What’s Up with Measles?   

Guest Essay by Kip Hansen  —  24 March 2025 — 1900 words

Measles is getting rather spotty coverage in the press over the last couple of months.  Most of the coverage deals with a measles outbreak in Texas, in and around Gaines, Terry and Dawson counties in the South Plains region of the U.S. state of Texas.

These three counties have a combined population of about 46,000 people.    The media reports that there are many Mennonite families in the area which fail more often to have their children vaccinated. 

What is MEASLES?

“Measles is an acute, viral, infectious disease. [The measles virus is a paramyxovirus of the genus Morbillivirus.]  References to measles can be found from as early as the 7th century. The disease was described by the Persian physician Rhazes in the 10th century as ‘more to be dreaded than smallpox.’ ”

“Before a vaccine was available, infection with measles virus was nearly universal during childhood, and more than 90% of persons were immune due to past infection by age 15 years. Measles is still a common and often fatal disease in developing countries. The World Health Organization estimates there were 142,300 deaths from measles globally in 2018. In the United States, there have been recent outbreaks; the largest occurring in 2019 primarily among people who were not vaccinated.”

[ CDC – Epidemiology and Prevention of Vaccine-Preventable Diseases: The Pink Book, Chapter 13: Measles ]

Important Things to Know about Measles:

Measles is one of the most contagious diseases.

There is no cure and no real treatment for measles infection: 

“There is no specific antiviral therapy for measles. Medical care is supportive and to help relieve symptoms and address complications such as bacterial infections.” [ CDC ]

Those supportive treatment options are limited to:

Rest: Encourage the patient to rest and avoid strenuous activities.

Hydration: Ensure the patient drinks plenty of fluids to prevent dehydration.

Fever management: Use over-the-counter medications like acetaminophen or ibuprofen to reduce fever.

Vitamin A supplementation: Two doses of vitamin A supplements may be given to patients, especially those with vitamin A deficiency.

Antibiotics: Antibiotics may be prescribed if the patient develops bacterial complications, such as pneumonia or ear infections.

Hospitalization: In severe cases, hospitalization may be necessary for supportive care, including oxygen therapy and intravenous fluids.

And Cod Liver Oil?  as above,

“Under the supervision of a healthcare provider, vitamin A may be administered to infants and children in the United States with measles as part of supportive management. Under a physician’s supervision, children with severe measles, such as those who are hospitalized, should be managed with vitamin A.” 

The World Health Organization states:  “The risk of developing severe or fatal measles increases for children aged <5 years, and persons living in overcrowded conditions, those who are malnourished especially with vitamin A deficiency…” …  “Vitamin A should be administered to all acute cases irrespective of the timing of previous doses of vitamin A. Vitamin A oral dosage should be given immediately on diagnosis and repeated the next day…”

Robert F. Kennedy Jr., current U.S. Secretary of Health and Human Services,  has publicly recommended Cod Liver Oil, a safe natural Vitamin A and D supplement, to parents whose children have the measles.  One teaspoon of Cod Liver Oil contains about 13,200 IU of Vitamin A – about 1/4^th the initial dosage recommended by the CDC for treatment to be followed by a second dose the next day.    RFK Jr. was vilified and pummeled in the mass media for this helpful and medically correct recommendation to parents and for noting that children who were malnourished were more at risk.  [Note that not one of the media reports that I have read in preparing this essay, well over 50 items, have mentioned the CDC or WHO recommendations on Vitamin A and its relation to Cod Liver Oil. ]

Where does measles come from?

Measles is endemic in human populations.  That means that it is everywhere you find humans, except where it has been eliminated by exposure and vaccination.  Vaccination creates pockets of measles-free populations, like the United States.   Humans are the reservoir for the measles virus — a paramyxovirus of the genus Morbillivirus – which is not found in any other animal.

“Measles Epidemiology

Reservoir : Human

Transmission:

• Person-to-person via large respiratory droplets
• Airborne in closed areas for up to 2 hours”  [ CDC Pink Book ]

Measles outbreaks in the United States in recent years have always been traced to those arriving from foreign countries, or those travelling abroad,  after measles was declared eliminated in the United States in the 2000 following a decades-long massive immunization campaign.  Now, outbreaks most often occur in “underimmunized close-knit communities” and can be traced to some infected individual coming into the community from abroad.  (This is the case in the current Texas outbreak, though the origin of the first case has not been determined). 

This graph, with the correct vertical scale, shows the true state of affairs with the measles in the United States over my lifetime (1940s onward).  By 1969, measles had been eliminated as a major childhood disease.  There were still occasional outbreaks, but no major outbreaks since 1992.  None that show at that scale, in any case – but from a Public Health viewpoint, there were and are still “serious” outbreaks.

The above is total measles cases, where the previous graphic was “cases per 100,000 population”.  The high points in this graph only show in the previous graph as a little blip around 1990.   The current Texas outbreak is shown at the far right “2025”. 

In today’s U.S.A., it is impossible for the measles to spread widely or to become epidemic.   The majority of the adult population is immune, either from prior infection (usually as a child in pre-vaccination times, like myself) or from vaccination as a child.  Measles can only be spread in a rare subpopulation that contains many non-immune people and then only to those not immune.

Infants younger than 6 months – too young to be vaccinated – are at risk everywhere – which is one of the reasons international travel is discouraged until they are older and can be vaccinated against measles and other diseases endemic in other parts of the world.  

Adults who were vaccinated as children or who had measles as a child, can lose some immunity as they age – not everyone is 100% protected by vaccination or prior illness.  Those adults re-infected with measles, or infected after having been vaccinated as children,  usually have a mild case if they are otherwise healthy. 

“Another group that may be at risk is adults who were immunized between 1963, when the first measles vaccine was approved, and 1967. During that period, some children received an inactivated (killed) measles vaccine that was less effective than the live vaccine. If you know that you got the inactivated vaccine and not the live one, or aren’t sure, you should get at least one dose of the live MMR vaccine, according to the CDC.” [ source ]

But, measles is a serious danger to pregnant women — “measles in pregnant women who are not vaccinated can increase the risk of miscarriage, premature labor [and] low birth weight” but not birth defects.   [ source ]

Re-vaccination is recommended for women intending to become pregnant if their immunity is in question and for older adults who fall into the 1963-1967 vaccine time frame.  (This would have included me if my father had not been a pediatrician). 

So why the vaccination hesitancy?

First there is this:

[ link to full sized image ]

This infographic, produced by a vaccine advocate, has the data correct – but it is nonetheless misleading (and very hard to see – click on the Full Sized Image link to see it in a new tab/window) .   In the United States, it has been over 3 decades since there have been 10,000 cases of measles….out of the handful of active measles cases each year, there are thus very few serious side effects actually experienced.   

However, 3.3 million children entered kindergarten in 2023.  Thus about 990 of those children statistically may have experienced ‘fever related seizures’ related to MMR vaccination (3 out of 10,000);  12 children experienced allergic reaction and about the same abnormal blood clotting.   The probability of your child having one of those adverse reactions is thus very small – but to some parents, it is still scary.

The controversial idea that MMR vaccination might cause conditions now classified as Autism Spectrum Disorder is widely considered to have been disproven – but it was recently announced that “The Centers for Disease Control and Prevention (CDC) will study whether vaccines cause autism, despite numerous existing studies already showing there is no link.”  [ ABC News ]

How well protected are our children today?

Here is the latest state-by-state percentages of fully vaccinated children entering kindergarten (those having received all vaccinations required, including 2 MMR vaccinations):

The light blue states, 20% of the 50 states,  are considered as “full vaccination” in respect to public health.  In total, about 92.7 % of children entering kindergarten in 2024 were fully vaccinated.  That is a little short of the public health ideal of 95%. 

The current situation with measles in the United States, as of 21 March 2025, is 378 known cases, 75% of those children.  52 children have required hospitalization (currently recommended for all serious measles cases).  One school-aged child, who was unvaccinated,  has died from measles.

Bottom Lines:

1.  Measles is a serious and highly contagious disease, though less dangerous in developed countries with general good health and adequate nutrition.

2.  There is no cure and no real treatment for measles – only recommended supportive care for those ill:  Rest, hydration, fever control, and Vitamin A supplementation.  Antibiotics can be given to handle bacterial complications.

3.  Measles outbreaks in the United States are rare, limited, and occur in pockets of un- and undervaccinated groups.  Initial infections originate outside the United States and arrive with immigrants or travelers. 

4.  Vaccination, with two doses of the MMR or MMRV vaccine, gives 97% immunity.  Not perfect for individuals, but more than adequate from a public health viewpoint.

5.  Vaccination against measles is clearly generally safe and effective.  That said, nothing is perfectly safe.

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Author’s Comment:

My father was a leading pediatrician in Los Angeles County, California for the forty years between 1950 and 1990.  He administered thousands of vaccinations to the baby boomer babies and then to their children.   When my wife and I faced the vaccination question for our children, starting in 1977, we asked The Doc (as everyone called my father).  He advised us to avoid the then-current MMR vaccine and instead opt for a single-antigen measles vaccine with the other two vaccines separate.  In his opinion, and at that time, he felt the measles component in the MMR was “rather crude, a bit harsh”.  All four of my kids got the single-antigen measles vaccine, though it was at times hard and not in conformance with current standards of care.   In the present, the single-antigen measles vaccine is not available in the United States – simply because it makes tracking and counting vaccination status more complicated for public health officials and agencies (yes, really).

Disease prevention through vaccination has been one of the greatest health advances in human medical history and continues to be so. 

Thanks for reading.

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Late Note: Sorry, didn’t realize that this was publishing so quickly, just getting to comments now! Noon 24 Mar 2025