What Coloradans Need To Know About Measles

Prior to 1963, catching measles was common. In fact, most kids would develop the virus before turning 15. But unlike a cold, the flu, or any other schoolhouse bug, measles can linger on surfaces or in the air for up to two hours—so back then, millions of people were infected, thousands were hospitalized, and more than 400 died from the disease each year. That changed in the mid-1960s with the measles vaccine. The shot is 97 percent effective at preventing infection to those who have received both doses. For it to prevent outbreaks, however, around 95 percent of the population needs to receive it.

Thanks to public vaccination efforts, measles was declared eliminated in the United States in 2000. Since then, though, cases have continued to pop up. In 2019, more than a thousand people were infected with the disease. And this year? We’re on pace to surpass that number, with more than 800 cases reported in the United States so far. Most of those are in Texas and New Mexico (and around 96 percent have occurred in unvaccinated people), but the disease finally reached Colorado at the end of March.

Today, five people in Colorado have reported measles cases: one in Pueblo, one in Archuleta County (in the southwestern part of the state), and three people in Denver (two of which live in the same household.) That might not seem like a big deal, but only one or two cases had been reported every year since 2014.

We sat down with Dr. Ned Calonge, chief medical officer for the Colorado Department of Public Health and Environment (CDPHE), to learn more about measles in Colorado.

Editor’s note: The following conversation has been edited for length and clarity. 

5280: Do you expect the number of cases to rise dramatically?
Dr. Ned Calonge: Measles is incredibly contagious, and we’re all susceptible to outbreaks, especially in communities that have lower vaccination rates. But it’s tough to predict how many additional cases we’ll have. Measles is so much different than, say, COVID-19. We do know more than 90 percent of Coloradans are immune, and so that means that fewer people will get it.

Do vaccinated people still have to worry about measles?
Three out of 100 people who have had two doses of the vaccine will still get sick. We know that typically, if they do get sick, they tend to have milder illness and are less likely to spread it to others. The vaccine is good, but it’s not a guarantee. Still, it’s the best way to prevent severe illness.

Why is getting the vaccine so critical?
As effective as the measles vaccine is, you actually have to get it in order for it to protect you. We know that there’s been upticks in cases in communities where vaccination rates are lower than the 95 percent that’s required to stop community transmission. Since 2000, our cases in the United States have come from infected individuals coming back into the country and coming into contact with unvaccinated people. That’s why I emphasize the importance of vaccination: A measles outbreak may only be a plane flight away.

What is the CDPHE doing about measles?
We’ve done community outreach since February to keep people informed of the confirmed measles cases. Our measles web page is up to date, and that’s where you can find where the cases are, vaccine recommendations, and answers to frequently asked questions. We’ve also been proactive in contacting providers who we provide the MMR [measles, mumps, and rubella] vaccine to, and we’ve actually seen a tripling in requests for publicly funded MMR vaccines. We’re sending direct texts and emails to families of children aged 12 months to 18 years who might not have up-to-date vaccination records. There are more than 100,000 children on that list. Thankfully, we’ve seen an increase in the measles vaccine this year as compared to last year.

What should people do if they suspect they have measles?
It’s really important to call your health care provider before just showing up at your doctor’s office or the emergency room. That helps them make arrangements so that their staff and other patients are protected. We want to make sure that health care facilities aren’t areas where people can get exposed.

The MMR vaccine is currently only available to people older than 12 months old. What should parents of infants know?
If they need to take their infant to an outbreak area, then they should talk to their pediatrician about receiving an earlier vaccination. 
Right now in Colorado, we’re not considered an outbreak area, so we’re not recommending that earlier vaccination. Unless you have to go, don’t travel somewhere where there are ongoing outbreaks.

Some of the main symptoms of measles are a rash and fever—but those symptoms are seen in other illnesses like hand, foot, and mouth disease. Are there any glaring symptoms that would point to measles rather than another illness?
The fever you get with measles is significantly higher than what you’d see in hand, foot, and mouth disease. It usually reaches over 103 degrees. There’s also this thing called “the measles look,” where infected people will sometimes have droopy red eyes. You’d also get a runny nose that runs down the back of the throat and a cough. The fever starts before the rash. You might get white spots in your mouth, which is pretty similar to hand, foot, and mouth disease, but that’s followed by a rash that’s obviously different. The measles rash usually starts at your hairline and goes down throughout your face.

You can check you or your child’s immunization status through the Colorado Immunization Information System, and find a vaccine provider through the CDPHE here.