Measles is resurging in the United States fueled by decreasing vaccination rates and rising vaccine hesitancy. Clinicians are confronted with a highly infectious vaccine-preventable disease that is unfamiliar to them since, as a result of routine childhood vaccination with measles, mumps, and rubella (MMR) vaccine, measles was declared non-endemic in the U.S. in 2000 and many pediatricians have never seen a case. In this article, we provide an update on measles presentation, clinical course, and outcomes by reviewing the literature and sharing the expertise of senior pediatric infectious disease physicians with experience in caring for children infected with measles. Measles typically presents with a recognizable clinical picture, allowing providers to appropriately triage cases, make the diagnosis, and implement infection control practices to mitigate transmission. Measles is associated with complications, including frequent pulmonary infections and central nervous system involvement which may result in morbidity and mortality. Since treatment options for measles are limited, prevention through vaccination and contact tracing are the mainstays in controlling measles outbreaks. Given the high infectivity of this virus, health care providers are an essential first line of defense for communities. Providers can protect children through advocacy for vaccination including effective communication techniques to educate parents and caregivers about measles infection and the benefits of vaccination. They can also maintain a high clinical index of suspicion so that appropriate infection prevention strategies are rapidly implemented when appropriate.
Competing Interests
CONFLICT OF INTEREST DISCLOSURES: Sheldon Kaplan has a collaborative grant for a pneumococcal surveillance study with Pfizer and a contract for another Pfizer study related to pneumococcal pneumonia. Kathryn Edwards is a consultant to Dynavax and AstraZeneca, and is a member of the Data Safety and Monitoring Board for Sanofi, X-4 Pharma, Seqirus, Moderna, Pfizer, Merck, Roche, Novavax, Brighton Collaboration. Gary S. Marshall received grants/contracts (paid to institution) from GSK, Merck, Pfizer, Sanofi, and Seqirus; advisory board consulting fees and travel/meeting support from GSK, Merck, Moderna, Pfizer, Sanofi, and Seqirus. Sarah Parker has a contract with the Colorado Department of Health and Environment to improve antimicrobial stewardship in the state of Colorado (paid to the University), a grant from Pfizer Global Bridges to improve antimicrobial stewardship in rural Colorado (paid to the University), honoraria from Society of Infectious Diseases Pharmacy, and reimbursement from Infectious Diseases Society of America to attend meetings as Pediatric Chair. C. Mary Healy received grants/contracts (paid to institution) from NIH, CDC and Cancer Prevention Research Institution of Texas, advisory board travel reimbursement from Hillevax, honoraria and reimbursement from the Infectious Diseases Society of America and American Academy of Pediatrics to travel to committee meetings.
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