Measles may be forgotten, and sometimes unrecognized, but it's not gone

Measles, an itchy, highly contagious and sometimes deadly infection, was declared eliminated from the U.S. in 2000. Even doctors began to pay the disease little mind, as it turns out.

But seven new cases—all unvaccinated young children traveling outside the country—are a reminder that the virus disappears only when everyone gets the vaccine against it. Opting out of vaccinations isn’t risk-free.

The seven latest cases were all little travelers, age 6 months to 2 years, who had recently been outside of the country. Two were from Massachusetts, and one from each of the states of Texas, New York, Pennsylvania, Washington and California. None had received the measles, mumps and rubella (MMR) vaccine, the only vaccine in the U.S. that protects against measles. All seven recovered.

But measles was so off the radar that for three of the children, doctors initially misdiagnosed the rashes.

One child was hospitalized for three days for pneumonia and a “drug-induced” rash, and only after a sibling caught the illness did doctors recognize the illness as measles. Another child made three visits to a pediatrician, only to have the measles diagnosed in an emergency room visit. A third got the diagnosis only after a follow-up visit. 

Measles isn’t the first suspect that comes to mind, the CDC notes in its Morbidity and Mortality Weekly Report:

“Measles often is not considered in the initial differential diagnosis of children returning from international travel with a rash illness.”

And international travel is where it almost always starts (especially Europe). Of the 692 measles cases reported in 2001-10, most (87%) of the cases could be tracked to another country. There are some 10 million cases worldwide.

The measles virus travels in mucus and saliva, so coughing or sneezing will send droplets in the air, where the virus can remain alive for up to two hours. Common signs of measles are a rash, high fever, cough, runny nose and red, watery eyes.

If you’re traveling soon, especially with a child, here are some things the CDC says to keep in mind:

-Children should have all their recommended vaccinations before leaving the country. The combined measles-mumps-rubella (MMR) vaccine is usually given when a child is between 12-15 months, but can be given to children as young as 6 months (who have special vaccine recommendations) traveling outside the U.S.     

-Clinicians should suspect measles if a child has a rash after recently traveling.

-Doctors should report a suspected measles case to the local health department.

Otherwise, measles isn’t a big day-to-day concern for children in the U.S. Unless they are unvaccinated. Some parents, against CDC recommendations, choose not to vaccinate. Surprisingly, some clinicians also downplay the risk.  The parents of one of the measles-stricken children said they asked a pediatrician about vaccination for their child before traveling. 

The parents were told it was unnecessary.  

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