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Measles Health Advisory Issued

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February 2, 2015

On January 23, 2015, the Centers for Disease Control and Prevention (CDC) issued a health advisory in response to an ongoing measles outbreak. The notice advises health practitioners to be vigilant for measles in their patients and to ensure their patients are up to date on their MMR, a combination vaccine for measles, mumps, and rubella.

Laboratory testing has confirmed that a total of 84 people in 14 states were infected with measles between January 1 and 28. (For the latest numbers, see the CDC's Measles Cases and Outbreaks.) Public health officials think that most of these recent cases can be attributed to a larger, ongoing outbreak that started in December 2014 among people who were exposed to measles at a California amusement park. Overall, a record number of measles cases were reported to the CDC in 2014. Across 27 states, 644 people were confirmed to be infected. This is the highest number reported since measles was declared eliminated in the U.S. in 2000. (Read also "CDC Reports Highest Number of U.S. Measles Cases Since 1994".)

Though no longer endemic in the U.S., measles infections still commonly occur in other parts of the world. Sporadic cases and outbreaks occur in the U.S. when travelers incubating the virus visit this country or unvaccinated U.S. residents visit other countries and are exposed to measles. Those exposed and not vaccinated then spread the infection to others. Usually those who become infected have not been immunized against measles or may be too young to be immunized. The CDC recommends that all children be given the first MMR vaccine between 12 and 15 months of age, with a booster given when they are between 4 and 6 years old.

Outbreaks can occur easily with one person infecting several others because measles is a highly contagious respiratory infection. The virus can spread through the air via droplets after an infected person sneezes or coughs, for example. It can remain in the air for as long as 2 hours after an infected person has left an area. The virus can also contaminate surfaces that are then touched by another person.

A case of measles may be identified by the characteristic signs and symptoms that appear 7 to 14 days after a person is infected, such as fever (as high as 105°F), cough, runny nose and itchy, watery, red eyes. After the first symptoms appear, a red rash may develop, starting at the hairline and then spreading down to the neck, trunk, arms, legs and feet. A person is contagious 1-2 days before the onset of symptoms, that is, 3-5 days before the rash appears. However, some of the symptoms can be confused with other infections, and a health practitioner may request measles testing to help make a diagnosis.

Laboratory testing is essential for confirming measles cases and tracking outbreaks. Since measles has not been a common infection in the U.S., samples may require transport to a reference laboratory, a public health laboratory, or the CDC laboratories, where the testing can be performed. A blood sample may be drawn to test for antibodies that are produced in response to a measles infection. A swab may be used to collect a sample from the back of the nose and throat (nasopharyngeal) and tested for the measles virus or its genetic material (RNA). Sometimes urine samples may be tested for the virus. (Read the article on Measles and Mumps Tests for additional details.)

While many people recover from measles within several days, some, especially children younger than 5 and adults older than 20, can suffer serious complications such as pneumonia or encephalitis. The CDC estimates that 1-2 children will die out of every 1,000 children who get measles. Pregnant women who get measles are at risk of complications such as miscarriage or premature birth. The latest CDC health advisory is a reminder that measles can still affect people in the U.S. and that immunization is the best protection against it.

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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used. To access online sources, copy and paste the URL into your browser.

(January 23, 2015) Centers for Disease Control and Prevention Health Advisory. U.S. Multi-state Measles Outbreak, December 2014-January 2015. Available online at http://emergency.cdc.gov/han/han00376.asp through http://emergency.cdc.gov. Accessed February 2, 2015.

(November 3, 2014) Centers for Disease Control and Prevention. Measles (Rubeola). Available online at http://www.cdc.gov/measles/about/index.html through http://www.cdc.gov. Accessed February 2, 2015.

(©2015) March of Dimes. Sick Baby Care, What is measles? Available online at http://www.marchofdimes.org/baby/sick-baby-care.aspx#QATabAlt through http://www.marchofdimes.org. Accessed February 2, 2015.