Measles

Cause: Measles virus, a paramyxovirus, genus Morbillivirus.

Illness and treatment: Measles, also known as rubeola, is a highly contagious viral illness. Infected individuals experience a high fever, reaching up to 105ºF, along with a cough, conjunctivitis, or a runny nose. This is followed by a distinctive, maculopapular rash that typically starts at the hairline and spreads down to cover the entire body. The rash can last for about 5 to 6 days or longer; the fever and rash usually overlap. Complications from measles are more likely to occur in children under 5 years old and adults over 20, and may include severe diarrhea, ear infections, pneumonia, acute encephalitis, and even death. A measles infection can result in immune amnesia, which destroys immune memory cells and eliminates previously established immunity. As a result, individuals may become susceptible to secondary infections for months to years following the primary measles infection. Treatment is supportive.

Sources: Humans are the only reservoir. The measles virus spreads easily when an infected person breathes, coughs or sneezes. The virus can remain suspended in the air for up to two hours after an infected person has left an enclosed space, such as a room or office,  depending upon circulation and airflow. 

Additional risks: Malnutrition increases the risk of severe complications and death.

Prevention: Vaccination is highly effective at preventing infection. Two appropriately spaced doses are about 97% effective at preventing measles disease. For those potentially exposed and susceptible,  it is crucial to conduct thorough follow-up and to administer prompt post-exposure prophylaxis to help prevent severe disease and further transmission.

United States trends: In 2000, measles was declared eliminated in the United States. Measles elimination is defined as the absence of ongoing disease ongoing transmission for 12 months or more in a specific geographic area (e.g., the United States). Since elimination was declared, most reported measles cases in the United States have been in individuals who were infected while living or traveling outside the country and their close contacts. 

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 and health care facilities: immediately notifiable to local health jurisdiction
  • Laboratories: immediately notifiable to local health jurisdiction; submission required – isolate and specimen associated with positive culture or with positive NAT or NAAT result, within 2 business days; submission on request – specimen associated with positive IgM or other specimen, within 2 business days.
  • Local health jurisdictions: immediately notifiable to Washington State Department of Health (DOH) Communicable Disease Epidemiology (CDE).

Resources

Notifiable Conditions Directory