There’s been quite a bit about it in the news lately, but few of us have knowledge of, or experience with this disease. That’s because this highly infectious viral illness was virtually eradicated in this country by an aggressive immunization campaign that began about five decades ago. By the year 2000, measles (also called Rubeola), was declared eliminated in the United States. The rest of the planet has not been so fortunate. Measles remains one of the leading causes of death worldwide; in developing countries it’s estimated there are about 30 million cases per year resulting in more than one million deaths.
Measles were first reported by Persian physicians as early as 900 A.D. The name comes from the Middle English term “mesels”, meaning speck, referring to the very characteristic rash associated with this illness. For centuries the nature of the scourge remained a mystery, until it’s identity as a contagious process was confirmed in the mid 1700’s. We now know it is caused by an RNA virus; viruses are particles much smaller than bacteria that damage our systems by inserting their genetic material into our cells. Measles is an extremely contagious disease spread by airborne droplets released by the sufferer’s sneeze or cough. 90% of exposed ,non-immune individuals will get sick with the disease within 2 weeks. The illness usually starts with a high fever, often exceeding 104 degrees. Then a trio of symptoms evolves: conjunctivitis (itchy, red eyes), coryza (runny nose) and cough. Following that, the classic rash erupts, red and itchy, starting at the hairline and spreading down the entire body. It usually lasts 5-7 days. Afterwards, most folks fully recover and are left with lifelong immunity. Not everyone fares as well, though. 30 % of the afflicted will develop complications.
Secondary infections such as pneumonia or ear infections can occur, sometimes leading to deafness. And the nervous system can get involved; a particularly dangerous brain condition called Measles encephalitis can develop; this is associated with seizures and blindness. Ten percent of patients who develop this severe complication will lose their life to this viral process. There is no specific treatment or cure for measles, which makes prevention by vaccination the key strategy to managing epidemics. If illness occurs, though, a patient may be helped tremendously, by intravenous fluids. Also, because individuals with low vitamin A levels have been shown to have much worse outcomes, Vitamin A supplementation is routinely part of the supportive care provided to a measles sufferer.
Unfortunately, these simple supportive measures are too often unavailable in third world countries and as a result many impoverished people, particularly children, still lose their lives to this preventable malady. Before the measles vaccine was easily obtainable,it was estimated there were an average of 3-4 million cases in America annually, with 400-500 deaths. The highly effective vaccine became available in the mid-1960’s after a decade of research trying to identify and study the culprit. It was soon realized that giving the vaccination too early, before a child’s first birthday, was not effective, as those young infants still have anti-measles antibodies in their bloodstream from their mothers which interfere with the bodies response to the shot. So now the first measles vaccine–usually conjoined with vaccines against mumps and rubella in mixture called “MMR”–is given AFTER the first birthday. A second shot is recommended at about age four; this has been shown to grant measles immunity to the 5% of kids that did not respond to the first shot. Measles vaccination can and should be given to people of any age, however, if they are susceptible to this illness. Despite being declared measles free in 2000, the United States has suffered a recent measles outbreak which is of great concern to physicians in light of measle’s deadly potential. 141 cases, in 7 states, were reported in 2014, almost all of which occurred in non-vaccinated individuals. And in just the 7 weeks of 2015, there have been 154 cases in 17 states.
There are varied reasons for vaccination absence; some communities, such as the Amish, maintain a cultural objection. Others hold on to unfounded fears that vaccination is linked to autism, an idea that has been thoroughly and repeatedly debunked by scientists. It is poverty, once again,though, that is the largest offender. Many countries lack the funds, education and infrastructure to support an aggressive vaccination campaign. Measles is an extremely contagious & severe illness with no known cure. It is a major killer in non-industrialized nations, and even in the highly advanced areas of Western Europe and North America it represents a serious threat to public health.
In order to reduce your chances of succumbing to this disease, get immunized ! If you are unsure of your vaccination status, your doctor can run a simple blood test to determine if you are vulnerable. And as a nation, we can protect our well-being supporting efforts to improve medical practices around the globe. Not all viral illnesses can be avoided,but fortunately,this one can.