Measles

Measles is an acute, highly communicable viral disease. Measles is not considered endemic (constantly present) in the United States, but outbreaks and isolated cases from travelers occur each year in the United States.

Symptoms

The average incubation period for measles from exposure to initial symptoms (fever, cough, watery eyes, runny nose) is about 10-12 days. Symptom onset ranges 7-21 days after exposure. Symptoms include:

• high fever
• cough
• runny nose
• watery eyes, and
• potentially Koplik spots (tiny white spots in the mouth). 

Measles Rash

The rash usually begins three to five days after initial symptoms begin. Rash appears as a 

• flat red rash (sometimes raised bumps on top of flat red lesions), and
• begins on the head and face and spreads downward to the neck, trunk, arms, legs, and feet.
• Fever may spike to more than 104°F when rash appears.

Risk Factors

Anyone, regardless of age, who is exposed to measles and is not immune.

People who are at risk of developing measles (people who have not had measles or been adequately immunized) may benefit from post-exposure prophylaxis (PEP). There are two forms of PEP that may be administered. 

1. Vaccine given within 72 hours of initial exposure may potentially prevent or modify the clinical course of disease.
2. Immune globulin given within 6 days of initial exposure may modify the clinical course of disease.

Spread & Infection

Measles is spread through the air by droplets from the nose, throat, and mouth of an infected person. A person may breathe in the droplets or touch a surface contaminated with the droplets. 

An infected person is able to spread measles from 4 days before the rash starts through 4 days after the rash appears

Diagnosis

A healthcare provider will suspect measles based on the symptoms, especially if the patient has recently traveled internationally or was exposed to someone with a fever and a rash. 

Laboratory tests (from a throat or nose swab or a urine specimen) can confirm the diagnosis.

Treatment

There is no specific treatment for measles. Complications should be managed by a healthcare provider.

Vaccine & Prevention

All children, adolescents, and adults born in 1957 or later without a valid contraindication should have documentation of vaccination or other evidence of immunity. 

Additionally, some healthcare personnel who were born before 1957 may also need proof of vaccination or other evidence of immunity.

Learn more about measles vaccination recommendations and adult boosters.

Immunity 

Presumptive evidence of immunity includes age-appropriate vaccination with a measles-containing vaccine, laboratory confirmation of measles infection, laboratory confirmation of immunity or you were born before 1957.

Immunity after illness is permanent.

If You May Be Infected

Non-immune persons exposed to a person with confirmed measles should stay in their home from five days after the first possible exposure through 21 days after their last possible exposure to the person with confirmed measles. 

Public health officials will work directly with K-12 school officials to determine which exclusions are appropriate.

Call your healthcare provider and discuss your symptoms and any possible exposure before showing up at the clinic. The healthcare provider will advise you to either come to the clinic or arrange for you to be seen at a different location so other people are not exposed.