Measles has been on the rise this past year. In 2018, measles cases were confirmed in 28 states, but on Aug. 1, 2019, 1172 cases of measles have been confirmed in 30 states. This is the greatest number of cases reported in the U.S. since 1992, and since measles was declared eliminated in 2000. As of August 1, 2019, 124 of the persons with measles this year were hospitalized, and 64 persons reported having complications, including pneumonia and encephalitis.

The majority of the measles cases (90 percent) are unvaccinated or have an unknown vaccination history. The good news is that there have not been any measles cases so far this year in North Dakota nor the surrounding states.

Measles is an acute viral illness with symptoms of fever, cough, runny nose, red watery eyes, and small, blue-red spots in the mouth followed by a rash. The rash spreads from the head to the trunk to the lower extremities. Measles is usually a mild or moderately severe illness. However, measles can lead to complications such as pneumonia, swelling of the brain, convulsions, deafness or intellectual disabilities, and even death. Symptoms usually appear 8 to 12 days after exposure but can occur as early as 7 days up to 21 days after exposure.

Measles is a highly contagious virus that lives in the nose and throat of an infected person. It can spread to others through coughing and sneezing. The measles virus can live for up to two hours in a room where the infected person has coughed or sneezed. If other people breathe the contaminated air or touch the infected surface and then touch their eyes, noses, or mouths, they can become infected. Measles is so contagious that if one person has it, up to 90 percent of the people close to that person who are not immune will also become infected. A person is able to spread the disease from four days before the first symptoms appear to four days after the appearance of the rash. Therefore, children or adults who are infected with the measles virus should be excluded from activities until four days after the rash appears. Unvaccinated persons should be vaccinated within 72 hours of exposure to provide some protection. Unvaccinated people should be excluded from all activities until the North Dakota Department of Health determines it is safe for them to return.

The Measles, Mumps, Rubella (MMR) vaccine is safe, even if given to persons who were previously vaccinated or had measles in the past. One dose of MMR vaccine is 93 percent effective against measles. Two doses of MMR vaccine are 97 percent effective against measles. All children between 12 and 15 months of age should be vaccinated with the first dose of MMR vaccine. A second dose of MMR is recommended at 4 to 6 years. Children are required to be fully immunized against measles in order to attend daycare centers, school, and colleges in North Dakota.

Most adults are at low risk for measles and need only one dose of the MMR vaccine. Certain adults are considered to be a high risk for either acquiring measles and/or transmitting the disease to vulnerable persons. High risk adults include college students, healthcare personnel, and international travelers. These adults are encouraged to have two doses the MMR vaccine. Some adults may already be immune to measles and do not need a MMR vaccine. Evidence of immunity includes birth before 1957, laboratory evidence of immunity, or laboratory confirmation of disease.

If you are wondering if you’re up-to-date with your measles vaccine, or would like a measles vaccine, call us at the health department at 701-642-7735.

Carol Lee, RN is with Richland County Public Health.

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