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The most common measles questions answered

As cases increase in these communities, we sit down with Dr. Julia S. Sammons, a pediatric infectious disease specialist and medical director of the Infection Prevention and Control Department at Children's Hospital of Philadelphia to talk about some of the more common problems . questions about the disease.

The measles virus spreads through coughing and sneezing and can live in the air where an infected person coughs or sneezed for up to two hours. If someone who is not immune to the virus breathes the air or touches an infected surface, they can become infected, according to the US Centers for Disease Control and Prevention.

"Measles is one of the most contagious diseases known," said Sammons. Once a person has measles, about 90% of the nearby contacts that are susceptible to it will develop the disease, she added.

In the United States, people who are not vaccinated usually get measles while traveling to other countries and then spread it to other unvaccinated people when they return, which can trigger outbreaks, according to the CDC.

What is measles like?

Measles usually manifests as a combination of high fever, as high as 105 degrees Fahrenheit, along with what is known as the three Cs: cough, coryza (another word for coryza) and conjunctivitis or pink eye, explained Sammons.

At first, measles may look like many other viral diseases, but the accompanying red rash can help separate it.

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"Imagine you have a bucket of rash. If you spill that bucket of rash on your head, the kind of rash cascades," Sammons said. "Then the rash begins in the head, usually on the scalp, and then spreads from head to toe."

People with measles are usually very sick. "They are miserable and very sick," she said.

If you suspect measles, call your doctor first.

She also asks anyone who is concerned about measles to talk to a health professional before entering the office.

"What you do not want to do is go to a busy pediatric waiting room, for example, and potentially expose others," said Sammons.

Instead, she recommends calling ahead and expressing concerns about measles, so the care team can provide guidance on how to bring the patient more safely.

Symptoms or not, argues Sammons, we should all be concerned about measles.

How concerned should parents be with measles?

"We should all be concerned when a vaccine-preventable disease is returning to our country," Sammons said. "We know we have a highly effective vaccine, and it's really due to the lack of vaccination that it's coming back."

The vaccine provides protection against the disease until adulthood, but Sammons warns that for those who are too young to be vaccinated or who have chosen not to vaccinate, the disease can be highly contagious and even deadly.

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And public health officials, such as Sammons, expressed concern about the small but growing number of unvaccinated children in the United States.
Although a high percentage of people vaccinated in a community can prevent the spread of the virus, a concept known as herd immunity, the number of people vaccinated needed to prevent a virus as infectious as measles is close to 95%. With families choosing not to vaccinate often together, herd immunity does not provide adequate protection.

Why do some parents decide not to vaccinate?

"Being victims of our own success with the vaccine, we have not seen it," Sammons said. "So when you think of parents bringing their children to immunizations, it's not a disease that hangs in their memory."

Thanks to the effectiveness of the measles vaccine, measles was declared eliminated in the United States in 2000.

She also acknowledges that it may be difficult for parents to navigate the amount of information available online and that disinformation and fear about vaccines have spread widely.

The American Academy of Pediatrics, the CDC, and the American Academy of Family Physicians recommend that children receive the measles, mumps, and rubella (MMR) vaccine at 12 to 15 months of age and again between 4 and 6 years of age.
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Children traveling overseas may need to be vaccinated before their first birthday, and women wishing to get pregnant should discuss the vaccines with their doctor, as the MMR vaccine is not recommended during pregnancy.

"We have made many decisions in our lives about parenting, unfortunately this does not only affect the decision you made for your child but it also affects other children and people around you," added Sammons.

And with increasing numbers, vaccinated people may be starting to wonder how protected they are.

Is it possible to contract measles if you have been vaccinated?

Two doses of the measles vaccine protect against measles in 97% of cases, according to the CDC.

In people who have been immunized, it is possible to contract the disease, but usually has a milder course, explains Sammons.

People who have had measles are also considered immune from contracting the disease a second time, similar to chicken pox.

As for measles outbreaks, it also reminds parents that many other viruses are much more common.

"Although we want to have a high level of concern and be aware of measles, there are many more common viruses circulating," she said. "But that's certainly something we need to pay attention to."

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