It starts with a high fever, sometimes reaching 105 degrees Fahrenheit. The child may also feel pain and lose energy.
The three “C’s” of measles: cough, conjunctivitis (burning eyes), and coryza (runny nose) occur about a day after the fever begins. Some children are sensitive to light and begin to squint.
However, the most characteristic signs of measles – small white spots in the mouth and a patchy rash that spreads from head to toe – do not appear immediately.
This spot usually appears on the inside of the cheek near the back teeth about 2 to 3 days after symptoms begin. The rash, which consists of flat red spots, occurs between the third and fifth day, forming at the hairline and then spreading to the neck, torso, arms, legs, and feet.
“It’s like pouring a bucket of measles on your head, and then the effects spread downwards,” said Dr. Paul Offit, who contracted measles as a child before a vaccine was available. says. Offit is director of the Center for Vaccine Education at Children’s Hospital of Philadelphia.
There have already been 35 measles cases this year. recorded in 15 states, according to the Centers for Disease Control and Prevention. This puts the United States ahead of last year’s total of 58 cases.
The two outbreaks occurred in Florida (which recorded its 10th measles case last weekend) and Pennsylvania. 9 items One month from December to January.
One to three out of every 1,000 children infected with measles will die from respiratory or neurological complications. In rare cases, measles can also cause blindness or long-term vision problems.
But doctors who treat measles patients say many people may not be aware of the symptoms or severity of the disease. And even for those who recover fully and quickly, the disease can be painful, Offit said. “If you look at the children who have measles, they are miserable.”
“At one point I was delirious.”
By the time the measles rash reaches the lower body, spots on the head and face begin to coalesce into giant red spots, said Dr. Mark Klein, an infectious disease specialist at Children’s Hospital of New Orleans.
“Typically, the disease itself peaks at that stage,” Klein says. “On the fourth or fifth day, the fever is highest and the child’s symptoms are most severe.”
Randy Blaser, 67, of Lake County, Illinois, said he contracted measles as a child in the 1960s.
“I had some pretty serious symptoms,” said Blazer, who could not provide medical records at the time. He developed a characteristic rash and had been feeling unwell for about a week.
“Most of what I remember is my mother telling me about how I was delirious at one point. I had a really high fever and she was going crazy. ,” Blazer said.
Immediately after his illness, he said, he needed glasses made for his nearsightedness. Blazer suspects the two are related given the timing, but his doctor doesn’t necessarily think so.
“Of all the childhood illnesses, it was the worst,” he said.
There is no cure for measles, so doctors focus on helping people manage their symptoms. If an unvaccinated person has been exposed to measles but has not yet developed symptoms, the vaccine can prevent infection if given within 72 hours. Another option is a vaccination called immunoglobulin, which must be given within six days of exposure.
Measles symptoms usually last 10 days, assuming the patient does not have serious complications such as brain swelling, pneumonia, or secondary bacterial infections.
In most cases, the rash heals slowly over six to nine days, Klein said, but may leave behind brown skin or peeling marks.
Klein said if a fever goes down and then comes back, it could indicate a secondary infection. Symptoms such as confusion, loss of consciousness, headaches, vomiting and seizures can be signs of neurological problems, which in some cases can lead to hearing loss and intellectual disability, he added.
Early surge in measles cases
Before the first measles vaccine became available in 1963, nearly all children contracted the disease by age 15. Approximately 3 to 4 million people in the United States were infected each year, and 400 to 500 people died from measles each year.
Measles is considered to have been eradicated in the United States since 2000, but outbreaks continue to occur from time to time, most often from other countries.
The United States nearly lost measles-free status in 2019, recording more than 1,200 cases, the most since 1992. Most were related to ongoing infections within the country. Large and close-knit Orthodox Jewish community In New York.
Two outbreaks this year involved measles outbreaks at a children’s hospital and day care facility in Philadelphia and at an elementary school in Florida. All nine patients in Broward County, Florida, were children, two of whom were 4 years old or younger. The state’s 10th confirmed case is a man in his 20s from Polk County.
Meanwhile, Arizona State reported: 2 measles patients Last week, Louisiana recorded two cases in the New Orleans area.
Klein, who cared for the Louisiana patients, said both were children under the age of 2 and neither required hospitalization.
However, although measles is now relatively rare, “these days, the vast majority of doctors and nurses staffing ER, clinic, and hospital floors have never seen an episode of measles.” No,” he said.
A few years ago, Klein said, he helped a patient with a high fever and rash after doctors had trouble making a diagnosis.
“I went into the room, opened the door, and said from across the room, ‘It’s measles,'” Klein said. “The child had already been in the hospital for a couple of days and had been exposed to people.”
Vaccination rates have fallen
Most people who get measles have not been vaccinated. Two shots are 97% effective, according to the CDC.
Children in the United States should receive their first dose between 12 and 15 months of age and their second dose between 4 and 6 years of age.
For nearly a decade, 95% of U.S. kindergarteners received both doses. However, in the 2022-23 school year, that percentage dropped to 93%. Doctors said this likely explains why the country has seen so many cases over the past two months.
“To prevent measles pandemics and epidemics, we need immunization coverage of 95%,” said Dr. Sameer Midani, chief of pediatric infectious diseases and immunology at Nemours Children’s Health in Jacksonville, Florida. said.
In the Broward County School District, one of Florida’s current hot spots, 91.7% of students had received all required vaccines, including measles shots, for the 2021-22 school year.
“People who have been vaccinated can become infected, but the vaccine is actually very effective,” Midani said. “I worry about people who haven’t been vaccinated.”
