Measles cases have risen to 97 this year, which is more than all of last year, according to new data from the Centers for Disease Control and Prevention (CDC).
The AAP has released a new five-minute webinar to help pediatricians recognize measles, which is “probably the most contagious disease known to humankind,” according to Sean T. O’Leary, M.D., M.P.H., FAAP, chair of the AAP Committee on Infectious Diseases.
“Think measles,” he said in the webinar. “There is measles in the U.S., and we need to have a high index of suspicion, particularly when it’s in our community.”
Cases this year have been reported in 18 jurisdictions — Arizona, California, Florida, Georgia, Illinois, Indiana, Louisiana, Maryland, Michigan, Minnesota, Missouri, New Jersey, New York City, New York state, Ohio, Pennsylvania, Virginia and Washington.
About half the cases were among children under 5 years, according to the CDC. About 22% were children ages 5-19 years, and 26% were in adults ages 20 years and older.
Just over half of people with measles have been hospitalized for isolation or management of complications. The disease can result in pneumonia, brain damage and deafness, and can be fatal.
The CDC issued a health advisory in mid-March urging vaccination of children in the U.S. and those traveling internationally to stop the spread of the virus. At that time, 93% of U.S. cases were linked to international travel. About 59% of people with measles this year have not been vaccinated, 12% received one dose, 5% received both doses and 24% had an unknown vaccination status.
“Consider measles in any patient presenting with a febrile rash illness, especially if they are unvaccinated for measles or traveled internationally in the last 21 days,” Dr. O’Leary said.
The AAP and CDC recommend children receive their first dose of measles, mumps and rubella (MMR) vaccine between 12 and 15 months of age and a second dose between 4 and 6 years. Infants traveling internationally can receive the vaccine as young as 6 months.
“The MMR vaccine is highly protective against measles,” Dr. O’Leary said. “One dose is very protective, and two doses brings you close to 100% protection.”
A recent CDC study found 93% of kindergartners were fully vaccinated against measles during the 2022-’23 school year, and officials estimated about 250,000 kindergartners remain at risk.
Measles is transmitted through contact with infectious droplets or by airborne spread when an infected person breathes, coughs or sneezes, according to the CDC. The virus can remain in the air and on surfaces for up to two hours.
The initial signs of measles typically appear about eight to 12 days after exposure and include a high fever, cough, runny nose and conjunctivitis, according to Dr. O’Leary. Koplik spots may appear in a patient’s mouth, although they are rare. A maculopapular rash typically appears two to four days after other symptoms begin. Patients are contagious from four days before the rash to four days after the rash appears.
Resources
- Information from the AAP and Project Firstline on caring for patients who present with a febrile rash illness or suspected measles
- AAP Red Book chapter on measles
- AAP’s five-minute webinar Identifying Measles in the Pediatric Setting
- Information for health care providers from the CDC on measles
- CDC measles fact sheet
- CDC guidance on measles infection prevention and control measures in health care settings
- AAP clinical report Countering Vaccine Hesitancy
- Information for parents from HealthyChildren.org on protecting your baby during measles outbreaks and what parents need to know about measles.
