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April 07, 2023

Measles is highly contagious, but vaccinations have made it rare

Illness Measles

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Measles is a highly contagious respiratory disease best known for the red rash it causes. Vaccines have made it rare in the United States, but measles can be a serious illness for the few who get it.

Measles and its stages

The virus that causes measles lives in the nose and throat mucus of infected people. When they talk, cough or sneeze, they produce respiratory droplets containing the virus. If you inhale the droplets, or touch a surface that has the droplets on it and then touch your nose, eyes, or mouth, you’re at high risk of contracting the disease.

The illness occurs in four stages over three to four weeks. During the incubation period, measles spreads in the body, but doesn’t cause any symptoms. This stage can last from six to 21 days, but usually lasts from 10 to 14 days.

The second stage is when the first symptoms appear. They usually include a fever, and may also include inflamed eyes, a runny nose, sore throat, and cough. Two to three days after the symptoms start, tiny white spots called Koplik spots or Koplik’s spots may appear on the inside of the cheeks.

The third stage features a red rash that usually first appears on the face and behind the ears, then spreads downward to the trunk, and finally to the legs and feet. It usually lasts about seven days and can be accompanied by a severe fever. People infected with measles can spread it to others during a period that begins four days before the rash appears and ends four days later.

In the fourth stage, the rash goes away, fading first from the head, then the trunk, and finally the legs and feet. The cough and a darkening (or peeling) of the skin in areas affected by the rash may remain for about 10 days.


Measles can be serious. About one in five unvaccinated Americans who get it wind up hospitalized. The people most likely to suffer complications from measles are children younger than five; adults over 20; pregnant people; and those with immune system problems.

Two common complications from measles are ear infections and diarrhea. A more severe complication is pneumonia.

An even more severe but rarer complication is a swelling of the brain called encephalitis. This can cause convulsions, deafness, and intellectual disabilities.

Measles also can cause pregnant people to give birth prematurely or have a low-birth-weight baby.

Diagnosis and treatment

Measles can usually be diagnosed from the rash and Koplik spots. The diagnosis can be confirmed with a blood test, throat swab, or urine sample.

Unvaccinated people who’ve been exposed to measles may be given a vaccine within 72 hours of their exposure. They may still get measles, but it usually will be milder and last for a shorter time than normal.

Infants, pregnant people, and those with weakened immune systems who are exposed to measles can receive an injection of antibodies called immune serum globulin. If they get the injection within six days of exposure, it can prevent them from getting the disease or can make their symptoms less severe.

There is no treatment for measles itself, just treatments for its symptoms and related conditions. These include over-the-counter medications to reduce fever; antibiotics if a bacterial infection such as pneumonia develops; and vitamin A for children with low levels of it.

Immunity and vaccination

Nearly everyone born before 1957 is naturally immune to measles from having been exposed to it. And almost everyone born since then has been vaccinated for it.

The Centers for Disease Control and Prevention recommends that children be given one of two types of vaccine to protect them from measles. The MMR vaccine gets its name because it offers protection from measles, mumps, and rubella. The MMRV vaccine offers protection from the same three diseases plus varicella, commonly known as chickenpox.

If you plan on getting pregnant, and are neither immune to measles nor vaccinated against it, you should get at least one dose of the MMR vaccine.

Don’t be rash

The best way to deal with measles is to avoid getting it! Nearly everyone can be safely vaccinated against measles. If you haven’t been vaccinated yourself, check with your doctor to make sure you can be, then get the vaccine as soon as you can.

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