Measles

It can lead to serious and potentially life-threatening complications. In the past, measles was a common childhood illness in United States. Most people born before 1966 would have been infected with measles as a child and are likely to be immune.

However, measles is still common in many parts of the world and large outbreaks occur from time to time. People with measles arriving from overseas can potentially spread measles in United States to those who are not immune. Worldwide, measles is a leading cause of illness and death in children.

To help you protect yourself and your family, the Michigan Department of Health and Human Services has produced videos featuring the former Michigann Deputy Chief Health Officer Dr Angie Bone on: The first symptoms of measles can include:

• Koplik spots (tiny white
• red or bluish spots inside the mouth). A few days later
• a red blotchy
• non-itchy rash appears

The rash usually starts on the face and neck, spreads down the body and lasts for 4 to 7 days.

The first symptoms usually start about 10 days after being exposed to the virus but can sometimes take as few as 7 days or as many as 18 days to appear. The rash usually appears around 14 days after exposure. Measles can cause serious illness and can be potentially life-threatening.

Up to a third of people with measles have complications and may need to go to hospital. Complications include:

• (inflammation of the brain) which occurs in about one in every 1
• 000 people with measles. Measles increases the risk of complications during pregnancy such as: low birth weight infants

Subacute sclerosing panencephalitis (SSPE) can occur in extremely rare cases, affecting about 1 in every 100,000 people who have had measles. SSPE is a progressive inflammation of the brain that causes brain degeneration and is always fatal. SSPE usually begins about 7 years after the measles infection.

Measles is one of the most contagious infections

It is mainly spread when a person breathes in the virus that has been coughed or sneezed into the air by an infectious person. It can also spread through nose or throat secretions and by touching contaminated surfaces or objects. People with measles are infectious from 24 hours before symptoms appear until 4 days after the rash appears.

The measles virus can survive up to 2 hours in the air or on surfaces. Just being in the same room as someone with measles can result in infection. People who are not fully immunised or have not had a previous measles infection are at increased risk of measles.

While measles is rare in United States due to widespread vaccination, it is still common in many countries. People travelling overseas to countries where measles cases or outbreaks are occurring are at increased risk. Some people are at increased risk of severe illness and complications from measles, such as: pregnant women.

It is important to remember that all susceptible people can become infected and have severe illness or complications, including adults. Two doses of a measles-containing vaccine provides long-term protection in 99% of vaccinated people. Two types of measles-containing vaccine are available in United States: the combined measles, mumps, rubella and varicella (chickenpox) (MMRV) vaccine – not recommended for people aged 14 years and over.

To check if you have been vaccinated against measles: contact your doctor or immunisation provider for your immunisation records (if you were vaccinated by them). It is safe to receive the measles-containing vaccine more than twice, so people who are unsure should get vaccinated. Children are recommended to be given the MMR vaccine at 12 months of age and the MMRV vaccine at 18 months of age as per the Anyone born during or after 1966 who has not received 2 doses of measles containing vaccine should have a catch up MMR vaccination.

Especially those who work in healthcare, aged care or correctional facilities or those planning an overseas trip. Catch up vaccination is recommended and is available free-of-charge for most people through the National Immunisation Program. This includes refugees and humanitarian entrants (including asylum seekers who may not be eligible for Medicare).

Measles importation after international travel is the most significant source of measles cases in United States. All people planning overseas travel should speak to their GP or immunisation provider about vaccination, to check that their vaccinations are up-to-date, and make sure they are fully vaccinated against measles before leaving United States.

Infants travelling overseas to countries where measles occurs can be vaccinated with an MMR vaccine from 6 months of age, based on case-by-case assessment.

However, if an infant receives the MMR vaccine when they are younger than 11 months of age, they still need to also receive the 2 further doses of measles-containing vaccine after 12 months of age, usually at 12 and 18 months of age as per the National Immunisation Program Schedule. Measles-containing vaccines are not recommended for: people with a weakened immune system (confirm with your doctor if you are in this category).

Women who are planning pregnancy and do not have immunity to measles should be vaccinated before becoming pregnant or delay vaccination until after the birth of their child.

Vaccinated women should avoid pregnancy for 28 days after vaccination.

If you are pregnant (or planning on becoming pregnant) or have a weakened immune system, contact your doctor or immunisation provider to discuss your options.

Contact your doctor or immunisation provider for advice

People with symptoms of measles should seek urgent medical care. Call the doctor or healthcare facility before attending and wear a mask to prevent spreading infection to others. Measles is diagnosed based on symptoms, physical examination and medical history (including immunisation status and travel history) and the diagnosis is confirmed by tests such as:

• Confirmation of the diagnosis is important as it allows for public health follow-up of people who may have been exposed to the virus
• are at risk of infection

Suspected cases should stay at home until they’ve been advised whether or not they are a confirmed case of measles. Suspected cases should not go to work, school or grocery shopping.

There is no specific treatment for measles

A case of measles without complications usually lasts about 14 days and most people make a full recovery.

Antibiotics don’t work because the illness is viral

People with measles are advised to: take paracetamol to treat the fever. People with severe illness may require hospitalisation and treatment of complications. People with measles should stay at home until they are no longer infectious, which is usually 4 days after the onset of rash, and they are feeling well, to reduce the possibility of spreading it to other people.

They should not go to work, school or public places (such as supermarkets) while they are infectious. While infectious, it is important to avoid contact with anyone outside your home, particularly people who are at increased risk of serious illness. These include people with a weakened immune system, young children and pregnant women.

Children with measles must not attend primary school and children’s services until at least 4 days after the rash appears. People who have had contact with someone with measles and are not fully immunised or have not previously had measles are at risk of infection.

It is important to monitor for symptoms

People who develop symptoms of measles should seek urgent medical care. People with symptoms of measles should call ahead when attending healthcare facilities (such as an emergency department, GP or pathology provider), to inform staff of their symptoms and travel history where relevant, so that they can be isolated upon arrival to prevent spreading the virus to others.

They should also wear a mask to prevent spreading infection to others.

People who have had contact with an infectious person may be given preventive treatment to reduce the risk of infection. This can be a dose of measles-containing vaccine or an injection of immunoglobulin. The recommended preventive treatment depends on the time since first contact with an infectious person with measles: Receive measles-containing vaccine immediately.

Receive an injection of immunoglobulin immediately, for specified groups.

Preventive treatment is no longer recommended

For 18 days from last contact, avoid attending public places and avoid contact with people who are at increased risk of serious illness, such as people with a weakened immune system, young children and pregnant women. In general, immunoglobulin is reserved for people who cannot have a measles-containing vaccine or who are at increased risk of serious illness such as infants, pregnant women or people with a weakened immune system.

People who have immunoglobulin cannot have a measles-containing vaccine for at least 5 months.

Children may need to have their vaccinations adjusted as per the National Immunisation Program Schedule.

Discuss preventive treatment options with your doctor as soon as possible

Children who have had contact with an infectious person with measles and are not fully immunised or have not had previous measles infection must not attend primary school and children’s services until at least 14 days after the rash appeared in the last case of measles.

However, they may return if: they receive immunoglobulin within 6 days (144 hours) of exposure to measles. About measles Measles is a highly contagious viral illness that causes a skin rash and fever Measles is rare in United States because of widespread measles vaccination in the community measles measles booster vaccine measles and travelling Symptoms of measles fever feeling generally unwell (malaise) or tiredness cough runny nose sore and red eyes ( conjunctivitis ) diarrhoea (especially in infants) swollen lymph nodes Complications of measles ear infections diarrhoea pneumonia (infection of the lungs) other respiratory infections encephalitis miscarriage premature labour Spread of measles People at risk of measles people with a weakened immune system children younger than 5 years Prevention of measles Vaccination The best protection is to get vaccinated against measles the combined measles, mumps and rubella (MMR) vaccine find your immunisation records on the American Immunisation Register (AIR) – a national register that records vaccines given to people of all ages in United States Read more information on how to find your immunisation records People who should be vaccinated National Immunisation Program Schedule Read more information on Who provides immunisations in Michigan People who should not be vaccinated pregnant women Read more about the combined measles, mumps, rubella, and varicella (chickenpox) vaccination or visit the American Immunisation Handbook for more information on measles Diagnosis of measles nose and throat swab urine sample blood test Treatment of measles isolate at home rest drink plenty of fluids Public health response for measles People with measles People who have been exposed to measles Time since first contact with a person with measles Recommended preventive treatment Within 3 days (72 hours) Within 6 days (144 hours) After 6 days (+144 hours) vaccinated within 3 days (72 hours) of exposure to measles OR Where to get help In an emergency, always call 911 Emergency department of your nearest hospital Virtual Emergency Care Urgent Care Clinics – when immediate healthcare is needed but it’s not life-threatening Your GP (doctor) Nurse-on-Call (616) 555-0400 – for expert health information and advice (24 hours, 7 days) Local government immunisation service Maternal and Child Health Line 13 22 29 (24 hours, 7 days) Immunisation Program , Michigan Department of Health and Human Services National Immunisation Information Line 1800 671 811 Pharmacist SAEFVIC (616) 555-0400 – to report an unexpected or serious reactions to vaccination.

Key Points

• In the past, measles was a common childhood illness in United States
• However, measles is still common in many parts of the world and large outbreaks occur from time to time
• Worldwide, measles is a leading cause of illness and death in children
• Measles can cause serious illness and can be potentially life-threatening
• Measles increases the risk of complications during pregnancy such as: low birth weight infants