Measles (Rubeola)

Also called: Rubeola

What Is Measles?

Measles is a very contagious infection that causes a total-body skin rash and flu-like symptoms. Measles is rare in the United States thanks to widespread immunization. But millions of cases happen worldwide every year.

Measles is caused by a virus, so there's no specific medical treatment for it. The virus has to run its course. A child who is sick should drink plenty of liquids, get lots of rest, and stay home from school, daycare, and other community or group activities to prevent spreading the infection.

What Are the Signs & Symptoms of Measles?

The first symptoms of a measles infection are usually a hacking cough, runny nose, high fever, and red eyes. Kids also may have Koplik's spots (small red spots with blue-white centers) inside the mouth before the rash starts.

The rash breaks out 3–5 days after symptoms start, sometimes along with a high fever up to 104°F (40°C). The red or reddish-brown rash usually begins as flat red spots on the forehead. It spreads to the rest of the face, then down the neck and torso to the arms, legs, and feet. The fever and rash slowly go away after a few days.

Is Measles Contagious?

Measles is very contagious. In fact, 9 out of 10 people who aren't vaccinated for measles will get it if they are near an infected person.

How Do People Get Measles?

Measles spreads when people breathe in or have direct contact with virus-infected fluid. It can pass through droplets sprayed into the air when someone with measles sneezes or coughs. Someone exposed to the virus usually shows symptoms 7–14 days later.

People with measles can spread the disease as early as 4 days before the rash starts. They're most contagious while they have a fever, runny nose, and cough. People with weak immune systems due to other conditions (like HIV and some cancers, or from being on some types of medicines) can spread the measles virus longer, until they recover.

How Is Measles Treated?

There is no specific medical treatment for measles. To help manage symptoms:

• give your child plenty of fluids
• encourage extra rest
• give a non-aspirin fever medicine, such as acetaminophen or ibuprofen if a fever makes your child uncomfortable. Never give aspirin to a child or teen who has a viral illness, as such use is linked to Reye syndrome, which can be life-threatening. 

Kids with measles should be closely watched by a doctor. In some cases, measles can lead to other problems, such as:

• ear infections
• croup
• diarrhea
• pneumonia
• encephalitis (irritation and swelling of the brain)

Children with measles should be kept away from others for 4 days after their rash appears. For those with a weak immune system, this should continue until they make a full recovery and all symptoms are gone.

How Long Does Measles Last?

A measles infection and the medical problems that may follow can last for several weeks in all.

Can Measles Be Prevented?

The best way to protect your kids is to make sure they're immunized against measles.

For most kids, measles protection is part of the measles-mumps-rubella vaccine (MMR) or measles-mumps-rubella-varicella vaccine (MMRV) given when they're 12 to 15 months old and again when they're 4 to 6 years old. About 95% of people achieve immunity during their first vaccine, and the rest develop it the second time they're vaccinated. Immunity lasts a lifetime.

The first vaccine can be given to babies as young as 6 months old if they will be traveling internationally. Talk to your doctor to see when the vaccine is needed.

Why Is Vaccination Important?

Widespread immunization has made measles rare in the U.S. But outbreaks do still happen. An outbreak is when a disease happens in greater numbers than expected in a particular area. Measles outbreaks have been increasing worldwide, mostly spreading from people who are not vaccinated.

It's important for all kids who can get the vaccine to get it on time. Some at-risk people (such as those with weak immune systems) can't get the vaccine. But when a lot of other people are immunized against a disease, it protects them, prevents the disease from spreading, and helps prevent outbreaks.

At highest risk during a measles outbreak are:

• infants who aren't old enough to get the measles vaccine
• children and adolescents who haven't gotten 2 doses of the measles vaccine
• pregnant women
• people with poor nutrition or weak immune systems

Doctors can give an injection of measles antibodies (called immune globulin) to at-risk people who are exposed to measles. It's most effective when given within 6 days of contact. These antibodies can either prevent measles or make symptoms less severe.

A dose of the measles vaccine also can help protect unvaccinated people from getting sick after exposure to measles if they get it within 3 days.

When Should I Call the Doctor?

Call the doctor right away if you think that your child has measles. Also call if your child was around someone who has measles, especially if your child:

• is an infant
• is taking medicines that suppress the immune system
• has tuberculosis, cancer, or a disease that affects the immune system
• hasn't gotten 2 doses of the measles vaccine