Currently, Florida is experiencing a measles outbreak in which nine people , mainly children, are infected. Despite this, Florida Surgeon General Dr. Joseph Ladapo went against Centers for Disease Control guidance and told parents of unvaccinated children they can decide whether they want to keep their children home from school during the outbreak. The current recommendations state that unvaccinated children should stay home for 21 days after exposure.

Experts stress that measles isnt something to dismiss particularly for those who arent protected.

What most people forget because we havent had a lot of measles in the United States for a long time is that measles can be a relatively serious disease, said Dr. Mark Roberts , a distinguished professor of health policy and management and director of the Public Health Dynamics Lab at University of Pittsburgh School of Public Health.

Measles starts with respiratory symptoms like coughing and sneezing and progresses to inflamed eyes, high fever, mouth sores, rash and more severe issues, said Dr. Gary Reschak , a pediatrician at Northwestern Medicine Huntley Hospital in Illinois.

130,000 to 140,000 children die of measles every year in the world where vaccination rates arent very high, and they dont have vaccines, Roberts said. Roughly 1 to 3 in 1,000 cases of measles results in death, according to the CDC . Measles is not just a rash, Roberts stressed.

Additionally, when you get measles, it causes your own immune system to take a hit ... a lot of the severe issues with measles are due to secondary infections taking over, Reschak explained.

Most commonly, secondary infections like pneumonia, diarrhea and ear infections in children are reported, he noted. An estimated 1 in 1,000 cases of measles turns into encephalitis, or swelling in the brain, which can result in lifelong neurological damage.

All of this is obviously concerning. Thankfully, theres an extremely effective vaccine that can help with this but the problem is that fewer people are giving it to their kids. What does that mean for us? Below, experts break it down:

More outbreaks will occur if measles vaccination rates continue to drop.

According to the CDC , roughly 93% of kindergarten students had their measles vaccine as of the 2021-2022 school year, and the target percentage is 95% . As a result, were seeing more and more of the outbreaks (like currently in Florida) in populations with high rates of unimmunized children throughout the country, Reschak said.

Roberts added that weve been lucky so far in that the outbreaks in the United States have not been very big. There were relatively small occurrences in Disneyland in California in 2014 and one in Ohio in 2022 but if just one infected child comes in contact with a community with low vaccination rates, an additional 15 to 16 kids can be easily infected.

So, it can explode relatively quickly if you happen to get people who are not vaccinated, Roberts explains.

Measles spreads quickly, both experts said. Measles itself as a viral infection is highly contagious highly contagious in a way that I think most people dont appreciate, especially [with] what weve just been through with cold, flu and RSV season , and, then of course, COVID , Reschak said. Measles is in, like, its own league in contagiousness. This is not washing your hands and everything is good ... youre not going to be able to wash your hands to get away from measles.

Measles is spread through contact with an infected individual, Roberts said. This can mean through direct touch, in addition to sneezing, coughing and touching a contaminated surface like a desk or doorknob,

Additionally, measles lingers in a space long after the infected person leaves. For example, if youre susceptible to measles, meaning you dont have immunity or werent vaccinated, you could be in a room where an infected person was two hours prior and have a 90% chance of becoming infected with measles, noted Reschak.

Roberts added that the more infectious someone is, the more people you need to be immune to reach herd immunity which is the amount of immunity you need in a population to stop the spread of an infectious disease.

Measles is just about the most infectious disease thats around ... and you need about somewhere in the middle 90% of people to be immune before you get herd immunity with measles, Roberts said.

Once you get below that 90% in a school, for example, you end up with large outbreaks stemming from one case.

Roberts who helps facilitate University of Pittsburghs online measles simulator , which simulates the spread of measles in several communities throughout the United States said When we did the work ... with the actual vaccination rates and modeled what would happen ... there were schools in the state of Texas that only had 40% of their children vaccinated. If you drop a case of active measles into a school that only has 40% of the kids vaccinated, it can explode hundreds of cases can happen from that introduction.