Measles, Mumps & Rubella
General Information
Students who are in group settings like residence halls are at higher risk for communicable diseases. For this reason, college students should have received two (2) doses of the measles-mumps-rubella (MMR) vaccine.
These illnesses are relatively rare in the U.S. but prior to the vaccine, they caused serious illness, lifelong disabilities and even death. The last big rubella academic in the U.S. was in 1964 and resulted in about 25,000 children with serious complications such as heart defects, deafness, blindness, or mental retardation because their mothers had the disease during pregnancy.
Routine childhood immunizations now protect most individuals but occasional outbreaks erupt and individuals who are not fully immunized are at risk, either in childhood or as adults. Further, they can expose pregnant women and fetuses to these illness. Are you protected?
If you are unvaccinated or unsure of your vaccination status the Measles, Mumps, & Rubella (MMR) vaccine is strongly encouraged. Contact your healthcare provider or local health department about getting vaccinated.
Measles signs and symptoms appear around 10 to 14 days after exposure to the virus. Signs and symptoms of measles typically include:
- Fever
- Dry Cough
- Runny Nose
- Sore Throat
- Inflamed eyes (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.
Vaccination
The measles vaccine is highly effective and very safe. A single dose of measles vaccine protects about 95 percent of children, but after two doses, almost 100 percent are immune. You cannot get measles from the vaccine. It is effective within 72 hours of exposure to prevent illness. In addition, immune globulin treatment is effective within six days of exposure for high-risk individuals. Talk to your healthcare provider to determine if immune globulin is right for you and if it is available.
High-risk individuals include those who are unvaccinated or unsure about vaccination status, pregnant women and those who are immune-compromised (have a weakened immune system due to illness and diseases like HIV, malnutrition and/or medications).
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The Washtenaw County Health Department offers vaccination by appointment (734-544-6700).
If you have Medicaid or Blue Cross Blue Shield insurance, or are uninsured or under-insured, and do not have proof of being vaccinated or having measles in the past, there will be no cost to you for the MMR vaccine. Please bring your insurance card. If you have another form of private insurance, contact your healthcase provider for the vaccine.
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Measles is transmitted by airborne particles, droplets, and direct contact with the respiratory secretions of an infected person;
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Measles virus can remain infectious in the air for up to two hours after an infected person leaves an area;
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Symptoms usually appear 10 to 12 days after exposure to measles, and in some cases, symptoms can start as early as seven days or as late as 21 days following exposure;
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Early symptoms include fever, cough, runny nose, and red, watery eyes;
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Small, white spots (often on a reddened background) occur on the inside of the cheeks early in the course of measles.
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Rash and fever are the defining symptoms of measles and usually occur four days following the early symptoms. The rash usually starts on the face and proceeds down the body and can persist for several days;
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Infected individuals are contagious from four days before rash onset through the fourth day after rash appearance;
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Any susceptible (unvaccinated) person can contract the measles;
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People at high risk for severe illness and complications from measles include:
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Infants and children aged younger than 5 years
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Adults aged 20 years or over
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Pregnant women
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People with compromised immune systems, such as from leukemia and HIV infection
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Contagious Period
Measles (Rubeola): 4 days before to 4 days after rash; highly contagious.
Mumps: 3 days before to about 9 days after symptoms.
Rubella (German Measles): 1 week before to 1 week after rash; people who have no symptoms can transmit it.
Onset of Symptoms
Measles (Rubeola): 10 - 12 days after exposure.
Mumps: 12 - 25 days after exposure.
Rubella (German Measles): Range 14-23 days; average 16-18 days.
Common Symptoms
Measles (Rubeola): Rash, high fever, cough, runny nose and watery eyes - lasts 1 to 2 weeks.
Mumps: Fever, headache, muscle aches, tiredness, loss of appetite and swelling of salivary glands and cheeks.
Rubella (German Measles): Mild symptoms (slight fever, rash, swilling of neck glands) - lasts about 2 days in children and young adults.
Complications
Measles (Rubeola): Diarrhea; ear infection in 1/10 children; pneumonia in 1/20 children; encephalitis (inflammation of the brain) in 1/1,000 children; seizures; death in 1/10,000 children.
Mumps: Meningitis (inflammation of the covering of the brain and spinal cord) in 1/10 children; encephalitis (inflammation of the brain), that typically goes away without permanent damage; deafness, usually permanent; inflammation of the ovaries, breasts, and testicles.
Rubella (German Measles): Swelling and aching of joints lasts 1 to 2 weeks especially in women; encephalitis (inflammation of the brain), that usually goes away without permanent damage; purpura (temporary bleeding disorder).
Complications for Pregnant Women and Their Babies
Measles (Rubeola): Miscarriage; premature births and low birth-weight.
Mumps: Miscarriage
Rubella (German Measles): Miscarriage; In babies - blindness, deafness, heart defects, cataracts, liver and spleen damage, mental retardation.
Immunization Recommendations
College students and others should be immunized against measles, mumps and rubella.
If you were born after 1956, two doses of a combination measles-mumps-rubella (MMR) vaccine is recommended.
Most people born in or before 1956 were infected with measles, mumps and rubella in childhood and are presumed to be immune.
People born in the 1970's are less likely to have received two doses.
If you are concerned about your immunity, a blood test can be ordered to provide immunity.
The MMR vaccine is a live, attenuated (weakened) vaccine. I twas first licensed in the combined form in 1971 and contains the safest and most effective forms of the vaccine.
The vaccine is 75-91% effective, even with two doses.
Side effects of the vaccine are usually mild and include rash, slight fever, mild swelling of salivary glands, aching or swelling joints (more common in adults). If you become ill within 4 weeks following an immunization, contact your health care provider.
The MMR vaccine is not recommended for pregnant women, although it is not known to cause illness. Women who are planning pregnancy should wait 3 months after immunization before getting pregnant.
Avoid immunization:
- When you are ill (have a fever or don't feel well)
- If you have systemic allergic reactions, like trouble breathing, to eggs, chicken protein or the antibiotic neomycin.
- Have cancer, leukemia, lymphoma or HIV/AIDS
- Have received gamma globulin (immune globulin) in the past 3 months
Contact your health care provider for advice.
Measles, mumps and rubella cases are tracked to identify and address outbreaks. Please report such illness to your health care provider. There are no consequences for individuals for reporting illnesses and you may be able to help prevent illness in others by reporting your own.
Treatment involves self-care to reduce symptoms; there are no cures for these viral illnesses.
Stay at home if you are ill to avoid exposing others. In the case of the mumps, do not return to work, school or child care for 9 days after symptoms begin.
If you are sick in a Residence Hall or group living quarters let your parents know you are ill or someone on campus. Have a friend bring you food.
- Avoid close contact with people who are sick.
- When you are sick, keep your distance from others and if possible, stay home.
- Cover your mouth and nose with a tissue or your sleeve (not your hand) when coughing or sneezing.
- Clean your hands with soap and water or alcohol-based cleaner.
- Avoid touching your eyes, mouth or nose.