The Return of Measles

July 2019

Meg Fisher, M.D., Chair of Pediatrics and Medical Director of The Unterberg Children’s Hospital at Monmouth Medical Center

Measles is a highly contagious viral illness that kills millions of children throughout the world every year. The illness starts with fever, cough, runny nose and red eyes; after about four days a rash starts on the face and spreads to the entire body. About one in 1,000 cases the brain becomes infected; this infection, encephalitis, may result in death. Survivors are often left with neurologic problems such as seizures and developmental delay. Bacterial superinfection is common in children with measles. Ear infections and croup are most common. Pneumonia occurs due to the virus but often due to bacteria such as Staphylococcus aureus and Streptococcus pneumoniae. Children with pneumonia often require oxygen or machines to assist with breathing. Measles, once a common childhood disease, is well worth preventing.

In the early 1900s there were about 6,000 deaths per year due to measles. By the 1960s there were 400 to 500 deaths a year. Following introduction of a measles vaccine, the incidence of infection dropped dramatically and within a decade it was rare to see a case of measles. One single dose of measles vaccine was about 95% effective and in 1989, both the Centers for Disease Control and Prevention and the American Academy of Pediatrics recommended a second dose of measles vaccine to protect the five percent of people who do not respond to the first dose. Measles rapidly disappeared and in 2000 the United States was declared measles free. In 2016, the entire region of the Americas (North, South and Central) was declared free of measles by the World Health Organization.

The number of measles cases in the US has increased over the past several years: in 2010 there were only 63 reported cases, but this year there are already over 1000 reported cases. Unfortunately, measles continues to occur in the rest of the world, including the United Kingdom, Ireland, Eastern and Western Europe, China, Russia, Southeast Asia, Korea, Japan, the Philippines, the Middle East and Africa. Travelers from these areas and unimmunized Americans who visit these places often bring measles to the United States. Since measles is highly contagious, it spreads easily to susceptible children and adults. So far in 2019, there have been outbreaks in 26 states; many are ongoing including those in New York, California, Michigan, Georgia, Maryland, Pennsylvania and Washington state.

Protect yourself, your children and your community. It is important to immunize everyone who can be immunized so that we can once again see measles disappear from the United States. Many parents have become concerned about the side effects of vaccines. This is understandable. However, it is important to remember that vaccines are tested extensively before and after licensure. These vaccines are given to healthy children to prevent illness; safety is a priority. The measles vaccine is very safe. As with all injections, there can be pain at the site of the shot. Further, because the vaccine is a live attenuated (weakened) virus, some children will develop a milder case of the measles about 10-14 days after vaccination but should also make a complete recovery.

Measles FAQ

  • Protection from the measles vaccine is generally lifelong.
  • Prior to their first birthday, many children will have maternal antibodies to protect them and these antibodies would also interfere with response to the vaccine. Measles immunization is therefore recommended universally for children ages 12 to 15 months (first dose) and ages four to six years (second dose)
  • Following a single dose of vaccine, 95% of people will be immune to measles. After two doses, that number increases to 99%.
  • If you or your child have received only one dose of vaccine in the past, a second dose should be given (note that the second dose should be given at least one month after the first dose).
  • If travelling outside the Western Hemisphere, your child should be immunized. At least two weeks prior to traveling, a child over six months but under a year of age, should get a dose of vaccine. It is recommended that children under six months get immunoglobulin shots.


Meg Fisher, M.D. is Chair of Pediatrics and Medical Director of The Unterberg Children’s Hospital at Monmouth Medical Center and specializes in pediatric infectious disease.