Given that vaccination rates are not 100%, the return of measles has triggered an aggressive public health alert in order to contain any new outbreaks that may occur.
In the pre-vaccine era, measles regularly affected a large percentage of the population in the U.S., primarily children. It killed about 1 to 3 people out of a thousand infected, and caused permanent brain damage in about 1 to 2 people out of a thousand people infected.
Measles information from the CDC http://1.usa.gov/1eYC2tW:
- Measles is a highly contagious rash illness that is transmitted from person to person by direct contact with respiratory droplets or airborne spread.
- About 90% of susceptible exposed individuals will get infected.
- The average incubation period for measles is 10 to 14 days from exposure to rash (range: 7–21 days).
- Persons with measles are infectious 4 days before through 4 days after rash onset.
- Commonly reported complications are pneumonia (6%), otitis media (7%), and diarrhea (8%)
- In low to middle income countries where malnutrition is common, measles is often more severe and the case-fatality ratio can be as high as 25%
- Measles can be severe and prolonged among immunocompromised persons, particularly those who have leukemias, lymphomas, or HIV infection. Among these persons, measles can occur without the typical rash and a patient can shed measles virus for several weeks after the acute illness. However, a fatal measles case without rash also has been reported in an apparently immunocompetent person.
- A persistent measles virus infection can result in subacute sclerosing panencephalitis (SSPE), a rare and usually fatal neurologic degenerative disease.Signs and symptoms of SSPE appear an average of 7 years after measles infection, but might appear decades later.
- Widespread use of measles vaccine has led to the virtual disappearance of SSPE in the United States, but imported cases still occur.
CDC - Measles: Photos http://www.cdc.gov/measles/about/photos.html
From the Whatcom County department of health:
Precautions To Take When Scheduling Visits for Measles Assessment
- Instruct telephone and triage staff to assess for rash illnesses prior to the patient coming to the facility
- Patient MUST wear a mask before they enter the facility. (surgical masks are sufficient). Examine patients in their vehicle if necessary.
- Rapidly isolate persons with suspected measles in a private room and call the Health Department. In hospital settings, patients with suspected measles should be placed immediately in a negative-pressure isolation room if one is available and, if possible, should not be sent to other parts of the facility.
- Only staff who have documented immunity to measles should be present in the room with the patient.
- Airborne precautions must be implemented during the exam. (N-95 masks are preferable, when available, for staff to use while in the room).
- The exam room should not be occupied for at least two hours after the patient leaves.