Ohio has seen two recent confirmed measles outbreaks in Ashtabula and Knox counties this year, leading public health officials and doctors to try to raise awareness about the disease and its vaccine.
The 10 infected people in Ashtabula County all completed their isolation periods and are no longer considered contagious, the county health department said. The county has held a series of vaccination clinics, including one Monday at the Monroe Township Fire Department in Conneaut.
"I took the measles shot (last month) and I just got the booster. I don't want to get the measles," said Wally Shetler, of Pierpont, at the Conneaut clinic. He came with his family of several brothers and a sister to get boosted.
His father, David Shetler, said he heard they were hosting the vaccine clinic near their home, so he took his children, all of whom were unvaccinated for measles. They said they didn't know anyone who was sick, but came as a precaution.
Measles was once considered eradicated by the United States in 2000, but has seen an uptick in cases amid a rise in vaccine hesitancy. Vaccine rates for measles, mumps and rubella — commonly known as the MMR shot — in kindergartners dropped in Ohio from 89.2% in the 2023-2024 school year to 88.3% in the current school year, according to the data from Ohio Department of Health.
The disease is highly contagious and especially dangerous among children, because it causes a series of serious conditions and has a fairly high mortality rate, said Dr. Amy Edwards, a pediatric infectious disease expert with University Hospitals.
Edwards helped answer listener questions about measles recently on Ideastream Public Media's Sound of Ideas.
What is measles?
Measles is a respiratory virus that can have serious repercussions, according to Edwards.
"So there's the respiratory virus component — cough, runny nose, fever, kind of the typical, and then you develop the rash that is so classic for measles. And that's the point at which measles can take a turn for the worse," Edwards said.
Children with measles are susceptible to pneumonia and infection of the ears, eyes, brain and heart. Any number of those can lead to permanent injury or disability, Edwards said, adding that one of every five children will require hospitalization to manage their illness, and one out every 1,000 children who get measles will die from it.
How contagious is measles?
Measles is one of the most contagious known viruses, Edwards said. Nine out of every 10 people who are vulnerable and exposed will get measles with that exposure. That compares with two or three vulnerable people who will get influenza from an infected person, she said.
Measles is so contagious because it can spread by any route, meaning it can be transmitted by contact, droplets or airborne, and is viable in the air for up to two hours.
"So a child can move through a hallway, cough in that hallway, and there is a viable, contagious virus in that air for two hours after that child has moved through," Edwards said.
What do symptoms look like?
Symptoms usually begin seven to 14 days after infection, according to the Centers for Disease Control and Prevention. Measles typically begins with high fever, cough, runny nose and red, watery eyes.
"That classic measles rash doesn't come until somewhere between day three and five of illness," Edwards said. "So [initially] the child has just a classic respiratory illness that could be anything, and they're contagious during that period."
Long-term outcomes can include pneumonia, encephalitis, brain damage, eye damage and loss of hearing, Edwards said.
How effective is the MMR vaccine, and who should receive a booster?
"Two doses of the MMR vaccine is 96% effective in preventing disease. In the 4% who will still get disease, we see an almost zero rate of hospitalization," Edwards said.
The vaccine prior to 1971 wasn't as effective as the live virus vaccine that we have now.
People who received that vaccine "probably [don't] have much, if any, protection," Edwards said. She recommended people in that situation consult their primary care provider.
For those who get the booster, two doses 28 days apart is the general recommendation.
Are there any risks in receiving the MMR vaccine?
Mark Meinke, from the city of Ashtabula, visited the Monroe Township Fire Department vaccine clinic with his wife and son. Meinke and his son both got boosted with the second dose of the MMR vaccine, after getting the first dose a month ago. He said he didn't have questions about the vaccine.
"Yeah, as long as it ain't none of that COVID [vaccine]," Meinke said. "All the other shots, I don't care what it is."
Edwards said there are many false claims about the MMR vaccine being dangerous, but years of data show adverse events are "one in a million, one in billion type rare." For example, there is no mercury in the vaccine, nor does it damage the immune system, as is sometimes claimed, she said.
"The truth of the matter is, vaccines are incredibly safe," Edwards said. "The live measles vaccine that's in the MMR vaccine was studied in a randomized placebo controlled trial with tens of thousands of children for decades."
Are there medicinal alternatives to the MMR vaccine?
No. Beyond getting vaccinated, there is nothing you can do to prevent a measles infection, Edwards said.
Health and Human Services Secretary Robert F. Kennedy Jr. has claimed that vitamin A and cod liver oil are effective treatments for measles. Kennedy recently visited west Texas, where dozens of measles cases have been confirmed and two unvaccinated children have died.
Edwards said vitamin A cannot treat or prevent measles.
"There have already been at least 10 cases of vitamin A toxicity in children in Texas, so we need to lay this to rest," Edwards said.
She said Vitamin A claims arose because malnourished children in undeveloped countries are given vitamin A supplements due to insufficiencies in their diet.
"It is very true that if we supplement them with vitamin A, they will do better when they catch measles," she said.
But people in the United States and in Europe do not show improvement in outcomes with vitamin A supplementation because they are not vitamin A deficient, Edwards said.
Can I vaccinate my infant?
The MMR vaccine is only licensed for use in children who are at least 12 months old. Right now, if you're not in one of the areas where the outbreak is ongoing, there is no concern, Edwards said.
"We are not currently recommending children under the age of one year get vaccinated," she said. "If the outbreak were to grow, if you were to travel outside the United States or need to travel to that part of Texas, or Ohio, you could discuss that with your pediatrician once your child reaches six months."
