As parents or caregivers of young children, making sense of health-related information is challenging, especially regarding childhood illnesses and vaccines. For example, you may have heard about measles outbreaks in the news. Let’s review the most commonly-asked questions about measles in children to help put your mind at ease.
What is measles?
Measles is a highly-contagious infection caused by a virus. Once in the air, measles can infect anyone who comes into contact with it for up to two hours. Direct contact with fluids from the nose or mouth of an infected person can also transmit the virus. Vaccination with the Measles, Mumps, and Rubella (MMR) vaccine is the highest level of protection against measles.
How does the measles (MMR) vaccine protect children?
The MMR vaccine prevents children from getting infected with the measles virus in the first place. Before widespread measles vaccination in the U.S., measles used to infect between three to four million Americans yearly. Worldwide, major epidemics occurred approximately every 2–3 years. Worldwide, measles vaccination resulted in a seventy-three percent drop in measles deaths between 2000 and 2018. The CDC declared measles eliminated (absence of continuous disease transmission for greater than 12 months) from the U.S. in 2000.
What about recent measles outbreaks in the U.S.?
Since 2016 there have been several smaller measles outbreaks (there were 24 measles cases in five different locations in the U.S. in 2022, for example). The CDC believes outbreaks like these occurred because:
- There was an increase in the number of travelers who get measles abroad and bring it into the U.S.
- There is further spread of measles in U.S. communities with pockets of unvaccinated people.
To prevent measles outbreaks within a community (also known as herd immunity), the vaccination rate for the population needs to be above 95 percent. In other words, if a community has 100 people, at least 95 people must be fully vaccinated to prevent an outbreak.
If you and your child are fully vaccinated with the MMR vaccine, you have a very low risk of getting sick with measles. The vaccine works very well, it’s about 97% effective! Infants too young for the vaccine (less than one year) and adults with certain medical conditions who can’t get vaccinated are at the greatest risk of getting seriously ill from a measles infection.
When should my child get the MMR vaccine?
According to the CDC, children should get the MMR vaccine when they are:
- 12 to 15 months old for the first dose
- 4 to 6 years old for the second dose
Children as young as 6 months may be eligible for vaccination in certain circumstances, particularly for any local outbreaks (with or without known exposure) or planned international travel. Talk to your pediatric provider if you’re wondering if this would be best for your child.
What are the risks or complications of measles infections in children?
In the short-term, young children with measles may develop other symptoms, including an ear infection, croup (a type of cough), diarrhea, pneumonia (a lung infection), and seizures (often associated with high fevers). Rarely, measles can cause hearing loss, permanent brain damage, or death if the infection worsens.
There are some rare long-term effects of measles to know about. Children who have recovered from measles may have an increased risk of severe infections for months or years through a process called immune amnesia. Imagine your body forgot every illness it ever had, and you had to start from scratch fighting off every bug. In addition, there is a fatal syndrome called SSPE which develops after it appears someone has recovered from measles.
All of these can be avoided through routine vaccination with the MMR vaccine. The MMR vaccine is a safe and well-tolerated vaccine. It carries none of the risks of measles infection and is recommended by the AAP, CDC, and WHO. Intentionally exposing your child to measles to avoid vaccination and gain immunity through illness is not recommended. Your child may not acquire measles or immunity, or they may get severe measles and suffer any of the complications listed above. There is no way to predict which child will become seriously ill.
What are the symptoms of measles in children?
Measles signs and symptoms appear around 7 to 14 days after exposure to the virus. Measles symptoms can include:
- A blotchy red skin rash, commonly starting on the face, made up of large, flat blotches that can run into one another
- Dry cough
- Runny nose
- Fever
- Red and irritated eyes
- White spots in the mouth (Koplik spots)
- Sore throat
Children with measles usually develop cold-like symptoms before developing a rash. The cold-like symptoms tend to worsen during the first 1 to 3 days of the illness.
After the first few days of symptoms, a rash usually appears first on the face, then spreads down the arms, chest, and back, then over the thighs, lower legs, and feet over the next several days. At the same time, children’s fevers can rise sharply, often to higher than 104F.
A person with measles can spread the virus to others for about eight days, starting four days before the rash appears and ending when the rash has been present for four days. The measles rash may last about seven days.
When should you call your child’s healthcare provider if you are worried about measles?
If your child develops symptoms associated with measles, isolate and contact your healthcare provider immediately. They will examine your child or send you for lab testing to diagnose the illness. In addition, if your child was exposed to measles, contact their provider as soon as possible whether they have symptoms or not. They may be eligible for preventative treatment to decrease their risk of serious illness if they are not yet vaccinated.
Your child’s healthcare provider can help plan how to keep your child from infecting other children and adults who might be at risk. If your child has confirmed measles, your local health department requires that your healthcare provider notify them to help prevent the spread of measles in your community.
How is measles treated?
Currently, there are no specific antiviral treatments (medications to treat viruses) to help treat measles once a person becomes infected. However, high-risk infants or children can get support after exposure, so it’s important not to wait for symptoms if you know your family was exposed. Your pediatric provider can also give you information on when and where to seek urgent care if certain symptoms develop, such as febrile seizures or difficulty breathing.
If your child has contracted measles, keep them home from school or child care. Be sure they stay away from others who are not vaccinated. To help your child recover, give them plenty of liquids to drink, use a humidifier where they sleep, and keep medications for fever and pain on hand. In general, Tylenol and Ibuprofen are preferred, but ask your pediatric provider for additional guidance. Children with low levels of vitamin A are more likely to have a more severe case of measles. Therefore, your provider may direct you to use a Vitamin A supplement.
What if I have questions about measles, the MMR vaccine, or childhood rashes?
Your pediatric provider can help you understand how you can protect your family from many childhood illnesses, such as measles. They can also help you sort out your family’s vaccination records to make sure everyone is up to date. Being up to date on vaccination against measles is so important to protect them, your family, and others. Speak with your pediatric provider about recommended vaccine schedules, vaccine safety, and ways to keep your family healthy.
Reviewed by the Ovia Health Clinical Team
Sources
D’Souza RM, D’Souza R. “Vitamin A for treating measles in children”. Cochrane Database Syst Rev. 2002;(1). October 19, 2005.
“Measles”. healthychildren.org. American Academy of Pediatrics. November 21, 2015. https://www.healthychildren.org/english/health-issues/vaccine-preventable-diseases/Pages/Measles.aspx
“Measles”. Mayo Clinic. Mayo Clinic. May 11, 2022. https://www.mayoclinic.org/diseases-conditions/measles/symptoms-causes/syc-20374857
“Measles history”. CDC. CDC. November 5, 2020. https://www.cdc.gov/measles/about/history.html
“Measles”. World Health Organization. World Health Organization. December 5, 2019. https://www.who.int/en/news-room/fact-sheets/detail/measles
“Measles, Mumps, and Rubella (MMR) Vaccine Information Sheet (VIS)”. CDC. CDC. August 6, 2021. https://www.cdc.gov/vaccines/hcp/vis/vis-statements/mmr.html
