From the Guidelines
Measles (Rubeola) is a highly contagious and potentially severe viral disease that can cause complications such as diarrhea, middle ear infection, bronchopneumonia, and encephalitis, with a mortality rate of 1-2 per 1,000 reported cases in the United States. The disease is caused by the rubeola virus, a paramyxovirus of the genus Morbillivirus, and is spread through droplet transmission from the nose, throat, and mouth of infected persons when they cough or sneeze 1. According to the most recent evidence, measles can be accompanied by pneumonia, blindness, brain damage, and even death, with over 20 million infections and 145,000 deaths worldwide in 2013 1. The incubation period of measles averages 10-12 days from exposure to prodrome and 14 days from exposure to rash, with a range of 7-18 days 1. The risk for death from measles or its complications is greater for infants, young children, and adults than for older children and adolescents, with the most common causes of death being pneumonia and acute encephalitis. In developing countries, measles is often more severe, with a case-fatality rate as high as 25% 1. Vaccination is the main means for preventing measles, mumps, and rubella virus infections and their related complications, with the MCC (measles, mumps, rubella) vaccine being the recommended immunization against measles, typically given in two doses:
- First dose at 12-15 months of age
- Second dose at 4-6 years of age For adults who haven't been vaccinated, two doses are given at least 28 days apart, with the vaccine being highly effective, providing about 97% protection after two doses 1. The MCC vaccine contains weakened live viruses that stimulate the immune system to produce antibodies, providing long-lasting immunity, with side effects generally being mild and including fever, mild rash, or swelling at the injection site 1. Measles is highly contagious, so vaccination is crucial for individual and community protection, especially for travelers to areas with higher measles rates and for healthcare workers, with pregnant women or immunocompromised individuals consulting their doctor before vaccination 1. The Advisory Committee on Immunization Practices (ACIP) recommends the use of the PRIORIX vaccine as an option to prevent measles, mumps, and rubella, according to the existing recommended schedules and for off-label uses 1. Overall, measles is a serious disease that can have severe complications, and vaccination is the most effective way to prevent it, with the MCC vaccine being highly effective and recommended for individuals of all ages 1.
From the Research
Definition and Overview of Measles (Rubeola)
- Measles, also known as Rubeola, is a highly communicable viral infection with serious complications 2.
- It is characterized by person-to-person spread through respiratory droplets or direct contact, and its diagnosis is based on recognizing the clinical picture, which can be confirmed with laboratory testing such as serologic tests or polymerase chain reaction 2.
Transmission and Complications
- The transmission of measles is dependent on person-to-person spread, and the infection leads to immune suppression for weeks to months 2.
- Complications of measles are of high frequency and severity, and there is no specific antiviral treatment for measles; however, treatment with vitamin A is recommended for younger children to decrease mortality from measles 2.
Prevention through Vaccination
- Vaccination against measles is effective, cost-effective, and safe, with no link between the measles vaccination and autism 2.
- The Advisory Committee on Immunization Practices (ACIP) recommends 2 doses of MMR vaccine routinely for children, with the first dose administered at age 12 through 15 months and the second dose administered at age 4 through 6 years before school entry 3.
- Measles can be eliminated from a population if coverage with 2 doses of vaccine reaches rates of 93% to 95% of the population 2.
Challenges in Controlling Measles
- Despite the effectiveness of vaccines, challenges remain to control measles, including insufficient immunization coverage and changing vaccination needs due to the new global environment (e.g., traveling, migration, population density) 4.
- Initiatives are needed to optimize vaccination policies, increase vaccination coverage, and strengthen outbreak preparedness, including the implementation of high-quality surveillance systems to monitor epidemiology 4.