Better Know a Plague: Measles, Mumps & Rubella

A couple of weeks ago, an interactive map compiled by the Council on Foreign Relations went viral online, although it first published in 2011. The map shows worldwide outbreaks of preventable diseases from 2008 to the present, including measles, mumps, and rubella.

Many news outlets that posted the map linked the surprisingly high occurrence of outbreaks in places like Europe and the United States to the anti-vaccination campaign that has raged in these regions since the early aughts, which has especially targeted the MMR vaccine because of a false claim that the shot causes autism. Rather than rehash all of the information on that, I suggest reading about it here, here, or here.

But what exactly are measles, mumps, and rubella? Why do we vaccinate against them to begin with? It has been such a long time these diseases were truly widespread, people seem to have forgotten just how serious they can be. Here is what you risk if you skip your children’s MMR vaccines:

Child with measles

Measles (aka rubeola)

This viral respiratory illness is caused by certain species of Morbillivirus and it is highly contagious—so contagious that 90 percent of people who aren’t immune will get sick if they interact with someone who is infected.

Symptoms show up around 10 days after exposure, and usually start with a fever accompanied by upper respiratory problems, including cough, runny nose, and sore throat. A few days later, small bluish-white blotches called Koplik’s spots show up inside the cheeks, and a couple of days after that a red rash appears near the hairline and then spreads all the way down the body to the feet.

Although measles itself isn’t usually fatal, it is associated with complications that include pneumonia, encephalitis, and eye irritation or infection that can lead to blindness. Vaccination has mostly wiped out the disease in the US, but an estimated 20 million people contract measles worldwide each year and 164,000 die. Before the measles vaccine was invented, the illness typically broke out every two or three years, mainly affecting infants and young children, and both cases and related deaths were far more common.

Classic swelling of the neck in a child with mumps

Mumps

The mumps virus, from the genus Rubulavirus, causes a contagious illness that is spread through infected saliva or mucus—usually through coughing, sneezing, and the like. Symptoms typically show up between 16 and 18 days after exposure, and include several days of fever, headache, muscle ache, tiredness, and loss of appetite. Between 30 and 40 percent of people with the mumps will also suffer an inflammation of the salivary glands, also called parotitis, which causes a prominent swelling under the lower jaw.

As with the measles, the mumps is mainly a childhood disease and generally affects people between the ages of five and nine. People who get the mumps usually recover. However, complications may include meningitis, encephalitis, and deafness. For the unlucky teens and adults who do contract mumps, the complications are usually worse and include painful inflammation the testicles, ovaries, and breasts. In severe cases, while rare, the inflammation can cause sterility in men and miscarriage in pregnant women who are in their first trimester.

Rubella (aka German measles)

A child with cataracts due to Congenital Rubella Syndrome.

As with measles and mumps, rubella is a contagious viral disease that is especially common in children. Symptoms include rash and fever lasting just a few days, and kids usually bounce back relatively easily. Complications for rubella, however, are most acute for pregnant women and their fetuses, especially during early pregnancy when the fetus has a least a 20 percent chance of birth defects that are collectively called Congenital Rubella Syndrome and range from deafness to cataracts to intellectual disability. Rubella can also cause miscarriage.

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Additional reading:

Encyclopedia of Pestilence, Pandemics, and Plagues, Vols I and II.

Measles (Rubeola), the Centers for Disease Control and Prevention.

Mumps, the Centers for Disease Control and Prevention.

Rubella (German Measles, Three-Day Measles), the Centers for Disease Control and Prevention.

MMR vaccine, National Health Service.

Q&As About Vaccination Options for Preventing Measles, Mumps, Rubella, and Varicella, the Centers for Disease Control and Prevention.