What is measles?
Measles, also known as rubeola, is a highly contagious viral infection that causes cough, fever, runny nose and a distinctive red rash. The measles virus spreads easily through the air when an infected person coughs or sneezes. Preventable through the measles-mumps-rubella (MMR) vaccine, measles was declared eliminated from the United States in 2000. However, recent measles outbreaks have occurred due to declining childhood immunization rates.
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How contagious is measles?
Measles is one of the most contagious infectious diseases in the world. About 90% of unvaccinated people who come in contact with an infected person will develop it too. The virus can remain active in the air or on surfaces for up to two hours.
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Is measles deadly?
Measles can be deadly, especially for young children, pregnant women and people with weakened immune systems. One to three in every 1,000 children who become infected with measles will die from respiratory and neurologic complications. The risk of death from measles in adults is rare, but higher in adults who are not fully vaccinated.
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Can adults get measles?
Yes, adults can get measles if they haven't been vaccinated or previously had the virus. Adults who were not vaccinated as children or did not develop immunity after infection are at risk, especially when traveling to areas with outbreaks.
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Can you get measles twice?
No, you cannot get measles if you've already had it. Your immune system develops lifelong immunity, meaning your body remembers the virus and can fight it off if you are exposed to it again.
How is measles spread?
Extremely contagious, measles is spread through respiratory droplets when an infected person coughs or sneezes. In fact, measles is so infectious that 90% of unvaccinated people exposed to an infected person will likely catch the virus.
The virus can linger in the air or on surfaces for up to two hours, making it easy to contract by breathing in contaminated air or touching infected surfaces and then touching your face. You can spread measles to others starting four days before you start to experience symptoms and up to four days after the rash develops.
You can catch measles by:
- Sharing food or drinks with an infected person
- Close contact or physical touch, such as kissing, handshakes, hugs or holding hands
- Touching contaminated surfaces and rubbing your eyes, nose or mouth
- Transmission from an infected mother to her baby during pregnancy, birth or through breastfeeding
Measles symptoms
Measles symptoms usually appear seven to 14 days after exposure to the virus. A typical case of measles often starts with flu-like symptoms before progressing to a widespread rash.
Key symptoms of measles include:
- Mild to moderate fever, which may spike above 104°F
- Cough
- Runny nose
- Red or watery eyes
- Sore throat
- Fatigue and body aches
- Small white spots inside the mouth (known as Koplik’s spots)
- Red or reddish-brown rash that starts on the face and spreads downward to the neck, torso, arms, legs and feet
If you think you’ve been exposed to someone with measles, you can use our Help Me Decide tool in the MyBSWHealth app to speak to a care guide. You can also check your symptoms and schedule a virtual care visit.
When to see a doctor
If you have symptoms of measles, immediately contact your healthcare provider to schedule a virtual care visit and isolate yourself and any symptomatic family members to prevent further transmission. Pregnant women, infants and children under five years old are at higher risk for complications, so scheduling a virtual care visit is especially important for these people.
If you are experiencing a true medical emergency, such as shortness of breath or confusion, go straight to the emergency room.
Measles risk factors
Certain factors can increase the risk of contracting measles. Since the virus spreads easily, being in close contact with an infected person significantly increases your risk of infection.
Being unvaccinated is the biggest risk for contracting measles, as the MMR vaccine provides strong protection for your entire life.
Other groups who are at greater risk for contracting measles include:
- Infants and children under the age of five
- Adults older than 20 years old
- Pregnant women
- Those with a weakened immune system due to illness or medical treatments
Measles complications
Complications from measles can happen to anyone, however, measles can be especially dangerous for babies and young children. In some cases, complications can be severe, leading to hospitalization, and can be fatal.
Complications from measles include:
- Diarrhea
- Ear infections
- Encephalitis, an infection causing swelling of the brain
- Pneumonia or breathing difficulties
- Blindness
- In pregnant women, babies may be premature or born with low birth weight
Diagnosing measles
Measles diagnosis requires careful clinical assessment by a healthcare provider, as well as confirmation through blood, saliva or urine samples. Early identification is crucial for implementing proper isolation measures and protecting vulnerable people
Your provider will typically follow these steps when diagnosing measles:
Medical history and exam
First, you may be asked about your medical history, including:
- Documentation of your vaccination status (most importantly, the MMR vaccine)
- Recent travel to areas with known outbreaks
- Possible exposure to confirmed cases
- Risk factors, such as not being vaccinated
Then, your provider will conduct a physical exam to assess some of the characteristic symptoms, such as:
- High fever
- The "3 Cs": cough, coryza (runny nose) and conjunctivitis (red eyes)
- Examination for white Koplik spots inside the mouth, which appear 1 to 2 days before the rash
- Evaluation of a rash that typically:
- Begins on the face at the hairline
- Spreads downward to your neck, torso, arms, legs and feet
Laboratory tests
Some basic laboratory tests can confirm a measles diagnosis, and testing is especially important if you’re pregnant or have a weakened immune system:
- Blood tests are the most common way to check for measles. The test looks for special proteins (antibodies) that your body makes when fighting measles, and results usually come back in a few days.
- Other sample tests include your doctor taking a swab from your throat or nose or asking for a urine sample. These samples can detect the measles virus directly and work best in the first few days of symptoms.
Remember, if you think you might have measles, call your doctor's office before going in. This helps them prepare and prevent spreading it to others in the waiting room.
Measles treatment
It's important to understand that there’s no cure for measles. Measles is a viral infection that needs to run its course (typically 10 to 14 days). Here's how to take care of yourself or a loved one with measles:
- Take over-the-counter pain relievers like acetaminophen or ibuprofen for pain, discomfort and fever
- Rest as much as possible
- Stay hydrated by drinking plenty of fluids
- Try gargling with salt water to soothe a sore throat
- Reduce eye discomfort by avoiding bright lights
- Stay home from work or school
- You can usually return to normal activities after having the rash for 4 days
- Unvaccinated household members should avoid contact with the infected person
If symptoms worsen or you're concerned about complications, contact your healthcare provider.
Measles prevention
The best way to protect yourself and your loved ones from measles is by getting vaccinated. The measles vaccine is proven to be safe and highly effective at preventing the virus. Once you receive the vaccine, your body builds strong immunity, which means you’re very unlikely to ever get sick with measles.
Staying up to date on your vaccines not only helps keep you healthy but also protects those around you—especially babies, older adults, and people with weakened immune systems who are more vulnerable to serious complications from measles.
Measles vaccine in children
The measles vaccines are 97% effective in preventing measles with just two doses and provide lifelong protection.
Here are the two vaccines available to children:
- MMR vaccine: The measles vaccine is typically given as a combined measles-mumps-rubella (MMR) vaccine. Healthcare providers recommend that children receive the MMR vaccine in two doses:
- The first between 12 and 15 months of age
- The second between 4 and 6 years of age*—before entering school
- MMRV vaccine: The MMRV vaccine also includes protection from chickenpox (varicella). This vaccine is only available for children from 12 months to 12 years of age. Anyone older than 13 gets the MMR vaccine. Here is the recommended schedule:
- The first between 12 and 15 months of age
- The second between 4 and 6 years of age*—before entering school. Your child should get the second shot around age 4 or 5 *The second shot can also be given three months after the first shot. Talk to your child’s healthcare provider about the best timing for your child.
*The second shot can also be given three months after the first shot. Talk to your child’s healthcare provider about the best timing for your child.
Measles vaccine in adults
Healthcare providers recommend that adults who aren't already immune to measles receive the measles-mumps-rubella (MMR) vaccine. You may need vaccination if:
- You were born after 1957 and have no record of vaccination
- You have previously only received one dose
- You're traveling internationally
- You work in healthcare or schools
With the MMR vaccine, one shot protects against three serious diseases and helps prevent spread to vulnerable populations who cannot be vaccinated.
Preventing new infections
The most effective way to prevent new measles infections is through vaccination. If you are unsure about your immunity, verify by checking your vaccination records for two MMR vaccine doses. If you've had measles previously, you have natural immunity. While blood tests can confirm immunity, they are not routinely recommended for everyone. Speak to your medical provider if you have questions or concerns about your immunity status.
Preventing the spread of measles during an outbreak
If you’re not immune, get vaccinated immediately—the MMR vaccine can prevent or reduce severity if given within 72 hours of exposure.
For high-risk people (pregnant women, infants and the immunocompromised) who cannot receive the vaccine, talk to your healthcare provider about next steps.
Additional precautions to take during a measles outbreak:
- Make sure your vaccinations are up to date before traveling
- Avoid public gatherings and crowded spaces
- Stay away from infected people
- Practice thorough handwashing
- Avoid touching your face, especially eyes, nose and mouth
- If symptoms develop, call your healthcare provider before visiting to prevent exposing others
Frequently asked questions
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If I am exposed to measles, what should I do?
Unvaccinated people exposed to measles should contact a healthcare provider immediately. Vaccination within 72 hours of exposure, or antibodies known as immune globulin within 6 days, may prevent or reduce the severity of the virus in unvaccinated people.
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How long is measles contagious?
People with measles are infectious 4 days before the rash appears until 4 days after the rash onset. The average incubation period for measles is 10 to 12 days from exposure to prodrome (non-rash symptoms) and 14 days from exposure to rash, which is typically 7 to 21 days.
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How often do you need the measles vaccine?
If you had two doses of the MMR vaccine as a child, you likely have lifelong protection. If you only had one dose, you might need a second one. People born before 1957 probably had measles as children and are likely immune.
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Is measles still common worldwide?
While measles cases have decreased significantly due to global vaccination efforts, outbreaks still occur, particularly in areas with low vaccination rates. The disease remains in many parts of the world, and international travel can introduce measles to regions where it had been eliminated.
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Can you get measles if you are vaccinated?
It is possible but unlikely. If vaccinated people do get measles, symptoms are usually mild.