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Measles Information

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Published on November 21, 2016. Last modified on October 30, 2024

CDC Measles

Measles, also called rubeola, is a highly contagious disease caused by the measles virus. Before a vaccine was available, almost everyone was infected with the measles virus during childhood. Vaccination for measles in the United States began in 1963, which dramatically reduced measles disease in the United States. However, measles remains a common disease in many parts of the world, including Europe, Asia, Africa, and the Pacific. Each year around the world, measles infects about 20 million people and kills about 164,000 people; 100,000 of these deaths are children.

Measles Signs and Symptoms

CDC_MeaslesRash

The symptoms of measles generally begin about 7 to 14 days after a person is infected. A typical case of measles begins with mild to moderate fever, cough, runny nose, red eyes, and sore throat. Two or three days after symptoms begin, tiny white spots (Koplik’s spots) may appear inside the mouth. Three to 5 days after the start of symptoms, a red or reddish-brown rash appears. The rash usually begins on a person’s face at the hairline and spreads downward to the neck, trunk, arms, legs, and feet. When the rash appears, a person’s fever may spike to more than 104 degrees Fahrenheit. After a few days, the fever subsides and the rash fades.

Complications

Measles can be a serious in all age groups. However, children younger than 5 years of age and adults older than 20 CDC_MeaslesCanBeSerious years of age are more likely to suffer from measles complications. About 1 out of 10 children with measles also gets an ear infection, and up to 1 out of 20 gets pneumonia. About 1 out of 1,000 gets meningitis (inflammation of the brain), and 1 or 2 out of 1,000 die. Other rash-causing diseases often confused with measles include roseola (roseola infantum) and rubella (German measles). Measles can also make a pregnant woman have a miscarriage or give birth prematurely.

Transmission (How It Spreads)

Measles is highly contagious and can be spread to others from 4 days before to 4 days after the rash appears. Measles is so contagious that if one person has it, 90% of the people close to that person who are not immune will also become infected with the measles virus. The virus lives in the mucus in the nose and throat of the infected person. When that person sneezes or coughs, droplets spray into the air. The droplets can get into other people’s noses or throats when they breathe or put their fingers in their mouth or nose after touching an infected surface. The virus can live on infected surfaces for up to 2 hours and spreads so easily that people who are not immune will probably get it when they come close to someone who is infected. Measles is a disease that affects humans; it is not spread by other animal species.

Measles Prevention

The measles, mumps, and rubella vaccine (MMR) is the best way to protect against getting measles. Children should be given the first dose of MMR vaccine soon after the first birthday (12 to 15 months of age). The second dose is recommended before the start of the kindergarten. Adults at increased risk of getting measles — college students, international travelers and healthcare workers — should make sure they have been vaccinated against measles.

If you are planning a trip to Europe, Asia, Africa, or the Pacific, please make sure you are vaccinated against measles before you travel. It takes a few weeks to build up immunity against measles after being vaccinated. Visit the CDC's travel notices website before traveling to make sure you are up to date on important vaccinations at least two months before traveling.

For Schools and Early Childhood Education Settings

School nurses and administrators who suspect there is a student or staff member with measles should call the County of Monterey Health Department's Communicable Disease Unit at 831-755-4521 for assistance. Disease control staff will assist with verifying diagnosis, evaluating exposures, and providing direction for post-exposure followup.

School measles exposure template letter: English Spanish

Measles Surveillance Data

Please click to view the Communicable Disease dashboard with local measles data available in English and Spanish.

California data is available at the California Department of Public Health’s measles website.

United States data is available at the Centers for Disease Control and Prevention’s measles website.

For More Information

For Healthcare Providers

Recommendations for Medical Providers

1. Encourage your patients to get vaccinated.

Children should get 2 doses of MMR vaccine: the first at 12-15 months of age and the second at 4-6 years of age.One dose is recommended prior to international travel for unvaccinated infants ages 6 to 11 months.
Adults born during or after 1957 who do not have evidence of immunity should get at least one dose of MMR vaccine.Two doses are recommended for healthcare workers, post-high school students and international travelers. See the CDC website for detailed recommendations and contraindications.

2. Ensure your clinic is prepared to isolate a person with suspected measles by reviewing the California Department of Public Health’s Healthcare Facility Infection Control Recommendations for Suspected Measles Patients.

3. Keep an eye out for measles symptoms.

Measles starts with a mild fever accompanied by cough, coryza, and conjunctivitis.
Two to three days later the fever spikes, often to 104-105°F, and a red blotchy maculopapular rash appears, usually first on the face, along the hairline. This slightly itchy rash rapidly spreads downward.
Patients with rash and fever and recent travel to countries with current measles outbreaks are at higher risk of measles.

4. Follow the California Department of Public Health's guide to determine whether to test for measles.

Immunization in the last month with MMR or MMRV can be a cause of measles-like rash.Check the patient’s immunization history. Testing is not indicated if the patient was immunized against measles in the last month AND the patient’s exposure history is negative.

5. Act immediately if you suspect measles.

Implement airborne infection control precautions immediately.Mask and isolate the patient.
Call the County of Monterey Health Department immediately at (831) 755-4521. After normal business hours, call (831) 755-5100 and ask for the Hazardous Materials Team, who will connect you with the on-call Public Health Official.
Only allow medical personnel who are immune to measles to be near the patient.
If screening is indicated, expedite measles testing through the County of Monterey Public Health Laboratory (831‑755‑4516). Use of commercial labs may delay diagnosis and expose others needlessly.
- Collect 10-15 mL of urine in a sterile collection container AND a throat specimen using a synthetic swab (e.g., Dacron) placed in liquid viral or universal transport medium.
Do not use any regular exam room for 2 hours after a suspected measles patient has left the room.