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Measles is caused by a virus, and many may be serious or even fatal. It usually causes a rash, high fever, cough, runny nose and watery eyes lasting one to two weeks. Its more serious effects are diarrhea, middle ear infections, pneumonia, and, less frequently, encephalitis leading to convulsions, deafness, mental retardation, or death.

Before 1963, when measles vaccine was first used, an average of about 500,000 cases were reported alone in the United States each year. Due to aggressive vaccination programs, measles cases reached their lowest point, less than 1500 cases, in 1983.

Measles is one of the most highly contagious infectious diseases. The virus is transmitted by airborne droplets, and is easily spread from person to person. The virus enters the body through the upper respiratory tract. Ten to twelve days after becoming infected, a person develops fever, cough, runny nose, red, watery eyes, and becomes contagious. The characteristic measles rash begins two to four days after the onset of fever. The rash usually begins on the face and over two to three days spreads to the trunk and abdomen, and finally to the arms and legs. A person becomes contagious at the time the fever begins, and remains contagious for seven to nine days after fever begins, or four to five days after the rash appears.

The diagnosis of measles is often made based on the signs and symptoms. Measles symptoms are usually distinctive and include fever, runny nose, cough, and red, watery eyes, often with sensitivity to light. The most definitive method of diagnosing measles is by either isolating the virus from the throat, or by a blood test for antibodies.

Once a person develops measles, treatment includes bed rest, maintenance of intake of fluids, and medication for fever and headache. The preventative use of antibiotics is of no value, and may increase the risk of severe secondary bacterial infection. Presently, there are no antiviral drugs available for treatment of measles.

In general, you can consider yourself immune to measles if you meet on of the following four criteria:

1. You have received, after your first birthday, at least one dose of live measles vaccine,
2. You have documentation of prior physician-diagnosed measles disease,
3. You have had laboratory testing which indicates immunity, or
4. You were born before 1957

Many states in the United States now require that children must have received a second dose of measles vaccine before they enter kindergarten. During a measles outbreak, infants may be vaccinated at a younger age. However, measles vaccine given to children less than twelve months of age may not produce immunity of the disease.

Some groups of adults are at higher risk of measles than others. These high-risk groups include:

1. Healthcare workers who have direct contact with patients
2. Students attending colleges, junior colleges, technical schools, and other institutions of post-high school education
3. International Travelers

Because of the increased risk of measles, it is very important that persons in these groups be certain that they are immune to measles. You can be certain that you are immune to measles if one or more of the following criteria apply to you:

1. You have received two doses of live measles vaccine after your first birthday
2. You have documented evidence of prior physician diagnosed measles disease
3. You have laboratory test results that indicate immunity

For anyone in doubt as to their immune status, it is recommended at least one dose of vaccine, be given.

Measles infection during pregnancy has been associated with an increased risk of miscarriages or premature delivery. Although birth defects have rarely been reported among children of women who had measles while they were pregnant, measles has not been proven to be the cause of the defects.

Measles vaccine should not be given to a woman known to be pregnant or who is considering becoming pregnant within the next few months. This precaution is based on the theoretical risk of fetal infection, although there is no evidence that this occurs. A pregnant woman who is not immune and who is exposed to measles should receive immune globulin, or IG, as soon as possible after known exposure. Measles vaccination during pregnancy should not be a reason to consider interruption of the pregnancy. The children of pregnant women can receive the vaccine. This will pose no risk to the pregnant mother.