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FAQ MEASLES

Frequently Asked Questions about Measles

Updated: April 29, 2015
 
A second case of measles (rubeola) has been diagnosed in an unvaccinated adult resident of Spokane County. This individual was not seen in any health care settings and is a close contact of the first case, previously confirmed to have measles on April 21.
 
Most people have immunity to the measles through vaccination, so the risk to the general public is low. But with confirmation of measles virus here, Spokane Regional Health District (SRHD) is advising individuals to check their children’s and their own vaccination status and verify that they are up-to-date with the measles mumps rubella (MMR) vaccine.

What should I know about Spokane's confirmed cases?

Before receiving the measles diagnosis, the second individual confirmed to have the virus was in the following public locations. Anyone who was at these locations during the times listed was possibly exposed to measles:
 
Thursday, April 23
7:30 a.m. – 3:30 p.m.
Madeleine’s Café – 415 W Main
 
Thursday, April 23
5:00 p.m. – 8:00 p.m.
WinCo Foods – 9257 N Nevada
 
Friday, April 24
7:30 a.m. – 3:00 p.m.
Madeleine’s Café – 415 W Main
 
If you were at these locations at the times listed above and are not immune to measles, the most likely time you would become sick is between April 30, 2015 and May 15, 2015. If an individual is experiencing symptoms of measles (high fever, cough, runny nose, red eyes, rash) and believes they may have been exposed, they should contact their health care provider. The health district also still encourages anyone who was at these locations related to the first measles case to contact their health care provider if symptomatic. 

How can I protect myself and family?

MMR vaccine is the best protection against measles. Review your own and your family’s vaccine records for MMR and make sure all other immunizations are up to date. Talk to your health care provider for further information and recommendations.
 

FAQ Sections

About Measles

What are the symptoms of measles?

Measles causes fever, runny nose, cough, and a rash all over the body. People can spread measles before they show symptoms.

How soon do symptoms appear?

  • 7 to 21 days after exposure: mild to moderate fever, cough, runny nose, red eyes, and sore throat.
  • 2 to 4 days after symptoms begin: tiny white spots may appear inside the mouth.
  • 3 to 5 days after symptoms begin: a red or reddish-brown raised rash that feels like sandpaper appears, usually beginning on the face. The rash rapidly spreads down the neck, upper arms, and chest. Later, it spreads over the back, abdomen, the rest of the arms, thighs, legs, and feet. When the rash appears, a person’s fever may spike to more than 104 degrees Fahrenheit.
Symptoms usually last seven to 10 days.

Who is at risk from measles?

Anyone who hasn’t been immunized or had measles in the past is at risk. Babies younger than 12 months are at risk because most are too young to have been vaccinated yet. Pregnant women, young kids, and people with weakened immune systems are at highest risk for complications from measles.

What if someone in my family may have measles or was exposed to someone with measles?

If you or someone in your family was in one of these locations, associated with first case, or one of these locations associated with second case, during the specified times, call your health care provider, especially if you do not have immunity to the measles. Before you go to the doctor’s office, call to tell them that you or your family member might have measles. This will allow them to take steps to avoid exposing other people. Try to stay away from other people until at least four days after the rash starts or a test proves it’s not measles.

How is measles prevented?

Getting vaccinated is the best protection against measles. When more than 90 percent of people are vaccinated against measles, the disease slows down and doesn’t spread. This is called community (or herd) immunity.

How is measles treated?

There is no specific treatment for measles. The MMR (measles, mumps, rubella) vaccine may prevent illness if given to unvaccinated kids over 12 months of age or adults within the first three days after being exposed to measles.

What is measles?

Measles is a highly-contagious respiratory disease caused by a virus. It spreads easily through coughing and sneezing. Measles starts with a fever, runny nose, cough, red eyes, and sore throat, and is followed by a rash that spreads all over the body. It spreads so easily that someone who is not protected (either by being immunized or having had measles in the past) can get it if they walk into a room where someone with the disease has been in the past couple of hours.

How serious is measles?

Measles spreads so easily that anyone who is exposed to it and is not immune (for example, someone who has not been vaccinated) will probably get the disease.
 
Measles is a very serious disease. About one out of 10 children with measles also gets an ear infection, and up to one out of 20 gets pneumonia. One or two out of 1,000 die from measles complications. Measles can also cause pregnant woman to miscarry or give birth prematurely. Complications from measles are very common among children younger than five and adults older than 20.

What does measles look like?

The Centers for Disease Control and Prevention offers photos that show what measles looks like.

What is the difference between rubella and rubeola (measles)?

Rubella, also called German measles or three-day measles, is a contagious viral infection best known by its distinctive red rash.

Rubella is not the same as measles (rubeola), though the two illnesses do share some characteristics, including the red rash. Rubeola, sometimes referred to as 'hard measles' or 'red measles' is the measles virus that is confirmed in Spokane. Rubeola (measles) is caused by a different virus than rubella, and is generally more infectious and more severe than rubella.

Isn’t measles rare in the United States?

Before the measles vaccine was introduced, measles caused about 400 deaths in the United States each year. Most Americans are now vaccinated against measles or have natural immunity, but outbreaks do happen. Most commonly, measles is brought into the United States by someone who has traveled outside the country. When unvaccinated people are exposed, measles spreads very quickly.
 
In a typical year, there are about 60 cases nationally, but there were 189 in 2013. While Washington typically has five or fewer cases a year, there were 32 cases reported in 2014.

Where can I get more information about measles?

  

About the Measles Vaccine

What is the measles vaccine?

The most common vaccine for measles is MMR, which protects against measles, mumps, and rubella.

Who needs the measles vaccine (MMR)?

Kids need two doses of MMR – the first dose at age 12-15 months and the second at four to six years of age.
 
Young kids who travel abroad and who are at risk need extra measles vaccine:
  • Infants six to 11 months old need one dose of MMR before travel. In addition, they still need to get both regular measles vaccine doses – the first at 12-15 months old and the second at 4-6 years old.
    • Kids 12 months or older need two doses of MMR (separated by at least 28 days) before travel.

Adults born in 1957 or later should get one dose of the vaccine if they have not had measles or did not get the vaccine in 1968 or later. If you’re unsure, you can have a blood test done that will let you know if you have immunity. Unsure adults can also still get the vaccine, since there is no harm in getting it a second time.

How do I get my level of immunity to measles checked? Someone mentioned a blood test called a "titer?"

Individuals not being monitored by the health district, but interested in obtaining this blood screening test, can talk to their health care provider, or simply walk into any PAML patient service center and pay $45 to get the test. The immunity screening test (also called a titer) measures antibody levels to determine whether an individual’s immune system has the capability to respond to a measles infection. If the antibody level is negative, an individual should consider getting an MMR vaccine.

 

Do people who received measles vaccine in the 1960s need to have their dose repeated?

Yes, unless you have documentation of receiving LIVE measles vaccine in the 1960s. If you have this documentation, then you do not need to be revaccinated.

People who were vaccinated prior to 1968 with either inactivated (killed) measles vaccine or measles vaccine of unknown type should be revaccinated with at least one dose of live attenuated measles vaccine. This recommendation is intended to protect those who may have received killed measles vaccine, which was available in 1963-1967 and was not effective.

Why are people born before 1957 exempt from receiving MMR vaccine?

People born before 1957 lived through several years of epidemic measles before the first measles vaccine was licensed. As a result, these people are very likely to have had the measles disease. Surveys suggest that 95% to 98% of those born before 1957 are immune to measles. Note: The "1957 rule" does not apply to women of childbearing age who could become pregnant. (Because rubella can occur in some people born before 1957 and because congenital rubella and congenital rubella syndrome can occur in the offspring of women infected with rubella virus during pregnancy, birth before 1957 is not acceptable evidence of rubella immunity for women who could become pregnant.)

If I previously had measles, does that mean I'm now immune from getting it again?

If a person was previously diagnosed with rubeola (measles), they have lifetime immunity protecting them from contracting measles again.

Note that rubeola is not the same as rubella, also called German measles or three-day measles, which is also a contagious viral infection best known by its distinctive red rash. Since rubella is caused by a different virus, it does not provide immunity against rubelo (measles).

 

Vaccine Safety and Monitoring

Are there side effects from the vaccine?

Like any medication, the measles vaccine (MMR) may cause side effects. Most are mild:
  • Pain at the injection site
  • Fever
  • Mild rash
  • Swollen glands in the cheek or neck

Is the measles vaccine safe?

Research has shown that the measles vaccine (MMR) is safe. Getting vaccinated is much safer than getting any of the three diseases the vaccine protects against.
 
You can get more information on the safety of the MMR vaccine from the Centers for Disease Control and Prevention.

How are vaccines monitored for safety?

Vaccines are tested before they’re licensed for use. Once a vaccine is in use, the Centers for Disease Control and Prevention and the Food and Drug Administration always monitor the vaccine to make sure it’s safe and effective.

Since this is a "live" vaccine, can someone recently immunized spread the virus to someone who is unvaccinated?

Available since the 1950s, live attenuated vaccines (LAV), like the MMR vaccine, are prepared from living micro-organisms (viruses, bacteria) that have been weakened under laboratory conditions. They then replicate in a vaccinated individual and produce an immune response that protects the person from the virus, but usually causes mild or no disease. According to the Control of Communicable Diseases Manual, the MMR vaccine has not been shown to be communicable, meaning it can not be spread or "shed" from a recently-vaccinated individual to an unvaccinated person.

 

Where to Get the Measles Vaccine

Where can I get the measles vaccine?

For those who are uninsured or underinsured, area Walgreens pharmacies have a limited supply of low-cost MMR vaccine.
 
Also, area Safeway pharmacies are able to administer MMR vaccine to children beginning at age 1.
 
If you need help finding a health care provider or if you don’t have health insurance, call the Family Health Hotline at 1-800-322-2588 or visit ParentHelp123 website.

Are there vaccination clinics?

Check the Spokane Regional Health District's event section on its home page.
 
 

How to Pay for the Measles Vaccine

How can I pay for the vaccine if I’m uninsured?

For those who are uninsured or underinsured, area Walgreens pharmacies have a limited supply of low-cost MMR vaccine.
 
There also may be programs that can help you. Call the Family Health Hotline at 1-800-322-2588 or visit parenthelp123 website for more information.
 
 

For Pregnant Women and New Parents

Should pregnant women get the measles vaccine (MMR)?

Pregnant women should not get the MMR vaccine. Pregnant women who need the vaccine should wait until after giving birth. Women should avoid getting pregnant for four weeks after getting the MMR vaccine.

How soon can a new baby get vaccinated against measles?

The recommendation for babies is to get the first of two doses of MMR at 12-15 months of age. The second dose, usually given at 4-6 years, will provide full protection for your child.
 
If you plan to travel out of the country with a baby who is between six and 11 months old, your baby should get a dose of MMR before traveling. He or she will also still need the two regular doses at 12-15 months and 4-6 years.
 
Also, if an area is considered to be in outbreak status, CDC's Pink Book specifies that the the vaccine may be administered at an age younger than 12 months (this dose would not be counted, and should be repeated at 12 months of age or older).
 
For Babies Under 6 Months of Age: If a baby’s mother has had her MMR shots and/or had measles infection in her life she passed antibodies to her baby during fetal development while in-utero and continues to pass them passively while breastfeeding. Those antibodies provide protection for young infants and typically are thought to protect infants for up to 6 months or more. The reason babies don’t get the MMR shot sooner than a year of age is because of the persistence of these maternal antibodies — if you put a vaccine in while maternal antibodies are still around the vaccine won’t stimulate the baby’s own immune system to respond, it will just get soaked up by the maternal antibodies doing their job.

Is it okay to go to the grocery store or have a playdate with your infant? 

Yes! With a few caveats, of course. If you’re in a county where multiple cases of active measles have been recently reported you may take more caution, disallowing strangers to hold your baby and/or steering clear of anyone with a cough. Measles is infectious on surfaces and in the air for 2 hours after an infected individual is there so it’s tricky to provide solid guidelines of how to avoid it if it’s around. If ever ANY concern for exposure, call your pediatrician to discuss a visit. Like everything in life we balance risk with benefit and being out and about in the world. If planning on visiting with guests or sharing in on a playdate, why not ask parents to children involved, “Is everyone here immunized against measles that can be?

Should new parents and caregivers get vaccinated?

If parents or caregivers haven’t gotten the MMR vaccine or had measles in the past, they should get vaccinated. It’s important to make sure people who are around your new baby do not expose your baby to measles – and other diseases like whooping cough – that your baby is too young to be vaccinated against. This includes siblings, who should also be up-to-date on all their childhood vaccines for their own protection and to protect the baby.
 
 

For People Traveling Outside the United States

Do I need to get the measles vaccine (MMR) if I’m traveling outside the country?

If you are not immune to measles – either from being immunized or having had measles in the past – you are at risk for getting measles. Even though measles is pretty rare in the United States, it’s still a very common disease in many other countries.
Anyone who has not been vaccinated or had measles in the past should get vaccinated before any travel outside the United States:
  • Infants aged six through 11 months should get one dose of measles vaccine (they will still need two additional doses, per the recommended schedule – one at 12-15 months and another at 4-6 years).
  • Children 12 months of age or older should get two doses separated by at least 28 days.
  • Adolescents and adults should get two doses separated by at least 28 days.
The Centers for Disease Control and Prevention offers more information on measles and international travel.
 
 

For Health Care Workers and Providers

Is the measles vaccine (MMR) recommended for health care workers?

Health care workers and providers in medical facilities should be immune to measles, mumps, and rubella. Those workers who were born in 1957 or later can be considered immune only if they have documentation of:
  • Lab confirmation of disease or immunity, or
    • Two doses of live measles and mumps vaccines given on after the first birthday and separated by 28 days or more and at least one dose of live rubella vaccine

There is a dedicated page for health care providers on the SRHD site located here.

Do I need to report measles cases?

In Washington state, measles is a notifiable condition. This means all health care providers and facilities must immediately report all confirmed and probable measles cases to Spokane Regional Health District.

Where can I get more information about measles?

 

During a Measles Outbreak

There’s a measles outbreak in my community. How can I protect myself and family?

MMR vaccine is the best protection against measles. Review your own and your family’s vaccine records for MMR and make sure all other immunizations are up to date. If there’s a measles outbreak in your community, talk to your health care provider for further information and recommendations.

What should I do as an adult during a measles outbreak?

Unless an adult has evidence of immunity (meaning they were born before 1957, have lab evidence of immunity to measles, or documentation of measles vaccination) he or she should get at least one dose of MMR vaccine unless the person is in a high-risk group. If an adult is at high risk, he or she should get two doses of MMR vaccine. Adults at high risk include healthcare workers, international travelers, college students, and others. Call your health care provider, or contact your local health department.

I’m pregnant and I plan on breastfeeding after I have my baby. Is it safe to get the MMR vaccine?

Pregnant women should not get the vaccine. You can get MMR vaccine any time after delivery. If you are susceptible to measles, mumps, or rubella, you can get MMR vaccine before hospital discharge, even if you get RhoGam during your hospital stay. Breast feeding does not interfere with the response to MMR vaccine, and your baby will not be affected by the vaccine through your breast milk.

We have an 8-month-old and we have travel plans to an area where there is known outbreak. We will be leaving next week. Is it safe to travel?

Please talk to your health care provider first. If you are traveling to an area with a known outbreak, the MMR shot can be given to kids 6 through 11 months of age. The MMR given before your child’s first birthday does not count as part of the 2-dose series. Instead, repeat the dose when the child is 12 months of age (as long as 28 days have passed since the last dose). It’s best to get your shot a month in advance if you’re traveling. Your health care provider knows you and your family best and can make the best determination based on his/her assessment.

We are grandparents and traveling to an outbreak area to babysit our grandchildren. We can’t remember having the measles or the shot and we can’t find our records. What should we do?

Without a written record, it’s hard to know what type of vaccine you may have received. If you were born before 1957 you are considered immune. Acceptable evidence of measles immunity includes a positive titer for antibody, birth before 1957, or written documentation of vaccination. A personal history of measles is not acceptable as proof of immunity. If your titer is not positive, you can have 1 dose of MMR.

My doctor does not have MMR vaccine. Where can I get it?

Individuals unable to get MMR vaccine through their provider should:

I’m looking for the measles-only vaccine. I've called a couple clinics and they don’t have it. Where can I find this?

The manufacturer no longer produces single antigen measles, mumps, and/or rubella vaccines for the U.S. market. Only combined MMR is available.
 

Related Resources

SRHD
Measles Fact Sheet

For Health Care Providers

Public Health - Seattle and King County
Translated Measles Fact Sheets - Chinese, Korean, Russian, Somali, Spanish and Vietnamese

Washington State Department of Health
Do You Have the Measles

U.S. Centers for Disease Control and Prevention (CDC)
Measles Infographic (Not Just a Rash)
Frequently Asked Questions (Centers for Disease Control and Prevention)
For Parents (Centers for Disease Control and Prevention)
For Travelers (Centers for Disease Control and Prevention)
For Pregnant Women (Centers for Disease Control and Prevention)Videos and Podcasts (Centers for Disease Control and Prevention)
For Healthcare Providers (Centers for Disease Control and Prevention)



 

 

 

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May 27, 2016