Measles (Rubeola)

Measles (Rubeola)


Measles is a highly contagious viral disease which has been largely controlled in the United States but which remains widespread in many other countries. The illness is characterized by fever, conjunctivitis, runny nose, cough, and rash, which begins on the face and spreads downward. Complications may include bacterial pneumonia or encephalitis (inflammation of the brain).

Combined measles, mumps, and rubella vaccine, known as MMR, is recommended for all children in a two-dose schedule at ages 12-15 months and 4-6 years. Children older than 6 months but younger than 12 months of age who will be traveling to countries where measles occurs should be given a dose of monovalent measles vaccine before departure, to be followed by two doses of MMR after age 12 months.

Adults born after January 1, 1957, who do not have two documented measles vaccinations should either be immunized against measles or tested for measles immunity by measuring antibody levels. This is particularly important for those born in the late 1950's and 1960's, many of whom remain susceptible to measles because the recommendation at the time they were growing up was to give only one dose of measles vaccine. Adults born before January 1, 1957, are presumed to be immune to measles due to early childhood exposure before measles vaccine became available.

Adverse reactions following MMR vaccine may include fever, rash, lymph node enlargement (due to the rubella component), inflammation of the parotid gland (due to the mumps component), or joint pains (due to the rubella component). Allergic reactions may occur but are rarely severe. Because MMR vaccine contains live, weakened strains of all three viruses, it should not be given to pregnant women or severely immunosuppressed individuals. It should also not be given to anyone with a history of severe allergy to gelatin, neomycin, or a prior dose of MMR. Reports that measles vaccine may be linked to autism, inflammatory bowel disease, and other disorders have not been confirmed. Unfortunately, these fears, which are medically unfounded, may have led to a decrease in measles immunization in a number of countries, including the United Kingdom.