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CDC and WHO Warn of Measles Outbreak Risk After 22 Million Babies Missed Their Vaccines During Pandemic

The Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) are warning about the potential threat of measles after more than 22 million babies across the world missed the first dose of their measles vaccination during the height of the pandemic.

The new report—which was published online ahead of the CDC's November 12 Morbidity and Mortality Weekly Report journal—notes that 22.3 million infants missed their first dose of the measles vaccine last year, which is 3 million more missed doses than in 2019. It's also the "largest annual increase in over 20 years" of unvaccinated children, the report states.

The potential concern, the report says, is that there will be a resurgence in measles cases globally. The WHO echoed those concerns in a news release on November 10, noting that the global progress against measles has been "threatened" by the COVID-19 pandemic.

Measles-CDC-Warning-GettyImages-153565602 Measles-CDC-Warning-GettyImages-153565602 . "We must act now to strengthen disease surveillance systems and close immunity gaps, before travel and trade return to pre-pandemic levels, to prevent­­ deadly measles outbreaks and mitigate the risk of other vaccine-preventable diseases."

Kate O'Brien, MD, director of WHO's Department of Immunization, Vaccines and Biologicals, agreed. "While reported measles cases dropped in 2020, evidence suggests we are likely seeing the calm before the storm as the risk of outbreaks continues to grow around the world," she said in the WHO news release.

This news raises a lot of questions about measles—including how the threat might impact you. Here's what you need to know.

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What is measles?

Measles is an acute viral respiratory illness, the CDC explains. It comes with a host of unpleasant symptoms, including a rash, high fever, and cough, and is usually regarded as a childhood illness.

Measles is considered one of the most contagious infectious diseases out there, with the CDC noting that up to nine out of 10 susceptible people with close contact with a measles patient will get the virus. "Measles is extraordinarily infectious," Thomas Russo, MD, professor and chief of infectious disease at the University at Buffalo in New York, tells Health. "We need about 95% of the population to have immunity, and any decrease in immunization could put us at risk of infection."

The two-dose MMR vaccine, which targets measles, mumps, and rubella, has largely helped tamp down measles cases in the US and across the world. In the US, the CDC recommends that children receive the first dose of the MMR vaccine when they are 12-15 months old and the second dose when they are 4-6 years old. Together, the two doses are about 97% effective at preventing measles.

However, not everyone gets the vaccine, and cases do occur. So far this year, there have been 47 cases of the illness reported in the US.

How does measles spread?

Measles is spread through direct contact with infectious droplets or through the air when an infected person breathes, coughs, or sneezes, the CDC says. The measles virus can live and linger in the air for up to two hours after an infected person leaves an area. That means that someone with measles could have come and gone from a spot but can continue to infect people who later go to that spot for hours afterward.

Even if you were vaccinated, it is still possible to get measles. According to the CDC, about three out of 100 people who get the standard two doses of the MMR vaccine and are later exposed to the virus will get measles. However, these vaccinated people are more likely to have a milder illness and are also less likely to spread the disease to others.

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Can you get measles as an adult?

The CDC and WHO warning comes after a steep decline in childhood vaccination rates. But these low rates can potentially lead to outbreaks that affect the population at large. Because unfortunately, yes, you can get measles as an adult. If you've been vaccinated against measles, your odds of contracting the virus are low, infectious disease expert Amesh A. Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security, tells Health. But if you're not vaccinated against it, you're more susceptible.

In addition to the usual uncomfortable symptoms, Dr. Russo says that adults are more likely to develop complications of measles, which can include ear infection, bronchitis, pneumonia, encephalitis (swelling in the brain), and pregnancy issues like preterm labor, low birth weight, and maternal death. "If adults get measles, like many childhood diseases, it can be extraordinarily severe and lethal," he says.

Can you get vaccinated against measles as an adult?

If you're a parent, you'll want to check that your child is up-to-date with their MMR vaccines. You can also check up on your own vaccination status. Because yes, you can get the MMR vaccine as an adult. Adults who were born before 1957 don't necessarily need to get the vaccine—it's assumed that they have immunity to measles through exposure "because it was so rampant at the time," Dr. Adalja says. But people born after that time who haven't had the MMR vaccine should get it, he says.

If you only had one dose of the vaccine as a child instead of the recommended two doses and were born after 1957, the CDC says that the one dose "is sufficient to be considered protected from measles." 

The CDC recommends that adults who don't have presumptive evidence of immunity—meaning you didn't receive any dose, you were born after 1957, or you don't have proof of a past infection—get at least one dose of the MMR vaccine. Adults who are at greater risk for being exposed to measles, such as health care personnel and international travelers, might need two doses. If you're planning to get two doses, they should be spaced 28 days apart.

However, not everyone should get this vaccine. "Because the MMR vaccine is a live vaccine, it's not recommended in pregnancy and in severely immunocompromised patients," Dr. Russo says.

Once you get the vaccine, though, it's expected to protect you for life. "It's one of our vaccines that seems to last for a long time," Dr. Russo says.

You can usually get the MMR vaccine at your doctor's office or local pharmacy, Dr. Adalja says, adding, "it's not hard to get the MMR vaccine if you want it." If you suspect that you or your child need the vaccine, talk to your doctor.

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What are the symptoms of measles?

Vaccinated or not, child or adult, it's good to know the symptoms of measles. Here's a breakdown, according to the Mayo Clinic:

  • Fever
  • Dry cough
  • Runny nose
  • Sore throat
  • Inflamed eyes (aka, conjunctivitis)
  • Tiny white spots with bluish-white centers on a red background found inside the mouth on the inner lining of the cheek
  • A skin rash made up of large, flat blotches that often flow into one another

Symptoms of measles usually show up between seven to 14 days after someone is infected, the CDC says. The virus is serious and dangerous and can be particularly risky for these groups of people, per the CDC:

  • Children younger than 5
  • Adults older than 20
  • Pregnant people
  • People with compromised immune systems, like from leukemia or an HIV infection

If you think you have measles, the CDC recommends immediately calling your doctor to let them know about your symptoms so that they can tell you what to do next.

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