Measles, mumps and rubella are all viral infections that caused widespread illness. Vaccines are now available for each and have been combined to form the MMR vaccine.
The face of measles
In 1991 the city of Philadelphia was in the grip of a measles epidemic. At the center of the epidemic were two religious groups that refused immunizations for themselves and their children. Children with measles developed high fever; a red, raised rash that started on the face and spread to the rest of the body; and “pink eye.” For some, the disease got much worse. Six children in these church groups and three children in the surrounding community died from measles.
By 2000, due to effective use of vaccine, measles was essentially eliminated from the United States. However, in 2014, more than 600 cases were reported, the largest outbreak in about 20 years. The reason: some parents were choosing not to vaccinate their children.
What is measles?
Measles is a disease that is caused by a virus. People with measles may have some or all of the following:
- A fever that gradually goes up to 103°-105°F
- Cough, runny nose, pink eye
- Raised, bluish-white spots inside the mouth
- A rash consisting of red spots, raised in the middle. The rash begins at the hairline and moves to the face and neck before descending downward and outward over the rest of the body
- Lack of appetite
How does measles spread?
When an infected person coughs or sneezes, measles viruses are spread in the small respiratory droplets. If a susceptible person breathes in these droplets or touches an infected surface and then puts his hand in his mouth or nose, he is likely to get measles.
How contagious is measles?
Measles is one of the most contagious diseases. In fact, if 100 susceptible people are in a room with someone who is infected, 90 of them are likely to become ill with measles. Further, if someone who has not had measles enters an elevator or other small space up to two hours after an infected person has left, he or she can still “catch” measles.
Are there complications from measles infections?
Yes. About 3 of every 10 people who get measles will develop complications such as:
- Ear infection
- Swelling of the brain
- Subacute sclerosing panencephalitis (a disease characterized by progressive neurological deterioration and early death)
- Hemorrhagic measles – includes seizures, delirium, difficulty breathing and bleeding under the skin
- Clotting disorder
Pregnant women who are infected with measles can miscarry, deliver early, or have a low-birth-weight baby. People who are immune compromised are at risk of having prolonged and severe illness.
What if I suspect measles?
Call your healthcare provider and mention your concern. Because measles is so contagious, providers typically do not want infected patients sharing a waiting room with other patients. This is particularly important for infants who are too young to receive the vaccine.
What is mumps?
Mumps is a virus that usually causes swelling in the salivary or parotid glands, just below the ear, lasting for about seven to 10 days. The chipmunk-like appearance of people infected with mumps is how mumps got its name.
But not all mumps infections were mild. Before the mumps vaccine, mumps was the most common cause of meningitis (inflammation of the lining of the brain and spinal cord). Virtually all children recovered from meningitis, but some were left with permanent deafness. Before the mumps vaccine, mumps was the most common cause of acquired deafness in the United States.
Mumps can also infect testicles and cause a disease known as orchitis. Some men with orchitis were found to be sterile after the infection resolved. Additionally, mumps infection during pregnancy occasionally resulted in the death of the unborn child.
The face of rubella
Before the rubella vaccine, children infected with rubella would develop a light, mild rash on the face. Some children would also develop swelling of the lymph glands behind the ear. Rubella was a mild infection of childhood. But in 1941, an Australian ophthalmologist made a curious observation. He found that many children were born with congenital cataracts and blindness following an outbreak of rubella. This was evidence that rubella could permanently damage the developing fetus.
What is rubella?
Rubella is a viral infection also known as German measles. Rubella infection of children causes a mild rash on the face, swelling of glands behind the ear, occasionally a short-lived swelling of small joints (like the joints of the hand), and low-grade fever. Children virtually always recover from rubella infection without consequence.
But rubella is not always a mild infection. Before the rubella vaccine as many as 20,000 babies were born every year with birth defects because of the capacity of rubella virus to infect the unborn child. In fact, 85 of 100 women infected with rubella in the first trimester of pregnancy had babies that were permanently harmed. Rubella virus can cause blindness, deafness, heart defects or mental deficits in infants whose mothers were infected early in pregnancy.
While rubella was not typically a severe childhood illness, it could be fatal when pregnant women were infected. Before the vaccine, each year about 20,000 babies were harmed when their mothers were infected during pregnancy. For this reason rubella parties were recommended by pediatricians to ensure that young girls were exposed before they were old enough to become pregnant. Today, with the availability of a vaccine, doctors and parents can be assured that children are becoming immune to these diseases in the safest way possible.
The MMR vaccine contains vaccines that protect against three viral infections: measles, mumps and rubella. It is given as a series of two doses at 12 to 15 months of age and at 4 to 6 years of age.