Never Seen Measles? 5 Things to Know

Andrew T. Pavia, MD


May 02, 2019

In This Article

Measles Re-emerges

Measles infections in the United States are reaching their highest level in decades, which means that most clinicians practicing in this country today have never actually seen a case of the highly contagious disease. Although measles was declared eliminated from the United States in 2000, 704 cases have been reported from 22 states as of April 26, 2019.[1] The infection's clinical presentation is fairly typical and predictable, but it can lead to serious complications and may even require hospitalization.

Here are five things to know about measles.

1. Certain Patient Groups Are Most Vulnerable

Before measles vaccination began in the United States in 1963, many children contracted this highly contagious disease and simply suffered through a miserable illness. Almost 500 people died each year from measles, with 1000 cases of encephalitis and 48,000 hospitalizations—in a population one third the current size.[2] Other complications include otitis media, laryngotracheobronchitis (croup), measles pneumonia, and bacterial pneumonia. Subacute sclerosing panencephalitis is a delayed form of encephalitis that may appear 3-30 years after the infection[3] and is more common in children infected with measles at a young age.

Malnourished children are particularly vulnerable; diarrhea and pneumonia can be lethal complications, and measles can cause blindness in these children. Vitamin A deficiency increases the risk for severe pneumonia, diarrhea, and eye disease.

Measles is more likely to be severe and cause complications in the following groups:

  • Children younger than 5 years of age but especially infants;

  • Adults older than 20 years;

  • Pregnant women; and

  • People with severely compromised immune systems (eg, from cancer chemotherapy, leukemia, transplantation, HIV, or immunosuppressive drugs).


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