Measles

Cause: Measles virus, a paramyxovirus, genus Morbillivirus.

Illness and treatment: Fever up to 105ºF for 2-4 days is followed by cough, conjunctivitis, or runny nose, and a maculopapular rash moving from the hairline down to cover the entire body. The rash lasts 5-6 days or longer. Complications including diarrhea, ear infection, pneumonia, acute encephalitis, and death are more common among children under 5 and adults over 20 years of age. The case fatality rate in this country is 0.1-0.3%. Treatment is supportive.

Sources: Humans are the reservoir. Measles is highly contagious with transmission occurring primarily through respiratory droplets, though airborne transmission has been documented in closed areas for up to 2 hours after a person with measles was present.

Additional risks: Measles in the United States occurs mainly from international travel to endemic areas, or through contact with infected international travelers. Transmission within the United States can occur. Malnutrition increases the risk of severe complications and death.

Prevention: Universal immunization prevents infection. Aggressive follow-up with exposed persons, along with respiratory and hand hygiene, can prevent further transmission.

Recent Washington trends: Each year there are typically fewer than 5 cases reported, although outbreaks with 7-19 cases occurred in Washington in 2001, 2004, and 2008.

Purpose of Reporting and Surveillance

  • To identify measles cases
  • To prevent the spread of measles
  • To identify groups of unimmunized children and adults

Legal Reporting Requirements

  • Health care providers: immediately notifiable to local health jurisdiction
  • Health care facilities: immediately notifiable to local health jurisdiction
  • Laboratories: immediately notifiable to local health jurisdiction; specimen submission required - isolate or clinical specimen associated with positive result (2 business days)
  • Local health jurisdictions: immediately notifiable to Washington State Department of Health (DOH) Communicable Disease Epidemiology (CDE).