Dear Doctors: I’ve never seen measles, and don’t know that I would recognize the symptoms. My children are vaccinated, and I had two shots as a kid. Am I still covered, or do I need a booster? My dad had the measles when he was a boy. Is he still safe?
Dear Reader: We are fielding a lot of questions about measles, both from readers and our patients. This is due to an outbreak in Texas and New Mexico, where several hundred cases of measles among unvaccinated children and adults have been confirmed. A child and an adult, both unvaccinated, have died from complications of the disease. Isolated cases are also being reported in other states and in Canada.
Measles has the dubious distinction of being one of the most contagious diseases in the world. It is caused by a virus that spreads via an infected person’s breath, sneeze or cough. The measles virus is so efficient at infecting the body, 90% of nonimmune people who are exposed will fall ill themselves. Symptoms include persistent and sometimes high fever, sore throat, dry cough, runny nose and inflamed eyes. Distinctive symptoms include small white spots inside the mouth and a slightly raised, blotchy red rash that begins on the face and spreads to the rest of the body.
For most people, a case of measles means a very unpleasant week with an upper respiratory infection. But the disease can also be deadly. This is particularly true for infants too young for the vaccine and young children whose immune systems are still booting up. People who, due to older age, illness or medical treatment, are living with a compromised immune system are also at increased risk of complications. These include bronchitis, ear infection, pneumonia and, more rarely, swelling of the brain, or encephalitis. For pregnant women, measles increases the risk of premature birth, low birth weight and even fetal death. The immune system can be adversely affected, as well. We will address that in a separate column.
People who have had the measles, like your dad, are immune for life. For everyone else, a two-dose series of the vaccine is 97% effective at preventing the disease. Known as the MMR vaccine, it protects against measles, mumps and rubella. The initial dose is given when children are between 1 year and 15 months old. Between the ages of 4 and 6, they receive a second dose. Anyone who has had two doses is fully vaccinated and has strong lifetime protection. Unvaccinated teens and adults are advised to get two doses of the MMR vaccine, separated by at least one month.
Anyone unsure of their vaccination status should track down their medical records. If that isn’t possible, or if you are only partially vaccinated, a simple blood test can measure immunity. Known as an MMR titer test, it screens for the presence of antibodies to measles, mumps and rubella. Results are typically available within one to three days. A positive result indicates immunity. If your test comes back negative, your physician will offer guidance on vaccination. Even if you're not sure, getting the vaccine won't hurt you.
(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)
