Over the weekend, Virginia reported its first case of measles this year, in a young child. This follows a case of measles exposure reported last week in DC, when health officials confirmed that an infected individual visited a Five Guys in Northwest in early April. Last month, another individual traveled through the District while contagious, and three measles cases stemming from international travel were confirmed in neighboring Maryland. With measles cases on the rise nationwide, it’s important to make sure you’re protected. Below, a quick guide on how to stay safe from measles.
What are the symptoms of measles, and how is it spread?
Measles is a highly contagious virus that can spread through the air when someone infected coughs or sneezes. The virus can also stay live in the air for up to two hours.
Measles symptoms start with high fevers that can spike to over 104 degrees and upper respiratory infection symptoms such as cough, runny nose, and red eyes. Other symptoms include ear infections and diarrhea. The first symptoms typically appear about one to two weeks after exposure. About four days after the fever, the characteristic measles rash usually appears, starting at the hairline and spreading downward. The rash generally fades after about five or six days.
Symptoms for measles are similar for both adults and children, and individuals are contagious four days both before and after the rash appears. In severe cases, those infected can experience seizures, deafness, blindness, complications during pregnancy, permanent lung damage, pneumonia, encephalitis, or even death. The US has already seen three measles-related deaths this year. Measles can also weaken your immune system, leaving you more susceptible to serious disease in the future.
According to the CDC, those at highest risk for measles complications include children under the age of five, adults over the age of 20, immunocompromised individuals, and pregnant women. Unvaccinated individuals are also at risk.
Am I safe if I’m already vaccinated?
Yes, for the most part. According to the CDC, one dose of the measles, mumps, and rubella (MMR) vaccine is 93 percent effective, and two doses are 97 percent effective.
People born before 1957 are considered to have natural immunity because measles was so widespread and contagious that these individuals likely already contracted it.
Most adults who have received a measles vaccine do not need to get vaccinated again. However, there is one exception: Between 1963, when the first measles vaccines were licensed for use in the US, and 1968, some children received an inactivated vaccine that is less effective than the live vaccine used today. “If they [were vaccinated] in that window, we either recommend revaccination, or they can check their antibodies first and then vaccinate,” says Dr. Jennifer Primeggia, an infectious disease specialist with VHC Health in Arlington. However, if you have documentation of receiving a live measles vaccine during that period, you do not need to be revaccinated.
In 1968, an improved measles vaccine was introduced, and we continue to use this live vaccine strain in the US to this day. Those vaccinated between 1968 and 1989 likely received just one shot of the measles vaccine, per the CDC’s recommendation at the time; however, the health agency upped its guidance to two doses following a 1989 measles outbreak among vaccinated children.
If you aren’t sure which vaccine you received or are concerned about your immunity status, you can get your blood work done to check your antibody levels and see if you’re immune to measles. Your primary care provider can order a blood test for you.
“This isn’t one of those situations where we’re really going to mask ourselves out of this or take supplements to help us,” says Primeggia. “It’s really to know your status.”
What should I do if I find out I’ve been recently exposed?
According to DC health officials, anyone who’s been recently exposed, regardless of vaccination status, needs to self-monitor for symptoms for 21 days. If you begin noticing symptoms of measles, you need to immediately self-isolate and contact your healthcare provider. However, make sure to call ahead so that the healthcare facility can arrange the appropriate protective equipment and isolation measures to protect everyone else present.
If you’ve never been vaccinated and find out you’ve been exposed, the CDC advises that you can still get an MMR vaccine after exposure. If administered within 72 hours after exposure, the vaccine can provide you with some protection, or make symptoms less severe if you ultimately develop measles. However, Primeggia notes that immunocompromised individuals may not be eligible to receive a live vaccine and will need to discuss with their healthcare providers. If you can’t get the vaccine in time, you can also receive immune globulin, a medication made from healthy human blood with high antibody levels, up to six days after exposure.
If you are immunocompromised and exposed to measles, Primeggia advises you contact your doctor or the health department because you may be eligible for intravenous immune globulin (IVIG).
Expect to see more instances of measles exposure in the District as summer approaches. “People are going to be traveling,” says Primeggia. “This is already an international region as it is, and people are going to be traveling here for vacation.”
