An person infected with measles may notice white spots on the inside of his or her mouth followed by a rash that breaks out on the face before moving down to the neck, torso, arms, legs and feet.

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In 2000, the Centers for Disease Control and Prevention declared the measles to be eliminated. But in 2019, multiple cases have been reported in 19 states.

According to numbers shared by the CDC in April, 465 cases of measles have been reported in the U.S. since January 1 and 78 new cases were reported during the first week of April. Arizona, California, Colorado, Connecticut, Georgia, Illinois, Kentucky, Michigan, Missouri, New Hampshire, New Jersey, New York, Oregon, Texas, and Washington have all reported measles cases in 2019.

What Are the Measles?

The measles are a highly contagious virus that can spread through the mucus of an infected person. The measles virus can survive in contaminated air or on a surface for up to two hours. It can take between seven and 14 days for an infected person to notice any symptoms, which can include:

• Cough
• Runny nose
• High fever
• Red, watery eyes

About two days after those symptoms appear, an infected person may notice white spots on the inside of his or her mouth (also known as Koplik spots) followed by a rash that breaks out on the face before moving down to the neck, torso, arms, legs and feet.

More severe complications can occur, especially in young children, that include diarrhea, ear infection, pneumonia, and encephalitis. Measles can also cause pregnant women to give birth prematurely or give birth to a low-weight baby.

A small number of people who contract measles are also at risk of developing subacute sclerosing panencephalitis (SSPE), a fatal disease of the nervous system that develops seven to 10 years after a measles infection.

While there is no specific treatment for measles, symptoms can be managed with OTC medications to reduce fever and manage pain, antibiotics to clear any bacterial infection, and vitamin A to lessen the severity of the measles in children. Rest and lots of fluids are also recommended.

A measles infection can be confirmed through a blood test that detects measles-specific IgM antibodies. A throat swab or urine sample may also be collected to identify the virus.

How Can Measles Be Prevented?

A measles vaccine was developed and licensed by John Enders in 1963. An improved vaccine developed by Dr. Maurice Hilleman followed in 1968. By 1981, the number of cases reported in the U.S. was 80 percent less than the previous year due to a goal set by the CDC to eliminate the measles through the vaccine. A second round of the MMR vaccine, which combines protection from measles, mumps, and rubella, was recommended for all school-age children following a 1989 outbreak and, by 2000, the measles was declared eliminated.

The CDC recommends children receive two doses of the vaccine: The first between the ages of 12 and 15 months, and the second dose between the age of 4 and 6. Children between the ages of 12 months and 12 years old can also receive the MMRV vaccine, which also protects against the chickenpox.

Receiving two doses of the vaccine is about 97 percent effective at guarding against measles, according to the CDC, while one dose is about 93 percent effective.

Why Is There a Measles Outbreak Now?

Although the measles virus was virtually eliminated in the United States by 2000, other countries have continued to experience outbreaks. So people who are unvaccinated and travel internationally on a regular basis are at an increased risk.

An increase in the percentage of children born in 2015 who received no vaccinations, as well as an increase in the number of kindergartners with vaccine exemptions, is also to blame, according to numbers reported in October by the CDC. Reasons for families choosing not to vaccinate their children include lack of health insurance, limited access to pediatricians in rural areas, and the belief the vaccinations can be harmful to children.

What’s Being Done to Stop the Outbreak?

States that have reported measles outbreaks are taking various steps to reduce outbreaks using education and, in some cases, the law.

New York City Mayor Bill de Blasio declared a public health emergency on April 9 requiring that unvaccinated people living in Williamsburg, Brooklyn—where 250 cases of measles have been documented since September 2018—receive the measles vaccine or risk being fined $1,000.

In Illinois, three health systems—NorthShore University Health System, Advocate Aurora Health and Lurie Children’s Hospital—announced in April that they’re planning to send letters to parents of children who aren’t vaccinated encouraging them to bring them in for immunizations.

And depending on the laws where you reside, if your school-age child is not vaccinated, he or she may be required to stay home from school for a designated amount of time following a documented measles outbreak, as is the current case with Birmingham Public Schools in Michigan.

Who Should Not Get the Measles Vaccine?

Although the CDC recommends the MMR vaccine for all children as well as for adults who do not have evidence of immunity to the virus, there are some that should delay receiving the vaccine or avoid getting it at all. Before receiving it, notify the health care professional administering the vaccine if:

• You have any severe, life-threatening allergies
• You’re pregnant or think you might be pregnant
• You have a weakened immune system
• Have a family history of immune system disorders
• You bruise or bleed easily
• You’ve recently received a blood transfusion
• You’ve received other vaccines within the past four weeks
• You’re not feeling well