Dear Alice,

A friend of mine is living with someone who might have just got measles (results pending). If true, and my friend has also got it, how contagious is it? I think it is measles, rather than German measles, which I had as a child. Does past illness provide any defense? That is, can you get it twice? I presume having had German measles does not provide any protection against measles.

How is it transmitted? Like a cold? (Physical contact, common contact with hard surfaces, and maybe airborne?)

Dear Reader,

Your concern is understandable, considering that measles is a highly contagious (but preventable) viral infection. If you’ve had measles in the past or have been vaccinated, your chances of contracting measles are likely pretty slim. It’s critical to understand that German measles (rubella) and measles are caused by different viruses, and thereby having had one doesn’t protect you from the other. While you wait for your friend’s roommate’s results, it would be good to check on your own vaccination and immunity status and practice some healthy habits to take care of yourself.

Measles and rubella are both spread through airborne droplets when infected individuals sneeze or cough. Uninfected people catch the virus by inhaling or otherwise coming into contact with these droplets through their eyes, noses, or mouths. These droplets, whether in the air or on surfaces, can remain active for about two hours. Symptoms of measles include high fever, rash, runny nose, watery eyes, and coughing. A few days after infection, small mouth sores and a skin rash may appear. Measles infects people of all ages, but those who are younger than five or over 20 years of age are more likely to experience complications due to the infection, which may be serious in some cases. Though rubella and measles share some similar symptoms, rubella is less contagious and considered a milder infection.

The best way to protect yourself against measles is to get vaccinated. Most people who grew up or attended school in the United States have likely been vaccinated with the mumps-measles-rubella (MMR) vaccine. The vaccine is quite effective  — one dose being about 93 percent effective and two doses being about 97 percent effective. While it doesn't guarantee that you'll have complete immunity, it's a great dose of prevention to have working in your favor. Those who are vaccinated and get the measles will likely have a milder case than those who aren’t vaccinated. Additionally, having a previous measles infection does provide immunity against measles, and a previous rubella infection provides immunity against rubella. It’s highly unlikely to get measles or rubella more than once, since having the same prior infection or adequate vaccination generally offers lifelong immunity.

Fortunately, with the advent of an effective vaccine, the number of measles cases in the United States has dropped dramatically. The sources of present-day outbreaks have generally been attributed to overseas travelers and unvaccinated individuals or communities. If you’re unsure of your immunity, look through your vaccination records or ask your health care provider for a blood test to determine your status (this may take a few visits to determine). If you're unsure whether you've received it already or not, it’s also possible to get another dose of the vaccine as the Centers for Disease Control and Prevention has determined that there’s no harm in getting another dose of the MMR vaccine if you’re already immune.

For now, you may consider maintaining healthy habits such as eating a balanced diet, getting plenty of rest, engaging in regular physical activity, and washing your hands to support your immune system. In the event your friend or their roommate is diagnosed with measles, keep an eye out for any measles symptoms. If you experience symptoms such as a high fever or rash, it's a good idea to visit a health care provider. Here's to hoping for a negative test result, and that you'll avoid any illness.

Take care,

Alice!

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