What to know about measles in children: Vaccination schedule and what measles rash looks like

A measles case in Montgomery County and outbreaks in other parts of the country have parents of young children worried about their risk.

The local cases, including one in Montgomery County and three in northern New Jersey, have been among patients who were unvaccinated. A baby who was too young to receive their first dose of the measles vaccine is the first case seen in Pennsylvania this year, said Richard Lorraine, the medical director of Montgomery County’s public health department.

The virus is known for being highly contagious — a person who is sick can spread the virus to up to 18 unvaccinated people, according to the U.S. Centers for Disease Control and Prevention. By comparison, one person with seasonal flu will spread the virus to about two unvaccinated people.

The measles vaccine, whose first dose is recommended at 12 months of age, is highly effective against the virus. The disease was essentially eradicated in the United States because the vast majority of children were routinely vaccinated as part of school immunization requirements. But as vaccination rates have dipped, outbreaks have become more common.

In the last year, several cases of measles have been identified in the Philadelphia region; last winter, a measles outbreak sickened nine people and sent seven to the hospital.

The latest outbreak in Texas has sickened more than 100 people, making it the largest in recent years, and one child has died, the first such death in this country in a decade. But medical experts urged families to remain calm.

“It’s not a time to panic,” said Karen Ravin, division chief of infectious diseases at Nemours Children’s Health, Delaware Valley. “It’s a time to do the things we know are the right things to do — get everybody up to date on their vaccines.”

But some worried parents are asking: What about babies who are too young to be vaccinated?

The Inquirer spoke with Ravin and Daniel R. Taylor, medical director of the outpatient center at St. Christopher’s Hospital for Children and a frequent contributor to The Inquirer, about what families of young children should know about measles.

Measles symptoms resemble other common childhood illnesses, but occur all together.

Early symptoms include a relentless cough, runny nose, and red, puffy eyes similar to conjunctivitis or pink eye.

A red, blotchy rash of small raised patches begins on the face and spreads downward across the body. Redness may be less vibrant on darker skin, but will still be apparent.

“It’s the combination of the three,” Taylor said. “If you have a kid with pink eye, cough, rash — and usually a fever, as well — we’re isolating the room.”

In serious cases, measles can lead to pneumonia, brain infections, and other organ complications.

About one in 1,000 children affected with measles will die, according to the CDC.

One in five unvaccinated people who contract measles will be hospitalized, and one in 20 children will develop pneumonia, the leading cause of death from measles in young children, according to the CDC.

The measles vaccine contains a tiny dose of weakened, live virus that teaches the immune system to recognize the virus and develop antibodies against it. Vaccines against smallpox and chickenpox are other examples of such live-attenuated vaccines.

Live-attenuated vaccines can provide lifelong protection. One dose of the measles vaccine provides 93% protection against the virus; a second dose increases immunity to 97%, according to the CDC.

Most children get their first measles vaccine around 12 months old and their second around 4 years old. Children who were not vaccinated at the recommended age can still get the vaccine.

Maybe. Talk to your pediatrician.

Babies 6 to 11 months old who are traveling internationally to a country with a known measles risk should get one dose of the vaccine. Babies who have had an MMR dose before their first birthday should get two more doses starting at a year old, according to the CDC.

Doctors may also recommend the vaccine for babies at least 6 months old whose families live in a community with a documented outbreak.

Lorraine said that parents who are traveling abroad or to a place with significant measles cases, like Texas, can talk to their doctor about getting a child’s second MMR dose early as well.

The child in the case reported this weekend had recently traveled internationally to an area where measles circulates more widely, Lorraine said, then traveled home to Montgomery County through New York, New Jersey, and Philadelphia.

» READ MORE: What to know about the Montgomery County measles case identified over the weekend

The vaccine is not given to babies younger than 6 months because infants are protected by antibodies they receive from their mothers for several months after birth, longer if they are breastfed.

People with immune deficiencies must take extra precautions and consult their doctor before getting the measles vaccine, because it contains weakened live virus. Immune deficiencies that would prevent a child from getting the measles vaccine are rare, but typically don’t become apparent until babies are several months old — another reason medical experts suggest following the recommended vaccination schedule, Taylor said.

Call your pediatrician immediately. If they decide your child needs emergency care, the doctor can alert the hospital to prepare an isolated room and an arrival plan to minimize the risk of spreading the virus to other patients and families at the hospital, Taylor said.

In an emergency, call the hospital to let them know you think your child has measles. If calling 911, tell the operator you suspect measles.

If possible, isolate the child at home to reduce the risk of spreading the virus to other family members.

Educate yourself, be vigilant, and try to stay calm.

Familiarize yourself with the symptoms of measles and have a plan of what to do if you believe your child is sick.

Do not allow your children to spend time with peers who are sick, if possible. Parents who are worried about the virus may choose to avoid crowds.

Practice good hand hygiene and teach children to do the same.

No, people who are pregnant cannot get the measles vaccine.

People who are pregnant are at greater risk for contracting measles if they have not been vaccinated. If you think you have measles and are pregnant, talk to your doctor about medications that are safe during pregnancy.

Staff writer Aubrey Whelan contributed to this article.