Which vaccine-preventable disease is sometimes referred to as “the black vomit”?
Rabies
Smallpox
Yellow fever
Typhoid
C

Yellow fever can cause internal bleeding, leading to bloody vomit. Read more

 

Measles

Centers for Disease Control and Prevention
Boy with measles
 
Measles cases in the United States by year, 1954-2008
000507,999991

Symptoms and Causative Agent

Measles is an extremely contagious disease caused by a virus from the paramyxovirus family and spread by air. Its symptoms include fever and coughing as well as its infamous rash. Typically, fever occurs before the measles rash; however, with the appearance of the rash, the existing fever may rise to temperatures of 104°F or higher.

These symptoms usually begin one to two weeks after infection with the measles virus; most people recover within two to three weeks.

Measles is also called “rubeola,” but should not be confused with rubella, or the so-called German measles.

Transmission

Measles is a highly contagious disease. The virus is found in the nose and throat of infected patients and is sprayed via coughs and sneezes into the air, where it can remain active and infectious for up two hours. As a result, a person can become infected simply by breathing the air in a room that had been occupied by a measles patient as much as two hours earlier.

Treatment and Care

There is no direct treatment for measles. Supportive care may be provided, including efforts to keep the patient hydrated and to lower the fever associated with the disease.

Complications

Measles can lead to complications ranging in severity from diarrhea to encephalitis (swelling of the brain), with adult patients typically being subject to more severe complications. Although the disease is rarely fatal in developed countries, the death rate can be quite high in underdeveloped nations. Case-fatality rates have been recorded as high as 28%, and tend to rise during wars or widespread food shortages. As recently as 2000, measles caused 1.1 million deaths globally among young children in a year’s time.

Available Vaccines and Vaccination Campaigns

A vaccine to protect against measles was developed in the 1960s and was quickly adopted. Widespread vaccination programs, including the Measles Initiative launched in 2001 by the American Red Cross, the United Nations Foundation, the U.S. Centers for Disease Control and Prevention, UNICEF and the World Health Organization, contributed to global decreases in measles cases until the case count among children fell as low as 118, 000 by 2008.

Since 2008, however, vaccination campaigns have suffered from funding cutbacks, allowing the highly contagious disease to roar back. Despite the cost of vaccinating a child against measles being less than $1 USD according to the World Health Organization, outbreaks have been reported in 30 African countries as well as Thailand, Bulgaria, Indonesia and Vietnam. Britain has also been experiencing a resurgence of the disease following the publication of a flawed 1998 paper suggesting a link between the MMR vaccine and autism. Although the paper has since been withdrawn and its author’s license to practice medicine in Britain revoked, the country’s MMR vaccination levels have not yet returned to those achieved before the paper was published. Measles cases, in turn, have risen to more than 10 times the number reported a decade earlier.

U.S. Vaccination Recommendations

Vaccination against the measles is included on the U.S. childhood immunization schedule as part of the combined MMR (measles, mumps and rubella) vaccination. This vaccine is given in two doses, the first of which is recommended after 12 months of age. Alternatively, measles vaccination is available as part of the newer MMRV (measles, mumps, rubella, and varicella) combination vaccine, which also protects against chickenpox.


Sources

Centers for Disease Control and Prevention. Measles. (600 KB). Epidemiology and Prevention of Vaccine-Preventable Diseases. Atkinson W, Wolfe S, Hamborsky J, McIntyre L, eds. 11th ed. Washington DC: Public Health Foundation, 2009. Accessed 7/31/2014.

Perry, RT, Halsey, NA. The Clinical Significance of Measles: A Review. The Journal of Infectious Diseases 2004 189:S1, S4-S16. Accessed 7/31/2014.

 

To read PDFs, download and install Adobe Reader.

Last update 31 July 2014

Timeline Entry: 1916 Measles Continues to Spread in the U.S.

The College of Physicians of Philadelphia
C. Everett Koop is asked which vaccine has had the most signficant impact on health.
000517

Measles killed nearly 12,000 people in the United States in 1916, 75% of them younger than five years old.

Estimates of the percentage of measles patients who suffer complications from the disease have ranged from 15% to as high as 30%. Serious complications include pneumonia, encephalitis, and corneal ulceration.

See This Item In The Timeline
EVT_100526
diseases-and-vaccines

Timeline Entry: 1971 Measles, Mumps, Rubella Vaccine Licensed

Footage courtesy of The Vaccine Makers project
Combined MMR vaccine
000819

The U.S. government licensed Merck’s combined trivalent measles, mumps, and rubella vaccine (MMR).

Combination vaccines have several advantages over single vaccines. They reduce the need for several separate injections, and they reduce costs of stocking and shipping multiple containers. Combination vaccines can help improve overall vaccination rates by simplifying the vaccination process.

See This Item In The Timeline
EVT_100824
pioneers

Assessment Questions

True or false? Measles is not considered to be highly contagious.
A) True
B) False
Measles is often recognized by which early symptom?
A) Distinctive swelling behind the ears
B) Runny nose
C) High fever
D) Distinctive rash
In developing countries, measles __________.
A) has all but disappeared
B) causes many deaths
C) is not preventable with vaccination
D) is always a mild illness
View Progress