What To Know During a Measles Outbreak: FAQ

We’ve declared measles “over” in the United States twice, once in 2000 and once in 2016. Unfortunately, like a bad fashion trend or the killer in a slasher film, measles outbreaks keep coming back.

So far in 2024, we’ve had a rash of small measles outbreaks. Pennsylvania, Arizona, Washington, and most recently, Florida. Already, we’ve seen 41 cases in the U.S. in the first 2 months compared to 58 in all of 2023. 2024 is off to a rough start, and cases are likely to continue to spread.

When you’ve got kids too young to be fully vaccinated, any measles outbreak is scary. And given the speed at which measles can move, no amount of distance is far enough away. It’s an even scarier situation for anyone with a newborn, or an immunocompromised loved one.

Many of us feel understandably helpless to defend ourselves and our loved ones against an outbreak. But knowing the facts is one way we can take power back. Here’s everything you need to know to protect yourself and those you care about from measles — from our infectious disease experts at UVA Health.

Should We Be Worried About Measles?

Yes. Because we’ve had vaccines, most of us haven’t seen anyone suffer with a sickness like measles.

“Many people aren’t familiar with these diseases. They don’t realize that measles can be fatal,” says Emily Wong, MD, a pediatrician at UVA Health Children’s.

Despite older people’s nostalgia about measles parties, it’s a really nasty virus. That’s mostly because it comes with the risk of a lot of complications.

What Are Common Measles’ Complications?

Measles complications run the range from “not a big deal” to deadly. Here’s a breakdown of the most common ones.

Assuming 1,000 people get measles:

• 200 will be hospitalized
• 100 will have ear infections, some resulting in lifelong hearing problems
• 100 will have severe diarrhea
• 50 kids will also get pneumonia
• 10 children with measles will go blind
• 1 will get brain swelling and damage
• 1 will die from respiratory complications

It’s also hard on your immune system. That means even after recovery you’ll be more vulnerable to other illnesses, like RSV or flu, which can also be deadly.

How Contagious Is the Measles?

“Measles has one of the highest attack rates of any infectious disease that we know of,” says Sarah Boggs, MD, a UVA Health Children’s pediatrician. It’s more contagious than the flu, smallpox, COVID-19, or chickenpox. What makes it so spreadable?

• The virus spreads through the air and can linger for up to 2 hours after an infected person leaves a space.
• If you aren’t vaccinated, you have a 90% chance of getting it if exposed. Just breathing the same air as an infected person is enough to be exposed.
• After exposure, you won’t know whether you’re in the clear for 21 days.
• You’re contagious for 4 days before you get a tell-tale rash.

So, Is This a Measles Outbreak?

Not yet. But we’ve got unvaccinated kids going to elementary school and parents sending exposed babies to daycare. An outbreak could happen anywhere. So, it’s a good time to be prepared.

In 2019, one of the worst years for measles outbreaks in the United States, we went from a few isolated cases to hundreds in very little time.

How Do We Stop Measles Outbreaks?

Vaccination is pretty much the only way to stop the spread of measles. Get yourself and your family vaccinated. Make sure only vaccinated people meet your children who are too young to be vaccinated. 

While there are many risks from measles, there are very few from vaccination. For most people, all they’ll experience is a mild fever and a little soreness.

“There is a very, very small risk of an allergic reaction,” Boggs says. “But they’re incredibly rare.”

But there’s a lot of information out there and it’s easy to get confused. Boggs says she’s always happy to talk with parents about vaccination fears.

“I always encourage parents of patients to bring me the resources they’ve read so we can review it together,” she says.

My Child Has Only Had 1 Round of Vaccines; Should I Worry?

The measles, mumps, and rubella vaccine (MMR) is 93% effective with just 1 dose. Since most kids get these shots at their 1-year pediatrician visit, people with kids past infancy don’t have a lot to be worried about.  

I’ve Been Vaccinated, But It Was a Long Time Ago. Am I Still Safe?

After age 5, when people get their 2^nd MMR, most people have 97% immunity.
There are some exceptions:

• If you were born before 1957, you may not have immunity.
• If you were born between 1963-1967, it’s possible you got an early version of the vaccine. This one wasn’t as effective.

If you’re in either of these 2 groups and are concerned, make an appointment with your primary care provider. They can check your blood antibody levels (called tithers). If you’re not immune, you can still get the MMR. And it’ll still be very effective.

How Can I Protect My Baby from Measles?

For babies younger than 1 year old, for whom measles can be the most devastating, there are options.

If you’re in an area where it’s circulating, pediatricians will sometimes advise vaccinating children as young as 6 months. You should also get your child’s MMR early if you’re traveling internationally to a country with a higher number of yearly measles’ cases.

Won’t Vaccinating My Child Too Early Hurt Them?

Infants are exposed to many germs in the environment starting at birth. And really, that’s all vaccination is. Vaccines teach a baby’s immune system how to respond to germs they may encounter.

Vaccines schedules are based on when we know a baby’s immune system will respond best to the vaccine.  

Why Don’t We Just Vaccinate All 6-Month-Olds?

At 6 months, babies still have so many of mom’s measles antibodies transferred during the pregnancy that they usually don’t mount a lasting response against measles. So, babies vaccinated at 6 months still need to get their 1-year and 5-year shots.  

Basically, it’s a “bonus” shot that gives a little protection now. But it won’t act as a substitute for the longer lasting immunity that the later vaccinations offer.

What If My Child Is Exposed to Measles?

The first thing to do is self-quarantine. People can be contagious long before they have symptoms. Then, call your healthcare provider. If your child hasn’t been immunized but is older than 6 months, they may suggest getting the MMR. If given within 72 hours after exposure, the vaccine is effective.

What If My Child is Vaccinated but Is Also Immune-Compromised?

For children with serious conditions like cancer, their immune system may not be able to react the way it needs to. Even with the benefit of being vaccinated.

There are immune globulin treatments available for these patients that may help. These treatments are most effective when given within 6 days of exposure.

What If, Despite Trying Everything, My Child Still Gets Measles?

If your child gets measles, hopefully it will be a mild case. You and your family should stay home and offer standard comfort items. Call your doctor for correct dosing on fever reducing medications like acetaminophen or ibuprofen. Offer your child warm foods that aren’t too rich. And oatmeal baths are a tried-and-true solution to an itchy rash that are ok at any age.

You do need to be on the lookout for common measles complications, though. For most children, the reason they’re hospitalized is a secondary pneumonia infection. This can cause serious breathing problems. If your child is showing any signs of not breathing well, call the hospital and arrange their stay.

It’s very important to not simply show up at the hospital. There are waiting rooms of people who could give your child secondary infections or get measles from your child.  

At the hospital, we can offer IV nutrition and respiratory support.

Be Cautious, Not Fearful

Having the information you need can help you understand when, and where, caution is warranted. It’s healthy to have some anxiety about measles. It’s a sometimes-fatal illness that’s basically an apex predator in terms of infectability. But with a very effective vaccine and treatment options available, there are many ways to protect yourself and your loved ones.