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Silent Spreaders: How Measles Can Infect Before Symptoms Appear

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The recent rise in measles cases has brought renewed attention to the risks posed by infectious diseases. While often associated with childhood, measles can also affect adults, particularly those with compromised immune systems or incomplete vaccination histories, underscoring the importance of preventive measures.

Understanding measles transmission

Measles is an acute viral illness caused by the measles virus, one of the most contagious pathogens known. The virus spreads primarily through airborne respiratory droplets when an infected individual coughs or sneezes. These droplets can remain suspended in the air and remain infectious for extended periods. Up to 90% of unvaccinated individuals exposed to the virus may become infected following contact with an infected person.

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Symptoms and progression

Early symptoms of measles can resemble those of the common cold. Patients may experience high fever, cough, runny nose, and conjunctivitis. These are often followed by the appearance of Koplik spots—tiny white patches inside the mouth—and a red rash that spreads across the body.

The rash typically starts behind the ears before moving to the face, neck, torso, and limbs. Measles is contagious from four days before the rash appears to four days after, making this window critical for minimizing transmission.

The greatest danger of measles lies in its potential complications. While many healthy children may recover without severe issues, others can develop complications such as otitis media, diarrhea, pneumonia, or even encephalitis. The risks are higher for individuals with compromised immune systems, older adults, and pregnant women. R measles can be fatal in rare cases, underscoring the need for serious precautions.

Prevention through vaccination

Measles is preventable through vaccination. In South Korea, the national immunization schedule recommends two doses of the MMR vaccine (measles, mumps, and rubella), typically administered at 12 months and again between ages 4 and 6. Completing both doses confers over 97% protection against the disease.

Adults who were not vaccinated in childhood or whose immunity may have declined are encouraged to verify their antibody levels, particularly before international travel or during periods of increased community transmission.

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Special considerations for travelers and women of childbearing age

Those planning to travel to countries experiencing active measles outbreaks should confirm their immunity through a simple blood test, available at most healthcare facilities. If antibody levels are low, vaccination can be administered to ensure protection.

The MMR vaccine is contraindicated during pregnancy. Therefore, women of reproductive age should confirm their immunity before conceiving, allowing time for appropriate vaccination if necessary.

There is currently no specific antiviral treatment for measles. Management focuses on relieving symptoms and preventing complications. Rest and adequate hydration are essential during the febrile phase, and antibiotics may be used if secondary bacterial infections occur.

Vaccination is key

Vaccination remains the most effective defense against measles. High community immunization rates are essential to maintaining herd immunity and preventing large-scale outbreaks.

Recent increases in measles cases, often driven by declining vaccination rates and vaccine hesitancy, reinforce the urgent need for public education and proactive healthcare engagement. Ensuring widespread vaccine coverage protects individuals and the broader community, especially its most vulnerable members.

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