Measles cases are on the rise. Here's what you should know.

[5 min read]

In this article:

• Already in 2024, measles cases in the U.S. are being reported at an alarming rate among unvaccinated children, a number higher than the total cases in all of 2023.
• Measles is a potentially deadly disease and is highly contagious, yet 97% preventable with the two-dose MMR vaccination.
• Pediatric Infectious Disease Specialist Frank Bell, M.D., emphasizes that vaccination is the best way to protect yourself and your children. 

By the first week in March 2024, the number of measles cases in the United States reported to the U.S Centers for Disease Control and Prevention (CDC) had exceeded the total number reported in all of 2023. Cases have been reported in numerous states across the country and, as a result, the CDC recently issued an alert to all U.S. communities.

“This is a significant outbreak. The numbers are climbing, and I’m very worried,” says Frank Bell, M.D., a pediatric infectious disease specialist at Swedish Pediatric Specialty Care. “In the back of my mind, I’m always concerned about measles. As soon as we hear there are measles outbreaks near us, we worry even more.”

Dr. Bell has served as Washington State chapter board member for the American Academy of Pediatrics and was designated as a 2022 Pediatric Infectious Disease Top Doc and has received the Seattle Top Doc award for multiple years.

“For public health, this recent measles outbreak is a huge concern,” Dr. Bell explains. “This outbreak poses a real threat to unvaccinated kids in our state and in every state.”

During measles infection, the measles virus is present in the secretions lining an infected person’s nose and throat — from there it very easily can spread to others through coughing or sneezing. If others breathe the same air or touch a surface that is contaminated, they can become infected with the measles virus.

Why public health officials are worried about this measles outbreak

“The current situation is precarious because immunization rates aren’t as high as they need to be. Measles vaccination rates need to be higher to keep our kids and communities safe. This is a very serious disease, and we have a safe and effective vaccine to prevent it,” Dr. Bell says. He adds that even a small outbreak has an enormous impact on health systems because hundreds of public health experts need to get involved to try to control the spread.

One reason even small outbreaks of measles are taken so seriously is that a handful of people with measles can turn into hundreds of cases in a very short time. That’s because measles is probably the most highly infectious, or transmissible, of all airborne diseases. For comparison, COVID-19 and the flu are much less contagious than measles.

“For public health, this recent measles outbreak is a huge concern. This outbreak poses a real threat to unvaccinated kids in our state and in every state.” - Frank Bell, M.D., pediatric infectious disease specialist 

Another contributing factor to the spread of measles is the fact that it has a relatively long infectious period. An infected person can spread measles to others up to four days before their symptoms first appear. And if you are exposed and infected, even without symptoms, you might go on to spread measles to others up to three weeks after exposure. Combined with it being so highly contagious, this creates a scary scenario, particularly for those with compromised immune systems.

“Four days of exposing others without knowing it’s measles makes it very challenging to control a measles outbreak,” Dr. Bell says, emphasizing that you don’t even have to come in contact with an infected person to catch it. Since it’s an airborne disease, you are exposed to the virus simply by being in the same space within a few hours of an infected person.

“If you’re in an elevator within two hours of a person infected with measles,” Dr. Bell explains, “you’re likely to become infected.”

The increase in international travel is concerning for public health officials, particularly during times of outbreak. Infectious disease specialists have worked hard to get immunization rates back up where they need to be after the COVID pandemic prevented some families from staying up to date on their vaccines. In the case of measles, it takes about 95% of a community’s members to be vaccinated for that community to be protected against the disease.

Symptoms and complications of measles

Most cases of the measles are mild, but it causes a lot of discomfort. Signs of the measles include a rash all over the body, high fever and a troublesome cough. Tiny white spots may appear inside the mouth, and most people have a runny nose and red, watery eyes.

Ear infections are the most common side effect from measles. Congestion can lead to croup and upper or lower respiratory complications such as pneumonia, which is the most common cause of death among kids with measles. Death is not common, but the disease can cause serious problems, especially for babies and young children.

“There is a long list of potential complications from measles,” says Dr. Bell. “Neurological complications are a big concern, sometimes showing up in patients up to 10 years after a person was infected with measles.” Encephalitis, for example, is an inflammation of brain tissue that can result from measles.

“If you have a fever and an all-over rash,” advises Dr. Bell, “be sure to call ahead before visiting any clinic or emergency department and let them know you suspect measles. You can call from the parking lot after you arrive. And wear a mask when you go inside.”

This advanced warning allows staff to prepare a separate space for your care, away from other patients. Some children who are infected with measles require care in a hospital and must be kept away from others to reduce potential spread of the virus.

Get your MMR vaccination

Before the measles virus vaccine was widely available, there were 3 to 4 million cases — and about 500 deaths — each year in the U.S. In 1971, the measles immunization was combined to create the measles, mumps and rubella vaccine, or MMR vaccine. Once vaccinations became mandated by public schools in all 50 states by 1981, spread of the disease faced a major decline.

Two doses are recommended for the MMR vaccination. A single dose is 93% effective in preventing the disease. Two doses protect with 97% effectiveness.

“There’s no need to panic, and we haven’t seen any cases yet in the Puget Sound region,” Dr. Bell says. “But things can change very quickly, so we need to be watchful. Make sure each of your family member’s MMR immunizations are up to date.”

“A lot of kids are not fully vaccinated,” Dr. Bell says. “We fear for these unvaccinated kids during this recent outbreak. This is a good time to make sure your kids are up to date with their measles vaccine, especially if you have any plans to travel.”

Read the CDC’s immunization recommendations:

CDC vaccine schedule for birth to age 6

CDC vaccine schedule for 7 to 18 years

CDC vaccine schedule for adults in English or Spanish

Learn more and find a practitioner

If you have questions about vaccinations or your child’s wellness health, Swedish Pediatrics can help. If your kids aren’t up to date on immunizations, particularly the measles vaccine, call their pediatrician today to schedule a visit.

You can contact Swedish Primary Care to schedule an appointment with a primary care provider. If you or a child has symptoms, you can connect virtually with your provider to review the symptoms, provide instruction and follow up as needed. With Swedish ExpressCare Virtual you can receive treatment in minutes for common conditions such as colds, flu, urinary tract infections, and more. If you don’t have a doctor, use our provider directory to find a specialist or primary care physician near you.

Information for patients and visitors

Additional resources

Keep kids healthy, safe with recommended vaccines

Growing Up Safely: Immunizations + Health | Talk with a Doc Podcast 

This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

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