Is Measles Making A Comeback?

Lately measles has been in the news a lot  Five years we had a big outbreak of measles here in Ohio.  Currently Europe is seeing the highest numbers of measles cases they have had in 20 years.  The Pacific Northwest,  Texas and New York (among others) are seeing cases and it’s estimated that the US may see more measles cases in 2019 than we have seen in 30 years.

It is ironic that the success of childhood vaccination is the reason we’re seeing the resurgence of this disease.

Most people have never seen measles and don’t know how to recognize it.  I have never seen measles either.  Before you go questioning my training, you should know the reason WHY I’ve never seen measles.  For a very long time, measles has been extraordinarily rare in the United States.  The reason for this is universal childhood vaccination.

The live measles vaccine was introduced in 1963.  Before that time, according to the CDC it is estimated that 3-4 million people in the US got measles every year.  About 48,000 people were hospitalized, over 400 people died and 1000 people were left permanently disabled from measles encephalitis (brain infection).  That’s EVERY YEAR.

In the 1990s over 500,000 children still died worldwide ever year from measles.  That’s like 3 Boeing 747 jumbo jets crashing EVERY DAY, all year long.  From 2000-2013 there were 37-220 cases of measles in the US per year.  All of these cases were related to international travel, or exposure to an infected international traveler.  Measles was common in other parts of the world, you see.  It is much less common now, but by no means gone.

Ten states in the USA are reporting measles outbreaks right now.  What is interesting is that researchers predicted this last year, by looking at the rates of non-medical exemptions for vaccination.  The areas that have the highest rates of non-medical exemptions are the hot spots for the current outbreaks.


If vaccination resulted in the near-eradication of measles in this country, it doesn’t take a genius to see that falling vaccination rates will result in a resurgence of the disease.

Well-intentioned parents who love their children are frightened by all the reports of vaccine injury in the news media and on bloggers’ websites.  So they refuse to vaccinate and therefore put their families at risk from a dangerous, highly contagious disease that has no specific treatment.

If you or a family member get measles it is critically important to recognize it as soon as possible.  So let’s review the symptoms of measles.

  1. Fever:  sudden onset of high fever, sometimes up to 105F
  2. Cough, runny nose (coryza) and conjunctivitis:  These are sometimes called the “3 C’s” of measles.  Measles is a respiratory illness so the cough and sneezing is how the virus is spread.  Anyone with a fever, cough and runny nose should stay at home until the fever is gone.  If they get red, watery eyes they should ESPECIALLY be isolated until the fever is gone.
  3. Koplik’s spots:  These are little gray-white spots (like grains of sand or salt) surrounded by a red ring on the insides of the cheeks.  Those who have these spots are VERY contagious.  You can see a picture of them here.
  4. Rash:  The rash is what most people associate with measles.  It starts at the hairline and spreads down to the feet, and disappears slowly the same way.  This picture is from the CDC website.


If you are planning to travel to a country where measles is common, make sure your immunizations are up-to-date.  Large outbreaks have been reported in England, France, Germany, India, and the Philippines, to name a few.  The outbreak here in Ohio five years ago was related to unvaccinated travelers to the Philippines who then came back and exposed people in Ohio’s unvaccinated Amish population.

These measles cases are a good illustration of why universal vaccination doesn’t work as well if it’s NOT universal.  As vaccination rates fall because parents refuse to allow their children to be immunized, outbreaks of vaccine-preventable diseases will become more and more common.

Measles is highly contagious.  Approximately 90% of non-immune people exposed to a sick patient will get sick with the disease.  This is compared to an estimated 33-45% for influenza.

There are people who CANNOT be immunized.  The immunocompromised, those who are allergic to vaccine components, and the very young are unable to be fully vaccinated.  They depend on us to limit our ability to spread these vaccine preventable illnesses to them.

QUESTION: Have you ever seen measles?


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  1. Pingback: Measles Outbreaks In The Pacific - Jennifer Wurst, MD

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