Dear Doctor: I've been reading about measles outbreaks in the United States and abroad. Are these new cases really all that dangerous? As an adult, should I get vaccinated?
Dear Reader: Measles is an ancient and highly contagious respiratory infection. It has inspired fear and dread from its earliest written references, which date all the way back to 600 A.D.
It wasn't until many centuries later, in 1954, that researchers were finally able to isolate the virus that causes the disease. In 1963, scientists in the U.S. developed a successful measles vaccine. Thanks to an aggressive national vaccination program, which continues today, what had once been a common and often-fatal disease has became a rarity. In fact, the Centers for Disease Control and Prevention declared measles officially eradicated in 2000 in the U.S.
Recently, though, as you point out, new outbreaks of measles have made news.
An infected person who visited Disneyland in California a few years ago spread the disease to 100 people. In 2016, more than 62 people in 17 states contracted the disease, the majority of whom had not been vaccinated.
The hard truth is that individuals who refuse to become vaccinated, and those who withhold the vaccine from their children, put themselves and others at risk of both the disease and its often-grave complications.
Measles, also known as rubeola, is closely related to the canine distemper virus. It's a leading cause of death among children worldwide, with most victims under 5 years old. Measles is so contagious that 90 percent of the people close to an infected person who are not themselves immune will also become infected.
The virus spreads through contact with contaminated saliva or mucous. With a single sneeze, a person who has measles can disperse the virus to multiple surfaces where it is capable of surviving for several hours.
Symptoms, which include high fever, cough and runny nose, appear one to two weeks after infection. These are followed in two or three days by white spots that appear inside the mouth. Within five days, a rash breaks out. At this point, fever spikes, often to more than 104 degrees.
About one-third of those who get the measles suffer from complications, which include diarrhea, severe ear infection and pneumonia. These are most common among children under 5 years old and adults over 20, and make a case of measles particularly dangerous for these age groups.
And it's not just contracting the virus itself that's so perilous.
New research reveals that the virus can spread to the brain. Once there, it may remain dormant for years. When it finally reappears, it is in the form of a progressive and debilitating brain disorder known as subacute sclerosing panencephalitis, or SSPE. There is no cure, and the condition is often fatal.
As to your question of whether you should be vaccinated, that depends. If you've already been vaccinated or have had a case of measles in the past, the answer is no. But if you have neither had measles nor a previous vaccination, then the answer is yes! You should call your family physician as soon as possible and discuss how to move forward.
(Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health.)
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