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     Indian Health Manual
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Part 1, Chapter 12:  Manual Appendix II

Measles, Mumps, and Rubella
and Measles, Mumps, and Rubella Vaccines


IMPORTANT INFORMATION ABOUT MEASLES, MUMPS, AND RUBELLA AND MEASLES MUMPS AND RUBELLA VACCINES

WHAT IS MEASLES?

Measles is the most serious of the common childhood diseases.  Usually it causes a rash, high fever, cough, runny nose, and watery eyes lasting 1 to 2 weeks.

Before measles vaccine shots were available, there were hundreds of thousands of cases and hundreds of deaths each year.  Nearly all children got measles by the time they were 15.  Now, wide use of measles vaccine has nearly eliminated measles from the United States.

Outbreaks of measles continue to occur in places where young people and adults congregate.  It is estimated that as high as 20 percent of young adults lack protective antibody to measles and may be susceptible to the infection.

WHAT IS MUMPS?

Mumps is a common disease of children.  Usually it causes fever, headache, and inflammation of the salivary glands, which causes the cheeks to swell.  Sometimes it is more serious.  About one out of every four male adolescents or adults who get mumps develops painful inflammation and swelling of the testicles.  While this condition usually resolves, on rare occasions it may cause sterility.  Deafness can be a result of mumps.

WHAT IS RUBELLA?

Rubella is also called German measles.  It is a common disease of children and may also affect adults.  Usually it is very mild and causes a slight fever, rash, and swelling of glands in the neck.  The sickness lasts about 3 days.  Sometimes, especially in adult women, there may be swelling and aching of joints for a week or two.  Very rarely, rubella can cause encephalitis, an inflammation of the brain, or purpura, a temporary bleeding disorder.

Rubella is most serious to a pregnant woman, for there is a good chance that she may have a miscarriage or that the baby will be born crippled, blind, or with other defects.  The last big rubella epidemic in the United States was in 1964.  Because of that epidemic, about 25,000 children were born with serious problems such as heart defects, deafness, blindness, or mental retardation because their mothers had rubella during the pregnancy.

Before rubella shots were available, rubella was so common that most children got the disease by the time they were 15.  Now, because of the wide use of rubella vaccine, the number of cases of rubella is much lower.  However, if children are not vaccinated, they have a high risk of getting rubella and possibly exposing a pregnant woman to the disease.  If an unvaccinated woman becomes pregnant and catches rubella, she may have a defective baby.

Since rubella is a mild illness, many women of childbearing age do not recall if they had rubella as a child.  A simple blood test can show whether a person is immune to rubella or is not protected against the disease.  Overall, about one in five women of childbearing age is not protected against rubella.

MEASLES, MUMPS, AND RUBELLA VACCINES:

The vaccines are given by injection and are very effective.  Ninety percent or more of people who get the shot will have protection, probably for life.  However, because of recent outbreaks of measles in young adults with prior measles vaccination, a routine two-dose schedule is now recommended for children, college students, and medical personnel.  Measles, mumps, and rubella vaccines can be given one at a time or in a combined vaccine, measles-rubella (MR), or measles-mumps-rubella (MMR), by a single shot.

Experts recommend that adolescents and adults, especially women of childbearing age, who are not known to be immune to rubella should receive rubella vaccine or MMR if they might also be susceptible to measles or mumps.  Women should not receive the shot if they are pregnant or might become pregnant within 3 months.  There is no known risk in being vaccinated against any or all three of these diseases if you are already immune to any of them.

POSSIBLE SIDE EFFECTS FROM THE VACCINES:

About 5 percent to 15 percent of persons who receive measles vaccine may develop a temperature of 103 degrees or higher, beginning between 5 and 12 days after vaccination.  The fever usually lasts for one to two days, rarely as long as 5 days.  In one out of 20 persons receiving the vaccine a skin rash may occur.

Mumps vaccine very rarely has side effects.  There have been reports of salivary glands swelling following vaccination.  Other side effects including rash and itching have been reported.

Up to 40 percent of susceptible adults who receive rubella vaccine have had joint pain, usually of the small joints.  Painful joints and transient arthritis occur more frequently and more severely in susceptible women than in children.  These symptom: usually begin 3 to 25 days after vaccination and may last for 1 to 11 days.  Adults with joint problems following vaccination usually do not have to disrupt work activities.  There are virtually, no side effects from the rubella vaccine in adults who are already immune through natural infection or previous immunization.

WARNING- SOME PERSONS WHO SHOULD NOT TAKE THESE VACCINES WITHOUT CHECKING WITH A DOCTOR INCLUDE:

Anyone who is sick right now with something more serious than a cold.

Anyone who had an allergic reaction to eating eggs so serious that it required medical treatment (does not apply to rubella vaccine).

Anyone with cancer, leukemia or lymphoma.

Anyone with a disease that lowers the body's resistance to infection.

Anyone taking a drug that lowers the body's resistance to infection (such as cortisone, prednisone or certain anticancer drugs),

Anyone who has received a gamma globulin (immune globulin) within the preceding 3 months.

Anyone who had an allergic reaction to an antibiotic called neomycin so serious that it required medical treatment.

PREGNANCY:

Measles, mumps, and rubella vaccines are not known to cause special problems for pregnant women or their unborn babies.  However, doctors usually avoid giving any drugs or vaccines to pregnant women unless there is a specific need. To be safe, pregnant women should not get these vaccines. A woman who gets any of these vaccines should wait 3 months before getting pregnant.

Vaccinating a child whose mother is pregnant is not dangerous to the fetus.

QUESTIONS:

If you have any questions about measles, mumps or rubella vaccination, please ask us now or call your doctor or health department before you sign the consent.


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