In 2000, measles was officially declared eliminated in the United States of America. This milestone marked a significant achievement in the fight against measles, a disease that, at one point, was associated with approximately 6,000 deaths per year.
So why is this highly infectious and deadly disease once again on the rise? Using CDC data, a graph showing the rates of measles in the USA since 1940 can be made. So, what can be done to stop it?
This article provides a comprehensive understanding of measles, including symptoms, prevention, treatment, and the importance of and understanding of vaccinations.
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What is Measles?
Measles, also called rubeola, is caused by the MeV virus. Before the introduction of the measles vaccine, most children were exposed to and contracted the virus due to its high transmissibility.
According to a virology report, this high-level infectious rate is due to the virus' structure, which provides the virus with multiple ways of infection and protects it from the immune system.
- The measles virus nucleoprotein (N) surrounds and protects the viral RNA genome, shielding it from the host's immune defenses.
- This protein is over-expressed at the time of viral replication.
- The C-terminal of N protein is intrinsically disordered, enabling it to interact with several host cell proteins and thus allowing multiple access points for infection.
Due to its high transmission rate, measles was associated with more than two million deaths worldwide each year before widespread vaccination efforts. The World Health Organization recognizes measles as a significant public health concern.
Part of what makes measles so easily transmitted is that it can be spread through several different methods, including:
- Contact with an infected patient.
- Airborne droplets from coughing and sneezing can survive for two hours and infect anyone who breathes them in.
- Touching a contaminated surface and then touching the face or eyes. The virus can live on multiple surfaces for several hours.
Individuals infected with measles can spread the virus for about four days before the appearance of the characteristic rash and for approximately four days afterward.
Recognizing Measles Symptoms
Measles has a specific 2-3 week course that includes:
Infection and Incubation
The virus spreads in the body about 10-14 days after infection. There are no signs or symptoms during this time.
Nonspecific Symptoms
For 2-3 days, symptoms may include:
- Mild to moderate fever
- Persistent cough
- Runny nose
- Inflamed eyes (conjunctivitis)
- Sore throat
Acute Illness and Rash
The following symptoms typically occur:
- Rash, usually beginning on the face.
- Tiny white spots with bluish-white centers atop a red background may develop on the inner cheek lining of the mouth, known as Koplik's spots.
- Small red spots (some may be slightly raised)
- Spots and bumps in tight clusters
Severe Symptoms
More severe symptoms can include:
- Rash spreading down the body, sometimes reaching as far as the feet
- High fever up to 106F (41C).
- Difficulty breathing
- Pneumonia
- Loss of consciousness
- Meningitis
- Blindness
- Seizures (fits)
Measles symptoms typically last about seven days, though the duration may vary among individuals. After that time:
- The rash fades in the same order it arrived
- The skin may darken and peel
- Low-grade cough may last for 10 days
Long-term Effects
Measles may have potential long-term effects, including:
Weakened Immune System
Some studies suggest that individuals who contract measles may experience a temporary reduction in immune function that could last for several years.
Subacute Sclerosing Panencephalitis (SSPE)
SSPE is a deadly neurological disorder that affects 1 in 100,000 measles cases. It can lay dormant for 6-8 years and causes the following symptoms:
- Loss of Motor Skills
- Loss of Vision
- Loss of Hearing
- Brain Damage
- Coma
- Death within two years
Prevention Strategies
Vaccination is considered one of the most effective ways to reduce the risk of measles. Studies indicate that the current vaccine, given in infancy, may provide up to 97% protection against measles infection.
It is part of the measles, mumps, and rubella (MMR) vaccine. The first dose is administered at 12-15 months of age, and the second dose at 4-6 years of age.
In addition, if a vaccinated patient does contract measles, the symptoms are mild and almost always result in a full recovery without the risk of severe infection or SSPE.
During the COVID-19 pandemic, many patients learned about "herd immunity." This is when:
- A large portion of a specific population is disease-resistant.
- The disease has fewer targets due to immunity.
- The disease disappears.
One common misconception is that herd immunity can only be achieved by infecting a population, so those who survive the infection are immune. Scientific evidence suggests that achieving herd immunity through natural infection has not been a reliable or effective strategy for controlling measles outbreaks.
Vaccination is the most effective method for establishing herd immunity and preventing measles outbreaks.
Widespread measles vaccination contributed to achieving herd immunity, leading to the official declaration of measles elimination in the United States in 2000.
Patients who believe they or their child has measles should seek immediate care from their healthcare team. Anyone with severe respiratory symptoms or loss of consciousness should seek emergency treatment.
The Return of Measles
According to researchers at Johns Hopkins, vaccine hesitancy in the US has led to lower vaccination rates, which may contribute to an increased number of measles cases.
The largest measles outbreak in the US since its near eradication was in 2019, when 1,200 cases were reported, most resulting from a significant outbreak in New York. A CDC report showed four times more measles outbreaks in 2024 than in 2023.
In 2025, there were already outbreaks in five states, including Georgia and Texas.
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Key Takeaways
- Measles is a very dangerous disease. It spreads quickly and easily through populations.
- It can spread through air droplets, surface droplets, and contact with infected individuals.
- The symptoms of measles include mild to moderate fever, persistent cough, runny nose, conjunctivitis, sore throat, and Koplik's spots.
- No specific antiviral treatment is available for measles; however, supportive care can help recovery.
- Vaccination remains the most effective way to prevent measles. They are safe, 97% effective, and can reduce the symptoms if measles is contracted.
- In the year 2000, measles was all but eliminated. Despite the current rise in cases, it is possible to do so again.
- Patients should be encouraged to receive the proper vaccines in an age of safe and effective vaccines. Medical teams play a crucial role in educating patients about vaccination benefits.
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