Measles on the rise
On March 18, the Centers for Disease Control and Prevention issued a Health Advisory warning of an increase in both global and U.S. measles cases. There were 132 confirmed cases in the U.S. from January 1 to May 9, which emerged as a result of eight outbreaks compared to a mere 58 cases in total in 2023. As practicing pediatricians trained since the widespread use of vaccines, we have never seen measles and never expected to see it in our careers. Some of our colleagues have seen measles, and their stories reinforce the severity of the disease. The rapid rise in measles cases is worrisome as it is affecting children in growing numbers around the world. We need to stop it together.
What is measles?
Measles is a virus that spreads very easily. Nine out of 10 unvaccinated children exposed to measles will get the disease. It causes high fever, cough, runny nose and eye redness followed by a rash. Children can also have life-threatening complications like pneumonia and swelling of the brain. Symptoms can take up to three weeks to appear after exposure.
How did measles come back?
In pre-vaccination years, there were 3 to 4 million cases of measles and 400 to 500 deaths from measles each year in the U.S. The measles, mumps and rubella vaccine (MMR) was introduced in 1963. By 2000, measles cases decreased by 90% and were virtually eliminated in the U.S. This means that cases seen in the U.S. after 2000 were more likely due to travel than being exposed to the virus in the U.S.
Vaccination rates have dropped since the 1980s, partly because of vaccine misinformation. The COVID-19 pandemic also made it difficult for children to get vaccinated against other non-COVID viruses.
These low vaccination rates have resulted in the measles virus making a comeback in the U.S. The measles virus is still common around the world and it is increasing globally because of low vaccination rates. When children travel to the U.S. or unvaccinated children from the U.S. travel to other countries, the virus can spread.
What is causing the current outbreaks?
If a child with measles is in contact with a child too young to receive the MMR vaccine, there will usually be a small number of cases. Others may be vaccinated so the virus stops spreading. Outbreaks in the U.S. happen when one of these measles cases finds a group of unvaccinated children and keeps spreading.
This year, 20 states have reported measles cases, with recent outbreaks in Chicago, New York and Florida.
How do I protect my children?
Getting the vaccine is much, much safer than getting the measles virus. The comparison is not even close.
Make sure your child is vaccinated. The MMR vaccine is safe and highly effective. Children should have one dose at 1 year old and a second dose at 4 years old. If your baby will be traveling out of the country, talk to their pediatrician about vaccinating as young as six months old. Two doses of the vaccine protect 98% of children, so they are unlikely to get the virus if they are exposed.
If finding a vaccine is difficult for your family, there are options for free vaccines for children who qualify through the Vaccines for Children Program. You can find a clinic here: https://findahealthcenter.hrsa.gov/ (site in multiple languages).
What else can we do?
Making sure your family is vaccinated is critical, but there are other ways we can prevent measles from spreading in our communities. Make sure you are registered to vote and choose candidates who you believe prioritize your community’s health. We can encourage our local representatives to write and vote for policies that encourage high vaccination rates and require proof in daycares and schools. We can also encourage public health surveillance and participate in community surveys given by our local and national public health officials.
By Drs. Megan Carey, pediatric global health resident and Lindy McGee assistant professor, pediatrics – academic general, Baylor College of Medicine
