Even though the current U.S. measles outbreak is the worst in 20 years, the 288 cases confirmed to date pale in comparison to the pre-vaccination era when the disease infected 3 to 4 million Americans a year, hospitalized 48,000 and killed 500. Thanks to widespread vaccination, the U.S. is measles-free except for cases contracted abroad and brought into the country by travelers. An unintended consequence of vaccination’s success is that Americans have forgotten the risk that the virus poses to life and health.
Measles is insidious because of the way it spreads. According to the World Health Organization, the virus that causes measles can survive in the air and on surfaces for two hours. A measles carrier can be long gone from a room by the time the virus spreads to someone else. The disease can also be spread by people who are unaware they are infected.
People with measles typically do not show symptoms until 10 to 12 days after they have been infected. While measles is best known for the rash it causes, it is primarily a respiratory disease which starts in the lining of the throat and lungs. The first symptom is typically a high fever, which is followed by white spots inside the cheeks, runny nose, cough and red, watery eyes. The rash usually starts several days later on the face and neck, spreads outward to hands and feet, and lasts for five to six days.
Common complications are diarrhea, vomiting, middle ear infection and laryngitis. Measles can inflame the airways and lungs, leading to pneumonia, bronchitis and croup. High fevers can lead to seizures, particularly among young children.
Like most viral diseases, there is no drug to cure measles once it strikes. It is never pleasant, but most cases resolve themselves without permanent harm.
Left untreated, though, measles has the potential to damage every organ in the body, posing a risk to both health and life. Ear infections can result in deafness, and infections of the optic nerve can cause blindness. Measles can lead to potentially lethal conditions including meningitis (infection of the membrane around the brain and spinal cord), encephalitis (brain swelling), heart damage and liver damage (hepatitis).
Measles is a particular threat for pregnant women. It can lead to miscarriages, still births, premature deliveries and underweight babies.
The danger from complications is greatest for children under one year of age, children who are malnourished, and children with weakened immune systems, including children with HIV/AIDS or children who are undergoing chemotherapy for leukemia. Teens and adults are at higher risk than children who are over the age of one and otherwise healthy.
Measles does not have to pose a risk to life and health. Odds of catching the virus can be minimized, if not eliminated, by getting vaccinated. Many victims of the current outbreak are members of Ohio Amish communities who were not vaccinated. They were exposed to measles by missionaries who brought the disease home with them from the Philippines. (Since the health threat has been recognized, the Amish have helped to contain it by getting immunized or, if they are already sick, staying home, according to Knox County, OH Health Commissioner Julie Miller.)
By J.W. Huttig