Move Over, Covid—There's Another Virus on the Rise

Last week I attended my quarterly conference for physicians addressing the latest concerns about virus illnesses. I expected the presentation done by Shira Shafir, Ph.D., Master of Public Health, and associate professor at UCLA, to be mostly about COVID-19 but, to my surprise, I learned that COVID-19 was not the major concern in the United States these last three months.

When I asked Shafir about the content of COVID-19 virus (SARS-CoV-2 virus) in wastewaters in the last three months, she said that the viral content was not high, which means that, currently, not many people are infected with COVID-19 in the United States.

Shafir mentioned that the press was writing a lot about the avian flu virus because it was recently discovered in cattle, but only one person in the U.S. has tested positive for avian flu so far this year, and no other case of cattle-to-human or bird-to-human transmission of the avian flu virus has been reported this year.

The major viral concern in the U.S. currently, according to Shafir, is measles.

This made me think of two questions: Why is measles such a concern when it was declared eliminated from the U.S. in 2000? And should you vaccinate your child against measles?

There are 5 reasons why measles is a concern this year

1. The measles virus is extremely contagious: According to the CDC, measles spreads through the air when an infected person coughs or sneezes. It is so contagious that if one person has measles, up to 90 percent of people around that person will also become infected if they are not protected. Your child can get measles just by being in a room where a person with measles has been, even up to two hours after that person has left. An infected person can spread measles to others even before knowing they have the disease—from four days before developing the measles rash through four days afterward, according to the CDC.
2. Not enough people are vaccinated: In several states, less than 94 percent of children are currently vaccinated, which means that over 6 percent of the children in these states are not protected against measles.
3. The number of measles cases is increasing every year in the United States. Prevalence was at its highest in 2019 before the pandemic, but then, during the pandemic, because people wore masks, the number of measles cases (and of all viral infections) decreased all over the country. Now that people aren’t wearing masks anymore in public places and many children are not up-to-date on their vaccinations, numbers are rising again.
4. Measles can cause brain swelling and death: Even though some people think that measles is just a little rash and fever that clears up in a few days, the CDC mentions that measles can cause serious health complications, especially in children younger than five. There is no way to tell in advance the severity of the symptoms your child will experience. About one in five people who get measles will be hospitalized. One out of every 1,000 people with measles will develop brain swelling, which could lead to brain damage. One to three out of 1,000 people with measles will die, even with the best care.
5. People travel in countries where there are measles outbreaks: People travel all over the world and because there are still measles outbreaks in many countries, travelers can bring the measles virus back to the U.S. and trigger an outbreak in unvaccinated communities.

What is the current measles situation?

According to the CDC, in 2024, so far, the United States had eight outbreaks (defined by three or more related cases), compared to four outbreaks in 2023. The total number of measles cases so far in the U.S. is 132, most of them in unvaccinated people. Out of those 132 cases, 58 cases were in children less than five years old, 30 were in individuals from five to 20 years old, and 44 were in people older than 20.

Out of these 132 cases, 70 (51 percent) had to be hospitalized. And it’s not only the children under five who had to be hospitalized; 50 percent of the people with measles who were older than 20 were also hospitalized.

What was the measles situation before 2000?

In the decade before the live measles vaccine was licensed in 1963, there were three to four million cases of measles estimated per year, 48,000 hospitalizations, 4,000 cases of brain swelling (encephalitis), and 450 to 500 deaths in the U.S.

In developing countries, still now, 1-5 percent of children with measles die from complications of the disease, and the case-fatality rate may be as high as 25 percent among people who have poor access to health care.

In 2000, thanks to a strong measles vaccination campaign, measles was declared eliminated in the U.S.

What are the symptoms of measles?

Symptoms of measles include high fever, runny nose, cough, red watery eyes (conjunctivitis), and skin rash.

What should you do if your child has measles?

Call your doctor for treatment and, most importantly, keep your child isolated at home. Do not put your child at a daycare center or send your child to school because measles is extremely contagious, and if an immunocompromised friend is in contact with your child, that friend could die or be brain-damaged for life.

Can there be other causes of fever and rash?

Yes, other viruses like a parvovirus, a roseola virus, or an enterovirus can cause fever and rash. If your child only has a rash without fever, that rash could be due to an allergic reaction. But the most dangerous fever and rash combination currently is in measles.

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Should you vaccinate your child against measles?

The answer is yes because vaccination is the only way that we know of to this day to protect your child and your child’s brothers, sisters, and friends against complications of this extremely contagious viral infection. When asked about the vaccination's side effects, Shafir said, "While side effects from the vaccine can and do occur, they are mostly mild and of significantly lower risk than the chance of hospitalization and severe disease as a result of measles infection."

In summary

Currently, the most worrisome human virus infection is measles, so make sure that you and your family are vaccinated with the recommended two doses of measles vaccine.