Measles, tuberculosis, scarlet fever?! If headlines about ancient diseases on the rise have you worried, you're not alone. Here's what you need to know to stay safe amid outbreaks.
Once a common illness among children and young adults, cases of mumps in the US have dropped by 99% since a vaccine was introduced in 1967. But occurrences crop up, particularly among close-knit communities. There were 322 reported cases of mumps in the U.S. in 2022.
The virus that causes mumps is spread in close quarters (think college dorms or locker rooms) via coughing, sneezing, talking, or sharing cups or eating utensils.
Symptoms of mumps typically appear 16 to 18 days after infection and include:
- Puffy cheeks
- Tender, swollen jaw
- Muscle aches
- Loss of appetite
There is no treatment, but most people recover fully in a few weeks. Complications are rare but can include hearing loss, meningitis, and inflammation of the testicles or ovaries.
The only way to prevent the mumps (aside from avoiding people with it) is to get the MMR (measles-mumps-rubella) vaccine. Though usually administered to kids, you can get the vaccine at any time. A person with two doses of the vaccine has about an 88% risk reduction for mumps; a person with one dose has a 78% reduction. Booster doses are often recommended during outbreaks.
Like mumps, measles was once widespread. At one time, nearly every American child got the disease before they turned 15, and an estimated 400 to 500 Americans died from it each year. Widespread adoption of the vaccine in the 1960s, however, led to the elimination of the disease from the U.S. in 2000.
Unfortunately, measles has made a comeback. In 2022, there were 121 cases of measles but in 2019 there were 1,274 cases.
The virus that causes measles is spread via coughing and sneezing and is so contagious that 90% of non-immune people near someone infected will get it.
"It travels like a gas through the air," said Dr. Phillips, making it "the ultimate transmissible infection."
Symptoms of measles include:
- High fever
- Runny nose
- Red eyes
- Rash typically beginning at the hairline and spreading downward across the body
Complications can include diarrhea and ear infections, and in rare cases, life-threatening pneumonia and encephalitis.
The United States has maintained measles elimination status for almost 20 years. This means that disease is no longer constantly present in this country. However, travelers continue to bring measles into the United States, and it can sometimes spread and cause outbreaks among people who are not vaccinated. This, plus the fact that there is no treatment for measles, makes vaccination imperative.
For children, two doses of the MMR (measles, mumps, and rubella) vaccine are required. Teenagers and adults without any evidence of immunity need at least one dose—with members of certain high-risk groups (such as international travelers, healthcare workers, and college students) needing two doses.
Two doses of the vaccine are about 97% effective at preventing the disease, with one dose of the vaccine being 93% effective. It's particularly important to get vaccinated if you're traveling internationally and to follow the vaccination schedule for travelers.
"Prevention is the hallmark," said Dr. Phillips. "If we develop pockets of under-vaccinated people and start having enough transmission, even those individuals who are vaccinated will be at risk."
Leading up to the 1882 discovery of the bacteria Mycobacterium tuberculosis, tuberculosis (TB) killed one out of every seven people living in the United States and Europe.
Antibiotics have dramatically reduced its deadliness, particularly in the U.S. In 2014 the World Health Organization launched a new global strategy (End TB) with a vision of a world free of TB, and a 2035 goal of TB elimination (defined as less than one incident case per million).
But it persists. TB is the second leading infectious cause of death worldwide. In 2021, a total of 1.6 million people died from TB.
Though most Americans don't consider TB a threat, it's showing signs of a resurgence: there were 7,882 reported TB cases in the United States in 2021.
TB is caused when Mycobacterium tuberculosis attacks the lungs. It's spread through the air when an infected person coughs, sneezes, or talks (though not by shaking hands, kissing, or sharing food, drink, or toothbrushes). People with compromised immune systems are especially vulnerable.
Symptoms of TB may include:
- A cough that lasts three weeks or longer, often producing blood
- Night sweats (heavy sweating during sleep)
- Chest pain
- Chills and fever
- Weight loss
- Loss of appetite
"Many cases we're seeing involve folks who were infected years before, were asymptomatic, and then the disease reactivates later in life," said Dr. Phillips.
The good news is that TB is curable with treatment, though several different antibiotics may need to be taken over three to 12 months. To stay safe, avoid contact with TB patients, particularly in crowded, enclosed environments. If you think you may have been exposed to someone with TB, see your healthcare provider immediately for testing and possible treatment.
TB is scary enough on its own, but health professionals are particularly worried about the rise of antibiotic-resistant TB throughout the world.
"We're seeing more and more cases that are multi-drug-resistant, which means it requires a second or a third line therapy to treat," said Dr. Phillips. "We have to think globally about this one: helping to prevent cases overseas and working on new drug development can only help keep us safe domestically."
Largely forgotten over the past century thanks to the rise of antibiotics, this bacterial infection is perhaps best known for its role in the classic children's book "The Velveteen Rabbit." (On doctor's orders, when the young protagonist comes down with scarlet fever, all his toys, including his beloved rabbit, must be destroyed.)
But in 2020, a study described scarlet fever as on the rise globally, after being nearly eradicated by the 1940s. The researchers described supercharged 'clones' of the bacteria Streptococcus pyogenes as responsible for the worldwide resurgence of scarlet fever that caused a more than a five-fold spike in the disease.
In 2022, France, Ireland, the Netherlands, Sweden, and the United Kingdom of Great Britain and Northern Ireland, experienced an increase in cases of scarlet fever, primarily among children under the age of 10.
Scarlet fever almost always begins as strep throat (then patients typically develop a rash)—in fact, scarlet fever is caused by the same type of bacteria as strep throat (Streptococcus). Scarlet fever commonly afflicts children ages 5 to 12.
Common symptoms of scarlet fever include:
- Sore throat
- Red, sandpapery rash that appears on the neck and chest (or the neck, underarm, and groin) and may spread across the body
Scarlet fever can be diagnosed via a throat swab or throat culture and can be effectively treated with antibiotics.
To stay safe, avoid contact with infected people (the disease spreads via sneezes or coughs), wash your hands regularly (as you would to ward off any communicable disease), and seek treatment as soon as symptoms develop.
"It's easily transmitted in group settings," said Dr. Phillips, "so there is the risk that when a toxigenic strain moves into a community, it would spread rapidly."
A Quick Review
Scarlet fever, tuberculosis, mumps, measles: You may think these are deadly diseases of the past, wiped out with vaccines and antibiotics. The truth is that these diseases are still infecting people worldwide, and some have made resurgences in the U.S. Stay healthy and safe with the precautions outlined here.
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