Measles (rubeola) - Epidemiology

What is measles?

Measles is a serious illness caused by the measles virus. It is spread very easily from person to person and can cause outbreaks of illness. Before the vaccine became available, most people contracted measles during childhood. Now the disease is rare in the United States, but it is still common in many countries.

Who gets measles?

Although measles is considered a childhood disease, people of any age can get it. In the United States, most cases are in unvaccinated infants, children, and teens. Adults at increased risk include college students, international travelers, and health care personnel.

How is measles spread?

Measles is one of the most contagious diseases. The measles virus is spread through the air or by direct contact with nose or throat discharges from someone who is infected. The measles virus can remain in the air for up to two hours after a person with measles has occupied the area.

What are the symptoms of measles?

Measles symptoms usually appear in two stages. In the first stage, most people have a fever, runny nose, redness of the eyes, and cough. The second stage begins around days 3-7 when a red blotchy rash begins to appear on the face and spreads over the entire body. The rash generally lasts 5-6 days. Small white spots, called Koplik spots, also may be seen on the gums and inside of the cheeks.

How soon after exposure do symptoms appear?

Symptoms may begin within 7-21 days after exposure with an average of 10 days after exposure. The rash usually appears within 14 days of exposure.

What is the treatment for measles?

Treatment focuses on relief of symptoms as the body fights the virus. This may include fluids, medications to control fever or pain, antibiotics to treat secondary infections from bacteria, and vitamin A supplements.

How can measles be prevented?

Vaccinating as many children as possible is the best way to prevent measles cases and outbreaks. Two doses of measles vaccine are recommended for all children. The first dose, as part of the measles, mumps, and rubella (MMR) vaccine, should be given at 12-15 months of age and the second dose before a child enters kindergarten (4-6 years of age). There are additional recommendations for adults and those who are traveling outside of the United States, including infants as young as 6 months of age.

How long can an infected person carry measles?

A person can spread the measles virus from just before the onset of the fever (usually four days before rash onset) to about four days after the appearance of the rash. Immunocompromised patients may spread the virus for the duration of their illness.

What are the complications associated with measles?

Middle ear infections, pneumonia, croup, and diarrhea commonly occur in young children. Encephalitis (inflammation of the brain) can occur in a small percentage of cases. Death due to measles is very rare in the United States and occurs in 1-3 of every 1,000 cases. Measles is more severe in children younger than 5 years and adults older than 20 years of age.

Can a person who had measles get it again?

No. Persons who have had measles do not get it again.

How can I get more information about measles?

If you have concerns about measles, contact your healthcare provider.
Call your local health department. A directory of local health departments is located at the VDH Local Health Districts page.
Visit the VDH measles website.
Visit the Centers for Disease Control and Prevention website at the CDC page on measles.