Everything You Need to Know About Measles Signs, Symptoms, and Treatments
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The infectious disease community celebrated when North and South America was declared measles-free in 2016. But outbreaks of the disease still happen—and the U.S. and the UK are currently dealing with several. To help curb the spread, it’s important to understand measles signs and symptoms—and know your treatment options.
An outbreak at a Philadelphia daycare that started after a child who was exposed to measles and allegedly violated quarantine recommendations has led to nine confirmed cases of the disease, according to city health officials. Health officials in Virginia are also warning about potential exposure after a person with the disease went through Dulles International Airport on January 3, and Ronald Reagan National Airport on January 4. Washington state and Georgia are also grappling with their own measles outbreaks.
In the U.K., health officials are warning about a “rapid rise” in measles cases happening now.
Meet the experts: Thomas Russo, M.D., chief of infectious diseases at the University at Buffalo in New York; Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security; William Schaffner, M.D., an infectious disease specialist and professor at the Vanderbilt University School of Medicine
Measles isn’t a condition most people in the U.S. are worried about, and you may be fuzzy on what, exactly, it is—and what all the fuss is about. Infectious disease experts break it down.
What is measles?
Measles, a.k.a rubeola, is an infection that’s caused by a virus, according to the Centers for Disease Control and Prevention (CDC). It’s a respiratory illness that consists of a cough, runny nose, tiny spots inside the mouth, a rash, and often a high fever.
Measles is one of the world’s most contagious diseases, the World Health Organization (WHO) explains. Among other things, the virus can stay active and contagious in the air or on infected surfaces for up to two hours.
While measles is considered a childhood infection, but unvaccinated adults can get it, too. “Not only can they get measles if they’re unvaccinated and not previously infected, but it is a much more severe disease in adults,” says Thomas Russo, M.D., chief of infectious diseases at the University at Buffalo in New York.
Measles symptoms
Measles symptoms usually show up seven to 14 days after someone has contact with the virus, the CDC says. Initial symptoms include:
high fever (patients may experience a fever greater than 104 degrees)
cough
runny nose
red, watery eyes (conjunctivitis)
Tiny spots (Koplik spots) inside of the mouth after one to two days after symptoms begin
Rash consisting of flat, red spots that appear on the face and spread down to the neck, trunk, arms, legs, and feet, the CDC says, may appear three to five days after Koplik spots develop.
How to tell measles apart from other respiratory illnesses
Measles can be “hard to distinguish” from other respiratory viruses in its early stage, says infectious disease expert Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security.
Dr. Russo agrees, noting that measles can “mimic the flu” early on. “Then, you develop the classic measles whole body rash—flu does not cause that,” he says.
Measles can also cause complications like ear infections, diarrhea, pneumonia, and swelling of the brain, the CDC says.
How measles spreads
Measles spreads when an infected person coughs and sneezes, the CDC says, noting that the virus lives in the nose and throat mucus of an infected person. People can breathe in those infectious particles or touch infected surfaces and then touch their eyes, nose, or mouths.
Again, measles is highly contagious. If someone has it, up to 90% of those around them who aren’t immune will also become infected, the CDC says. The infectious period is long, too: People who are sick with measles can spread the disease to others four days before and after the rash appears.
Measles treatment
There is no treatment for measles, although the Mayo Clinic says there are some steps you can take if you have a known exposure to the disease and aren’t vaccinated against it.
Post-exposure vaccination. People who aren’t immune to measles can be given the measles vaccine within 72 hours of being exposed to the virus to help provide protection.
Immune serum globulin. Pregnant women, infants, and people with weakened immune systems who are exposed to the virus can get an injection of antibodies called immune serum globulin. If they’re given within six days of being exposed to measles, the antibodies can prevent measles or make symptoms less severe.
Otherwise, “hydration and fever-reducing medications are the mainstay of treatment in the U.S.,” Dr. Adalja says. (Those fever-reducing medications can include acetaminophen, ibuprofen, and naproxen sodium, Dr. Russo says.) Supplementing with vitamin A may also help, Dr. Schaffner says.
Why is measles spreading right now?
Again, measles was eradicated from the Americas back in 2016. However, the U.S. sees a few cases each year. Last year, for example, there were 56 measles cases reported in the country, per the CDC. But in January 2024 alone, there have already been at least 16 reported cases of the disease.
What’s going on here? “It’s largely due to decreased vaccination rates,” Dr. Russo says. “Some of it is fallout from the COVID-19 pandemic—either children missed appointments with the pediatrician or didn’t get vaccinated due to vaccine hesitancy that’s occurred.”
Experts speculate that people aren’t worried about measles anymore because they’re not familiar with it—and they’re not vaccinating their children against it as a result, says William Schaffner, M.D., an infectious disease specialist and professor at the Vanderbilt University School of Medicine. “We now have had at least two generations of parents who have never dealt with measles,” he says. “They think it’s a mild infection. It’s not. It’s a very serious infection that can have all kinds of complications and even uncomplicated measles makes children miserable for a week to week and a half.”
While getting vaccinated against measles with the MMR vaccine is required in many public schools, “there has been a big increase in non-medical exemptions in most states for vaccines,” Dr. Russo says. “That’s a marker that we’re not doing well with vaccination,” he adds.
People are traveling to different parts of the world that may not have high measles vaccination rates and are bringing back the disease, Dr. Russo says. “Then, it can spread easily in vulnerable populations,” he says.
Measles prevention
The best way to prevent measles is to get vaccinated against the virus. The measles vaccine is incredibly effective at preventing the disease—two doses are about 97% effective and preventing measles, according to the CDC. It is possible to get measles if you’ve already been vaccinated against the disease and are exposed to the virus, but it’s rare. The CDC says that about three out of 100 people who get two doses of MMR vaccine will get measles if they’re exposed to the virus, but they are more likely to have a milder illness and are also less likely to spread the disease to other people.
“It’s always best to prevent an infection than to have to deal with an infection,” Dr. Russo says. “Vaccination has been extraordinarily beneficial for public health when it comes to measles. People have become desensitized because we’ve had these vaccines for so long.”
Dr. Schaffner agrees: “Vaccinate your children. It’s important.”
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