Measles (Rubeola): What You Should Know
Measles is a highly contagious disease caused by a virus that spreads easily through the air. Although it is rare in the United States thanks to widespread vaccination, measles still circulates in other countries and can be brought here by unvaccinated travelers.
What is Measles?
Measles is a viral illness that can be serious, especially for young children, older adults, pregnant individuals, and people with weakened immune systems. The virus only infects humans, and it spreads quickly in communities with low vaccination rates.
How Does It Spread?
Measles is one of the most contagious diseases. It spreads when an infected person coughs or sneezes, releasing droplets into the air. You can catch measles just by being in a room where an infected person was—up to two hours after they’ve left.
You can only get measles once—after recovering, you're considered immune.
Symptoms: What to Watch For
Measles symptoms usually develop 8–12 days after exposure and progress in stages:
Early Symptoms (7–14 days post-exposure):
- High fever
- Runny nose
- Cough
- Red, watery eyes (conjunctivitis)
After 2–3 days:
- Small white spots (Koplik spots) inside the mouth
3–5 days after early symptoms begin:
- A red, blotchy rash appears, typically starting on the face at the hairline and spreading down the body.
A person with measles can spread the virus 4 days before and 4 days after the rash appears.
Who’s Most at Risk?
Certain people are more likely to experience severe illness or complications from measles, including:
- Children under 5 years old
- Adults over 20
- Pregnant women
- People with compromised immune systems
Complications can include pneumonia, ear infections, diarrhea, and in rare cases, brain swelling (encephalitis) or death. For pregnant individuals, measles can lead to miscarriage, early labor, or low birth weight.
Diagnosis
Doctors may suspect measles based on symptoms, but lab tests are needed to confirm it. Diagnosis typically includes:
- A throat swab
- A blood test
- Occasionally a urine sample
Since measles is rare in the U.S., many healthcare providers have never seen a case—so testing is essential.
Treatment
There is no specific antiviral treatment for measles. Supportive care includes:
- Plenty of rest
- Staying hydrated
- Managing symptoms like fever
In some cases, doctors may offer:
- A post-exposure MMR vaccine (if given within 3 days of exposure)
- Immune globulin (antibody) treatment within 6 days for high-risk individuals
Prevention: MMR Vaccine
The best protection against measles is the Measles-Mumps-Rubella (MMR) vaccine. It is safe and highly effective:
- 1 dose gives about 95% protection
- 2 doses protect 99% of people
- Children should receive:
- The first dose at 12–15 months
- A second dose at 4–6 years (can be given as early as 4 weeks after the first)
- Adults:
- If born in 1957 or later and haven’t had two doses or a confirmed case, get vaccinated.
- Those born before 1957 are likely immune but may choose to get vaccinated.
- Travelers:
- Children 6–11 months should get 1 early MMR dose before international travel (note: this does not count toward their 2 routine doses).
- Travelers 12 months and older should have 2 doses of MMR.
- Protecting Infants: Babies under 12 months who are too young to be vaccinated rely on the people around them to be immunized. This "ring of protection" is especially important during outbreaks.
What To Do If You Suspect Measles
If you or your child has symptoms of measles:
- Stay home and avoid visitors.
- Call your healthcare provider before going in—they’ll give you instructions to avoid spreading it to others.
If you've been exposed and are not immune:
- Contact your doctor right away. You may be eligible for a dose of MMR vaccine or immune globulin.
Reporting
Measles is a reportable condition. If a provider suspects measles, they must report it to the local health department immediately to start public health investigation and help prevent further spread.
Get Vaccinated
Protect yourself and your community by staying up to date on your vaccinations.
Learn more about vaccines for children & adults: StayInTheLoop.org
Resources