Recently, measles has started to make a big comeback in the United States, with the latest noteworthy outbreak taking place in the state of South Carolina. What are measles? What are its typical symptoms? How is it spread? What sorts of cautions can be taken to be proactive?
Measles, once considered eliminated from the United States in 2000, is making an alarming return. Recent outbreaks, including a notable one in South Carolina, have reignited public health concerns over a disease that had largely faded from the national conversation. But what exactly is measles, and why is it resurging now?
What are measles?
Measles is a highly-contagious viral disease caused by the measles virus, a member of the Paramyxoviridae family. It spreads rapidly and can lead to serious health complications, especially in young children, pregnant women, and those with weakened immune systems. While many may think of it as a childhood illness, measles is neither benign nor trivial.
Before widespread vaccination, measles infected nearly every child and caused hundreds of deaths annually in the U.S. alone. Thanks to the introduction of the MMR (measles, mumps, and rubella) vaccine in 1971 here in the United States, cases dropped sharply - until recently.
Symptoms and progression
Measles begins like a bad cold, which can make it difficult to diagnose in its early stages. Typical symptoms include:
- High fever, often over 104°F
- Cough
- Runny nose
- Red, watery eyes (conjunctivitis)
- Koplik spots, tiny white dots inside the mouth that are unique to measles
- A full-body rash, which appears 3 to 5 days after symptoms begin, starting on the face and spreading downward
How measles spreads
Measles is one of the most contagious diseases known to medicine. It spreads through respiratory droplets when an infected person coughs or sneezes. The virus can live in the air and on surfaces for up to two hours. A person can catch measles simply by entering a room where an infected person has recently been. In fact, up to 90% of people exposed to measles will become infected if they are not immune.
People are contagious from about four days before the rash appears to four days after. This wide, roughly eight-day, window for transmission, combined with the ease of airborne spread, makes outbreaks very difficult to contain once they begin.
Why the comeback?
The resurgence of measles in places like South Carolina reflects a larger, troubling trend: declining vaccination rates. The MMR vaccine, first introduced here in the United States in 1971, is safe, and it provides lifelong immunity after two doses. Yet misinformation, vaccine hesitancy, and complacency have led some parents to skip or delay vaccinations.
Measles thrives in these gaps. When vaccination rates fall below the threshold for “herd immunity” (about 95%), the virus can spread more easily, especially in communities where clusters of unvaccinated individuals live or attend school together.
Global travel also plays a role. Though measles may be rare in the United States, it remains common in parts of Asia, Africa, and Eastern Europe. Travelers who bring the virus back can unknowingly spark outbreaks in under-vaccinated communities.
Prevention and proactive measures
The most effective way to prevent measles is simple: vaccination. The CDC recommends two doses of the MMR vaccine - one at 12 to 15 months of age and another at 4 to 6 years. Adults who are unsure of their immunity or who never received the vaccine should consult their healthcare provider about getting vaccinated.
Other proactive measures include:
- Immediate isolation of suspected cases to prevent spread.
- Prompt public health response to trace contacts and contain outbreaks.
- Education and outreach to combat misinformation and encourage immunization.
Measles should not be making a comeback - not when we have the tools, strategies, and education to either limit its spread or even prevent it outright. Yet its return is a stark reminder of how fragile public health victories can be. The disease is not just a threat to individuals; it’s a litmus test for the strength of our healthcare systems, our trust in the scientific method, and our commitment to protecting our fellow citizens.
The lesson is clear: vigilance matters. And in the case of measles, the cost of complacency can be dangerously high.
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