Definition

Measles is an infection that spreads easily. It causes fever, cough, and a rash. It was once a common childhood illness, but it is now less common in the United States due to the use of the measles vaccine.

Causes

Measles is caused by a virus. The virus is spread by:

• Direct contact with nasal or throat secretions of infected people
• Airborne transmission, which is less common

Measles can be spread:

• 1-2 days before symptoms appear
• 3-5 days before the rash
• 4 days after the appearance of the rash

Risk Factors

Factors that may increase your risk of measles include:

• Unvaccinated or inadequately vaccinated
• Living in crowded and/or unsanitary conditions
• Traveling to less developed countries where measles is common
• Season: winter and spring
• Weakened immune system even if vaccinated
• Born after 1956 and either:
  • You have never been diagnosed with measles
  • You received a vaccine before 1968 and you have never been fully vaccinated since

Symptoms

Measles symptoms generally appear 8-12 days following exposure. They include:

• Conjunctivitis
• Fever, often high
• Runny nose
• Sneezing
• Discomfort
• Red eyes
• Hacking cough
• Sore throat
• Exhaustion
• Very small spots inside the mouth—2-4 days after initial symptoms
• Raised, itchy red to brownish rash:
  • Starts around the ears, face, and side of the neck 3-5 days after the first symptoms appear
  • Generally spreads to the arms, trunk, and legs over the next 2 days
  • Lasts about 4-6 days

Full recovery, without scarring, generally takes 7-10 days from the onset of the rash.

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. Diagnosis is made from the symptoms and the rash. Lab tests are usually not needed.

Treatment

Measles is caused by a virus. It cannot be treated with antibiotics. The focus is on relieving symptoms with rest and comfort measures such as:

• Gargling with warm salt water
• Using a humidifier
• Over-the-counter pain relievers
• Cold sponge baths
• Drinking plenty of liquids and eating a soft, bland diet

Prevention

Getting vaccinated is the best way to prevent measles. The vaccine contains live viruses that can no longer cause disease. There is a single vaccine to prevent measles. It is also available in combination with:

• Mumps and rubella vaccine (MMR)
• Mumps, rubella, and varicella (chickenpox) vaccine (MMRV)

The regular schedule for giving the vaccine is at age 12-15 months and again at age 4-6 years. If you or your child has never been vaccinated against the measles, talk to the doctor.

In some cases, the MMR vaccine is given within 3 days after exposure. This can prevent or reduce symptoms. Immune globulin is given to certain unvaccinated people within 6 days of exposure. This is usually for infants and pregnant women.

If you or someone in your family gets measles, family members may need to be vaccinated or given immune globulin.

If you are not vaccinated, avoid contact with someone who has measles. Recent outbreaks of measles have occurred in Europe and the United States. They may have been caused by increasing numbers of children who are not vaccinated. Discuss the benefits of vaccination with your doctor.

National Foundation for Infectious Diseases http://www.nfid.org

Public Health Agency of Canada http://www.phac-aspc.gc.ca

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Measles. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated June 8, 2015. Accessed June 9, 2015.

Measles (rubeola). Centers for Disease Control and Prevention website. Available at:
http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3-infectious-diseases-related-to-travel/measles-rubeola.htm
Updated December 13, 2013. Accessed June 9, 2015.

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5/27/2011 DynaMed’s Systematic Literature Surveillance
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Measles—United States, January—May 20, 2011. MMWR Morb Mortal Wkly Rep. 2011;60(20)666-668.