Measles, also called rubeola, is a viral respiratory disease and one of the most highly contagious diseases known.
It is so contagious that nine out of 10 people who are not immune or vaccinated will get measles if exposed to a person with measles, explains Roberta DeBiasi, MD, Division Chief of Pediatric Infectious Diseases at Children's National.
Measles is spread through airborne droplets, from breathing, coughing, or sneezing. Because it is airborne, you can still be exposed even if you are not in close contact with an infected person, since the live virus can linger in the air and also on surfaces for as long as two hours.
Individuals with measles are contagious in the four-day period before and after the blotchy rash associated with this disease appears.
Watch a video with Children's National Infectious Disease Specialist Bernhard Wiedermann, M.D., as he discusses the rise of measles in the United States in 2019. Also, in an op-ed Dr. Wiedermann explains why immunization is so critically important, especially amid a “perfect storm” caused by complacency, anti-vaccine sentiment, increasing international travel and a highly contagious virus like measles.
Signs and Symptoms of Measles
- Symptoms generally develop seven-14 days after an individual is infected.
- Symptoms typically begin with a mild to moderate fever, cough, runny nose, red eyes, and a sore throat.
- Two to three days after symptoms begin, tiny white spots with bluish-white centers, called Koplik’s spots, may appear inside the mouth.
- Three to five days after the symptoms begin a red or reddish-brown rash appears on the head and spreads to the rest of the body. A spike in fever may occur.
Complications of Measles
Measles has potential for severe complications and/or death, particularly in young children. These complications include pneumonia, lifelong brain damage, or deafness. For every thousand children who get measles, close to 300 will require hospitalization, and as many as three will die.
When to Call the Pediatrician
Call your pediatrician immediately if you suspect your child was exposed to measles or exhibits symptoms. It’s particularly important if your child is an infant, is taking immune suppressant medication or has a medical condition that affects the immune system such as cancer or tuberculosis.
If a child is exposed and has not been immunized, vaccination within 72 hours of exposure may help prevent the disease. Read our Measles Q&A with a Pediatrician.
Protecting Your Child Against Measles
The measles vaccination is a safe and effective way of protecting your child against measles.
The Centers for Disease Control (CDC) recommends the MMR vaccine, which also includes protection against mumps and rubella, for all children at age 12–15 months, with a second dose before the start of kindergarten or at age 4–6 years old. Two doses are also recommended for healthcare providers and post-high school-aged young people or students headed off to college. Learn more about the CDC guidelines for the measles vaccination.
If you’re unsure if you or other family members are protected against measles, try to find your vaccination records or written documentation of measles immunity. Your doctor can also test your immunity through a simple blood test.
Why is the Current Measles Outbreak Occurring?
There is no question that the United States is experiencing a serious nationwide measles outbreak, beginning with a Disneyland-related outbreak in late 2014. There have subsequently been more than 60 confirmed secondary cases related to exposure to the first Disneyland case in mid-December, primarily in California.
However, the CDC is now reporting over 155 cases across 16 states, including several cases in a Chicago area daycare, and those numbers are expected to increase. Most of the more recent cases are believed to be unrelated to the Disneyland outbreak. Importantly, the vast majority of these cases have occurred in unvaccinated or incompletely vaccinated individuals.
But Wasn't Measles Eliminated?
Measles is still common around the world, with approximately 20 million cases and approximately 134,200 deaths each year. Measles can come into our country easily through visitors or when Americans travel abroad and bring it back.
Measles was declared eliminated in the United States in 2000. But since then, declining immunization rates have resulted in a concerning and rising number of cases in our country. Last year, there were 644 cases of measles in the United States-about ten times the average annual number between 2001 and 2011.
When vaccination rates decline, it's not just those individuals who are at risk, it's the whole community, explains Dr. DeBiasi. This is because vaccinated people act as a barrier to disease for their communities. This "herd immunity" reduces the risk of infection for people who can't be immunized, like very young children or those with compromised immune systems.