Tag: disease

Understanding the Health Impacts of Measles

Posted on by Nicol Walsh

According to the American Pediatric Association, measles was eliminated in the United States in 2000, when there was a year without recording an endemic spread of the virus. Measles is a highly contagious virus. Only humans can spread and get measles. Measles outbreaks in the United States result from an infected person bringing measles into a community. 

Studies have shown that the quickest way to protect against measles is with the measles, mumps, and rubella (MMR) vaccine. Two doses of the MMR are about 97% effective in preventing measles and one dose is 93% effective in preventing measles.

Both children and adults can get the MMR vaccine.

Brief Overview:

This article:

  • Provides information on why measles is beginning to spread again in the United States after several years with no community-wide infections
  • Explains how “herd immunity” protection works and why it can stop working
  • Describes the complications that can result from measles, including permanent conditions
  • Includes the signs and symptoms of measles
  • The quickest way to protect against measles is the Measles, Mumps, and Rubella (MMR) vaccine, which can be given to children and adults

Full Article:

Why are we talking about Measles? What is herd immunity?

According to the American Pediatric Association, measles was eliminated in the United States in 2000, when there was a year without recording an endemic spread of the virus. Measles outbreaks in the United States result from an infected person bringing measles into a community.

Measles outbreaks have happened in small pockets or communities of unvaccinated people in recent years. Within these communities the measles virus spreads quickly; without herd immunity, it is difficult to stop the outbreak. The COVID shutdown made it difficult for many families to vaccinate their children, and it has been a slow process to provide information on why vaccinations create safety barriers for children and families from disease. One of the most significant outbreaks in a while is happening this year (2025) in Texas and New Mexico and has shown up in 12 other states including Washington. Health officials are keeping an eye on the spread, and you can get information on cases in Washington State through the Washington State Health Department website.

This year was the first documented case of a death from measles in the U.S. in a decade. About 1 out of 5 unvaccinated people in the U.S. who get measles are hospitalized. Measles can have severe health complications: pneumonia, encephalitis (swelling of the brain), convulsions, and brain damage, resulting in possible deafness or an intellectual disability. One result of having measles can be a suppressed immune system lasting 2-3 years or longer. In addition, The MedlinePlus medical library of the National Institutes of Health states, “SSPE Subacute sclerosing panencephalitis (SSPE) is a progressive, disabling, and deadly brain disorder related to measles (rubeola) infection. SSPE is rarely seen in the United States since the implementation of the vaccination program.”

The United States was able to eliminate measles by having a high percentage of the population develop immunity by measles vaccination or natural immunity by having the virus known as herd immunity. Herd immunity is achieved when 95 percent of the population has developed immunity by contracting a virus or other disease or being vaccinated. In past years, the large number of people protected from the measles virus protected the few unprotected people from getting the virus. If they did get the virus, herd immunity keeps it from spreading. In the United States, by the year 2020, we had achieved zero percent cases of measles per every 100,000 people, or for all practical purposes, we had achieved 100% herd immunity.

How is the measles virus spread?

Measles is a highly contagious virus. Only humans can spread and get measles. Measles lives in the mucus of the nose and throat of an infected person. Measles can spread when a person coughs or sneezes in the air. If another person breathes in the contaminated droplets or by touching the infected surface, then touches their eyes, nose, or mouth, they can become infected. The virus can live in the air for up to 2 hours.

A person is infectious even before they know they have the disease. They can spread the disease up to four days before and four days after they have the rash.

Prevention

Studies have shown that the quickest way to protect against measles is with the measles, mumps, and rubella (MMR) vaccine. Two doses of the MMR are about 97% effective in preventing measles and one dose is 93% effective in preventing measles.

Both children and adults can get the MMR vaccine. This webpage on the Centers for Disease Control (CDC) website has information on who is recommended to get the vaccine, who should not get it, and where to get the vaccine and options for paying for it.

The Measles, Mumps and Rubella (MMR) vaccine is free to all infants and children in the United States, and you can request a vaccine for your child if they are unvaccinated, through their doctor or at a Community Health Clinic.

Seattle’s Children’s Hospital provides the following information on side effects from the vaccine shot.

  • A mild fever of less than 103 degrees F. in 10% of children vaccinated lasting 2 or 3 days.
  • A mild pink rash on the body’s trunk lasts 2 or 3 days. No treatment is needed. Your child can go to school or childcare with the rash.

It is recommended that caregivers call your doctor if:

  • Rash changes to blood-colored spots.
  • Rash lasts more than 3 days.

A lot has been shared about Vitamin A and measles across many avenues of information. It has been documented across the medical field in multiple medical journals and from various Children’s Hospitals that vitamin A cannot prevent a person from getting measles. Where Vitamin A has been most effective in the treatment of measles has been as a supplemental treatment that can be added in severe cases to reduce the risk of death for some children with a deficiency of Vitamin A in their system. Still, it does not prevent catching measles and can be toxic if a child or adult gets too much.

Signs and Symptoms of Measles

The first sign of measles symptoms appears 7-14 days after a measles infection. A person is contagious before showing any signs of the measles rash.

Measles usually begins with:

  • A consistent high fever. (may peak at 104 degrees F)
  • A cough
  • Runny nose
  • Red watery eyes

2-3 days after symptoms begin tiny white spots (Koplik spots) may appear inside the mouth.

The measles rash may start to appear 3-5 days after the initial onset of symptoms. The rash begins as flat red spots that begin on the face at the edge of the hairline. The rash spreads downward to the neck, trunk, arms, legs, and feet. Small, raised bumps may appear on top of the flat red spots. As the rash spreads across the body the spots may become joined together. When the rash appears a person’s fever may spike higher than 104 degrees F.

Common Complications from Measles

  • Ear infections occur in one out of every ten children with measles.
  • Diarrhea can occur with measles.

What to do if you think your child has measles

The CDC states, “Measles is not just a little rash. Measles can be dangerous, especially for babies and young children. If you suspect that you or your child has been exposed to the measles, call you healthcare provider immediately.”

Here are some additional links and resources:

Center for Disease Control    

Preventing Measles Before and After Travel Fact Sheet – also available for download in the following languages: Spanish, Russian, Ukrainian, Romanian, Amharic, Hindi, Somali, Arabic and Urdu.

A Measles facts sheet is provided by the Pediatric Pandemic Network that can be kept as a reference sheet and provides images of measles.

Seattle Children’s Hospital information on measles vaccine side effects

If you are planning international travel talk to your doctor.  Here is an infographic link from the CDC you can click on and download to use for helpful tips.  Protect your child from contracting measles.

Here are some additional links and resources:

Center for Disease Control   information provided about measles – Preventing Measles Before and After Travel Fact Sheet – also available for download in the following languages: Spanish, Russian, Ukrainian, Romanian, Amharic, Hindi, Somali, Arabic and Urdu.

Measles facts sheet is provided by the Pediatric Pandemic Network that can be kept as a reference sheet and provides images of measles.

Seattle Children’s Hospital information on measles vaccine side effects

If you are planning international travel talk to your doctor. 

Protect your child from contracting measles. an infographic link from the CDC you can click on and download to use for helpful tips.

Does My Child Need a Medical Action Plan?

Posted on by Nicol Walsh

Medical action plans are for situations where a child has a life-threatening illness or condition, when medication needs to be taken on schedule, and/or they need to be monitored for symptoms. This article explains what a medical action plan is, when it’s needed, where to use it, and how it’s separate from but can support Individualized Education Programs (IEPs) or Section 504 plans.

A Brief Overview

  • Medical action plans are for situations where a child has a life-threatening illness or condition, when medication needs to be taken on schedule, and/or they need to be monitored for symptoms
  • Medical action plans can be used in school, in community settings, and at home or while traveling.
  • Your child’s pediatrician or primary care provider and their staff can be good resources to help you create the medical action plan.
  • In schools, parents and their medically aware children) meet with the school nurse to develop or complete a plan. School staff are responsible for carrying out the plan.
  • If a child has an IEP or 504 plan, a medical action plan can be referred to in any appropriate section to address limits on physical activities or modified academic expectations when a condition affects a child’s learning or ability to function well at school. 
  • Home, community and travel medical plans are very useful to inform first responders and others not familiar with your child’s needs with essential information about their typical routine and the steps to take in case of an emergency.

What is a medical action plan?

It’s a plan for when a child has a life-threatening illness or condition and/or requires medical monitoring or medication.

In school settings, school staff have responsibility for following the medical action plan. The plan is for the health and wellbeing of the student in the school environment.

Examples of illnesses and conditions might include:

  • Allergies, like food allergies, that can cause anaphylaxis and need an epi-pen
  • Diabetes which may require monitoring and insulin injections
  • Asthma, and a backup inhaler
  • Seizure disorders
  • Mental/behavioral health conditions
  • Complex medical conditions with ongoing needs
  • Cancer, heart conditions, and any other serious or life-threatening illnesses and conditions

A medical action plan explains important steps like when to give rescue medication if needed, when to call emergency services (911), if the student should use a buddy system when going from place to place if there isn’t a support dog, and other essential actions based on the student’s individual medical needs.

Other items which might need to be on the plan:

  • what kinds of durable medical equipment might be needed for support at school, and who is responsible for providing them
  • what kinds of medication and medical interventions could come up day to day
  • what kinds of emergency situations are possible

The medical action plan is developed to help school, their staff, the family, and student all be on the same page about the impact of an emergency event or a day that might have higher needs.

Here are some plan examples to guide you:

Medical action plans are not IEPs or 504 plans. If a student has an IEP or 504 plan, a medical action plan can be referred to in any appropriate section to address limits on physical activities or modified academic expectations when a condition affects a student’s learning or ability to function well at school.

Here’s more information about 504 plans and Individualized Education Programs (IEPs).

How do I request a medical action plan for my child?

A medical action plan is developed in a meeting or series of meetings with the school nurse and an IEP or 504 plan team, if your child is on a 504 plan or IEP. Parents can prepare for the meeting by drawing up their own list of their child’s medical needs in the school environment, but templates, or pre-made plans you can personalize are also available from the school nurse or your child’s pediatrician and/or specialty provider.

Once your child understands their medical needs and their body’s signals, it is vital to request that the student be a part of this meeting so that they can express what their triggers may be and what it looks like when they have a flare-up, attack, or episode. These points should also be written in the plan.

Some school districts require a doctor’s input or signature, especially if medication is involved. It’s a good idea to schedule a doctor’s visit in late July or August to help fill out the action plan so that you can get any input and signatures you need.

Parents should ideally meet with the school nurse and teachers or teams working with their child before registration or the start of school. If that’s not possible, schedule as soon after the school year begins to avoid potential emergency situations with no plan in place.

For students who already have medical action plans, this timeline is important to update the school nurse and staff about any changes in the student’s condition and adjust the plan accordingly. This may also include changes to the 504 plan and IEP if required.

Having information on hand for your child/youth when you or they travel or go on field trips can be accomplished through a one-pager or card that can be kept with you or your child. It would have:

  • Your child’s diagnosis
  • Medications prescribed and when your child takes them
  • Any over-the-counter medications used and when your child takes them
  • Emergency contacts
  • What a medical emergency looks like for your child, and what steps to take to deal with it.

Essential brief “information at a glance” can be on a single sheet of paper or card and put on the refrigerator for first responders, sitters, and respite workers. You or your child can carry it when visiting or in a community setting. Plastic peel-and-stick “laminating” sheets are handy to protect the paper or card and are available at office supply stores and online. Information on how to create these forms and the templates can be found at the links below.

Family to Family Health Information Center (opens on a new website)

My Child’s Care (PAVE’s articles on Health and Wellness)