's followed by a rash that starts on the face and spreads over the body.

• High fever (over 101˚ F)
• Cough
• Coryza (runny nose)
• Conjunctivitis (red, watery eyes)
• Tiny white spots on the inner cheeks, gums, and roof of the mouth (Koplik Spots) 2-3 days after symptoms begin
• A rash that is red, raised, blotchy; usually starts on face, spreads to trunk, arms, and legs 3-5 days after symptoms begin

 
How long after exposure do symptoms begin?
Symptoms usually begin 7-14 days after exposure, but can appear as long as 21 days after exposure. If symptoms develop, call ahead before you visit your doctor, urgent care or emergency room so they can take precautions to prevent exposure to other individuals.
 
How is measles spread?
Measles is a very contagious disease that is easily spread by person-to-person direct contact and airborne spread of droplets from the nose, throat, and mouth through sneezing, coughing, and speaking. It is spread through even minimal air exposure and contact with contaminated surfaces.
 
How long is a person contagious?
Measles can be spread four days before developing the rash through four days after the rash appears. Measles is highly contagious. A person can be infected with measles just by being in a room with an infected person, even up to two hours after the infected person has left.
 
I have been exposed to someone with measles, what do I do?

• Unvaccinated individuals need to get vaccinated within 72 hours of exposure. If you do not have a record of receiving two measles (MMR) vaccines, unsure if you have been vaccinated, or unsure if you have had measles in the past, contact your healthcare provider.
• Immune Globulin (IG) treatment is effective within six days of exposure for high-risk individuals including those who are unvaccinated or unsure about vaccination status, pregnant women, and those with a weakened immune system due to illness and diseases like HIV, malnutrition, and/or medications.
• If symptoms develop, call ahead before you visit your doctor or emergency room so they can take precautions to prevent exposure to other individuals.
• Stay home if you are sick and don't allow visitors in your home as measles is highly contagious.
• Watch for symptoms for 21 days after potential exposure. Call your preferred healthcare provider if symptoms develop and you believe you were exposed.

 
Are there complications from measles?
Measles can make individuals very ill. Encephalitis (inflammation of the brain) is a serious complication of measles. A more common complication of measles is an ear infection or pneumonia. During pregnancy, measles may cause preterm birth or the baby being born at a low birthweight. Death due to measles is rare in the U.S.
 
Is there a treatment for measles?
If exposed to someone with measles, unvaccinated individuals or those without evidence of immunity can be vaccinated within 72 hours of exposure to help prevent disease. Immune Globulin (IG) treatment is effective within six days of exposure for high-risk individuals.
Bed rest at home for at least four days after the appearance of the rash is necessary to not infect others. Supportive care can be given to relieve symptoms and address complications.
 
How can measles be prevented?

• Measles is preventable by vaccination.
• If you do not have a record of two documented measles (MMR) vaccines from a doctor or in the Michigan Care Improvement Registry (MCIR), unsure if you were vaccinated, or unsure if you had measles in the past, contact your healthcare provider about getting vaccinated.
• Measles vaccine is a two-dose series. If you have two documented doses of the MMR vaccine you do not need another dose.
• All healthy children should be vaccinated at 12 - 15 months with the combination shot for measles, mumps, rubella (MMR).
• A second MMR vaccine is usually given at 4 - 6 years of age, but can be given earlier if it is at least four weeks after the first dose. Children who receive two MMR vaccines at least four weeks apart at any time after the age of 12 months are considered to have completed the MMR series. 
• Some infants under 12 months should get a dose of MMR if they are in an area with ongoing transmission or are traveling out of the country. This dose will not count toward their routine series, so these children would still need to receive two MMR vaccines after 12 months of age. Contact your healthcare provider to determine if your infant should get a dose of MMR.
• Adults born in 1957 or later should receive at least one dose of MMR vaccine unless they have other acceptable evidence of immunity. A second dose of MMR vaccine is needed for adults who may have been exposed to a measles case, or those who are students in colleges/universities, work in health care, or plan to travel internationally. Check with your health care provider to see if you need to be vaccinated.
• In an outbreak situation: potentially exposed individuals without documentation of two MMR doses should receive a dose of MMR.
• Pregnant women should not get vaccinated as this is a live viral vaccine.
• All women of childbearing age should avoid contact with those who have measles.
• Be sure to keep a record of all immunizations. Write down when the shots were received.

 
What if measles occurs at school or a day care center?
All cases must be reported to your local health department within 24 hours. People born in 1957 or later who cannot prove that they either have had: laboratory evidence of immunity to measles, or measles vaccine after 12 months of age and a second dose at least four weeks later, should get a measles vaccine. Otherwise, they will be excluded from school/day care for at least 21 days after the beginning of the last measles case.
 
The Caring Steps staff is cautious in protecting the health and wellness of our children and families. If you suspect you may have a contagious condition, you are urged to stay home and seek medical attention to prevent infecting others.
 
The following information is available from reputable sources.
 
Downloadable fact sheets are available here:
Measles, What You Need to Know, Oakland County Health Division
Top 4 Things Parents Need to Know About Measles, Center for Disease Control and Prevention
 
Sources with links: Oakland County Health Division, Centers for Disease Control and Prevention, Michigan Department of Health and Human Services, HealthyChildren.Org
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