Measles outbreaks in the Pacific Northwest: What to know

Measles is making headlines again. 

Health officials in southwest Washington reported several cases this winter. They’ve asked healthcare providers to watch for signs of the contagious illness like fever, pink eye, cough and a red rash.

The outbreak wasn’t the only one. Nationwide, about two dozen cases were identified in December and January. The uptick caused the U.S. Centers for Disease Control and Prevention to issue an emergency notice.

Measles was once in decline, but it has been coming back in recent years. In 2019, Washington state had two outbreaks. State officials declared a public health emergency because of 51 cases, almost all in Clark County. Then as now, the illnesses affected people who weren't protected with vaccines.

“Measles cases can range from mild to more severe, particularly in those too young to be vaccinated and those whose immune systems aren’t working well,” says Jordana Hawkins, MD, pediatrics section chief at PeaceHealth in Bellingham, Washington.

Even in mild cases, people miss a lot of school and work because they need to stay home while they’re contagious,  Dr. Hawkins adds.

Here’s what you should know about measles, and what to do if you think you’ve been exposed.

What is measles?

Measles is an illness caused by the rubeola virus. It can spread through coughs, sneezing and drops of saliva. The virus is so contagious that if one person has it, 9 out of 10 people exposed to it can get sick if they're not protected with a vaccine.

When you have measles, symptoms usually show up about 10 days after you get the virus. The first signs are often fever, runny nose and a cough. About 3 days after that, a rash breaks out on your face, then spreads to the rest of your body.

“Measles is contagious 4 days before the tell-tale rash appears and 4 additional days after,” Dr. Hawkins notes. “This leads to a lot of unintentional spread to others before people know they are sick.”

Complications from measles can include ear infections and diarrhea. Sometimes it can cause more serious conditions like brain swelling, pneumonia, seizures or blindness.

Complications are more likely to affect children 5 or younger, people who are pregnant or people with compromised immune systems, the CDC says. Worldwide, measles is a big cause of disability and death in babies and children, according to the World Health Organization.

How do we protect ourselves from measles?

There's no cure for measles, but it is preventable. The best way to limit its spread in our communities is to get a vaccine, called MMR or MMRV. The abbreviation stands for the illnesses it protects us from: measles, mumps, rubella and/or varicella.  

MMR is given in two doses. Children should get their first dose when they’re about 1 year old. The CDC recommends the second dose between ages 4 and 6.

If you got two doses as a child, you should be protected for life. If you’re not sure, you can find out by reviewing your health record. If MMR isn’t noted on your chart, you can ask your doctor to do a blood test to check your immunity to the virus.

“MMR has been around since the late 1960s and has proven to be incredibly safe,” says Dr. Hawkins. “It’s also very effective once the 2 dose series is completed.”

One dose is about 93% effective in preventing measles if you're exposed to the virus, according to the CDC. With two doses, your protection rises to about 97%.

Why are these outbreaks important to know about?

We've had a vaccine for a long time. And Americans have been good about getting their MMR doses. So good, in fact, that by the year 2000 we considered measles eliminated in the United States.

But lately outbreaks are more common. “We are seeing significant cases in groups that are unvaccinated,” Dr. Hawkins notes. “These numbers rival those we saw before the vaccine was available.”

She says the rise is likely because of the long amount of time that someone can be contagious and how easily the virus can spread to unvaccinated people. The 2019 outbreak in southwest Washington could have been prevented, for example. Of the people who got sick, more than 85% hadn’t been vaccinated.

The virus also is surging in other parts of the world, and Americans who travel abroad may bring it back with them.

If you plan to go overseas, it’s a good idea to check if your health record shows two doses of MMR. If not, you may want to get the vaccine before you travel.

You can get MMR without an order from your PCP at many retail pharmacies and same-day clinics, or at your doctor’s office. Vaccines are usually covered by insurance, but you may want to ask your health plan if there’s any cost to you.

What to do if you're exposed or you think you have measles

If you think you have measles, reach out to your healthcare provider right away. Since the virus is so contagious, it's important to let your doctor know before coming into the office. If you have measles, you could expose other patients and staff to it.

When you call your PCP, tell them about your exposure and explain your current symptoms. They can check whether you're current on your MMR vaccine, and make a plan to examine you without putting other people at risk.

Treatment for measles

If your doctor confirms that you have measles, they’ll encourage you to stay home and avoid other people, so you don’t pass the virus along. Home treatment can include resting, drinking plenty of fluids and taking pain relievers to ease symptoms.

If you haven't had the MMR vaccine, you can get a dose within 3 days of exposure. Or you can have a treatment called immunoglobulin within 6 days of exposure. It can introduce disease-fighting substances called antibodies into your bloodstream.

Both of these treatment options may keep you from getting sick or lessen your symptoms if you already have measles.

"Vaccinations some of the most-researched medical developments in the world, so we know they are extremely safe and effective,” Dr. Hawkins says. “They protect us, and they protect those around us.”

She encourages everyone to check their MMR status. If you’re not current, now’s a good time to get an updated measles vaccine.