Since the beginning of this year, 159 cases of measles in 10 states have been confirmed by the U.S. Centers for Disease Control and Prevention. That’s a lot for just two months, especially for a disease that, back in 2000, was declared eliminated from the United States. (For comparison, most recent years haven’t seen that many cases in an entire 12-month span. Two exception were 2018, which saw 372 cases, and 2014, which saw 667.)
Many of this year’s cases are part of measles outbreaks in Washington, New York, Texas, and Illinois (today, the state’s health officials warned Chicago Midway International Airport travelers that they may have been exposed to the disease). Experts say many of these outbreaks are being fueled by low vaccination rates among children. The number of nationwide cases is so concerning, in fact, that a heated Congressional hearing was held on the topic just this week.
But despite countless news articles—and doctors’ attempts to communicate the risks of measles to their patients and the public—there’s a lot of confusion and misinformation around this topic. Just this month, the wife of a Trump cabinet member tweeted that America should “bring back” childhood diseases like measles because they “keep you healthy & fight cancer.”
Doctors and measles researchers say that statements like these are not only false, but they’re also dangerous. Because while many people who get measles do recover fully, some don’t. Some will experience lifelong effects from the illness, and some will even die.
How bad is measles, really?
The severity of measles varies from case to case, says Robert Murphy, MD, professor of medicine at Northwestern University. “It runs the whole spectrum—from just a rash and a sore throat to total, multi-organ failure and death,” he says. “So if you had a mild case and recovered, you might not be aware of how bad it can really be.”
When measles was first brought to North America by Europeans in the 1400s, he says, the mortality rate among American Indians—who had no natural immunity—was as high as 10%. More recently, before the modern measles vaccine was developed in 1963, more than 48,000 people were hospitalized—and around 500 people died—each year in the U.S. alone.
Today, measles prevalence is much lower. And thanks to medical advances and better knowledge of the disease, serious complications are less likely. According to the CDC, for every 1,000 people who get measles, about 1 or 2 will die.
But even if you survive measles, there are other possible risks. Encephalitis—a dangerous condition that involves swelling around the brain—happens in about 1 in every 1,000 measles cases. This can cause seizures, deafness, and permanent brain damage and disability, says Dr. Murphy.
In very rare cases, a fatal neurological disease called subacute sclerosing panencephalitis (SSPE) can develop 7 to 10 years after a person gets measles—even if they recovered fully from the illness. Fewer than 10 cases a year of SSPE are reported in the U.S., but it’s much more common in developing countries with lower vaccination rates.
Other complications happen much more frequently, even here in the U.S. About one in every four people who get measles will need to be hospitalized—often because of severe ear infections, diarrhea, or pneumonia. About 1 in 20 children with measles will get pneumonia, historically the most common cause of measles-related death in children.
Who gets hit hardest by measles?
Measles can affect people of any age, although complications are more common in kids under 5 and adults over 20, according to the CDC. Research also suggests that children who get measles before age 2 have a higher risk of developing SSPE later in life.
People with weakened immune systems—due to another illness or certain medications—are also at increased risk of getting a more serious case of measles, says Dr. Murphy.
Deaths from measles in the U.S. are rare. The last reported fatal case was in 2015, and the last one before that was 12 years prior. The most recent victim was a woman in her 20s, according to the Seattle Times, who had several health conditions and was taking drugs to suppress her immune system. Her official cause of death was pneumonia caused by measles.
How to protect yourself and your kids
There is no cure for measles, but medical care help reduce fever and inflammation, and ensure that a patient is getting enough fluids and nutrition. “If you or your child begins to have symptoms, seek medical care right away,” says Dr. Murphy. “And try not to contaminate people on the way to the doctors or the hospital—wear a mask try to avoid public places.”
But, of course, the best way to avoid getting really sick from measles is to be up-to-date on your vaccinations, says Dr. Murphy. A full course (two shots) of the measles, mumps, and rubella (MMR) vaccine is about 97% effective at preventing the disease, while one shot is about 93% effective.
“The vaccine is extremely effective and extremely safe,” he says. Anti-vaccine groups claim that vaccines are somehow related to autism but that idea has been debunked numerous times by rigorous studies. “There is no association with autism,” he says. “Literally, none.”
Research shows that a community’s vaccination rate must be above 90% to contain the spread of measles, and Dr. Murphy worries that rates are dropping below that in several U.S. cities. “The development of the measles vaccine was a dramatic medical breakthrough, because so many people were dying or getting really sick,” he says. “This is a completely preventable illness, and it’s very frightening that we’re seeing it make a comeback.”
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