While measles was declared eliminated in the United States in 2000, it is still common around the world, with approximately 134,200 deaths each year, according to the World Health Organization’s 2015 fact sheet. Measles can come into our country easily through visitors or returning Americans who have traveled abroad and brought it back. As a result, measles outbreaks still occur every year in the United States. Here are five facts to know about measles:

  1. Nine in 10 people who are not vaccinated and have close contact with a single person with measles will become infected.
  2. Measles spreads through the air when an infected person breathes coughs or sneezes. In fact, even if you’re not right next to someone with measles who’s sneezing or coughing, you can still be exposed since the live virus can linger in the air and also on surfaces two hours later.
  3. High vaccination rates in the United States virtually eliminated measles by the year 2000. However, in recent years, we have seen an increase in measles cases in the country.
  4. We had more cases in 2014 than we had previously seen in over two decades in the U.S.
  5. Although increased vaccine uptake has reduced the annual number of cases since 2014, in the first four months of 2017, there were still 61 cases of measles in the U.S,

What is measles?

Measles, also called rubeola, is a viral respiratory disease and one of the most highly contagious diseases known. It is spread from one child to another through direct contact with discharge from the nose and throat, or via air-borne droplets from an infected child.

What causes measles?

The measles virus, which causes the disease, is classified as a Morbillivirus. It is mostly seen in the winter and spring, but measles is preventable with proper immunization.

The measles vaccine is usually given in combination with the mumps and rubella vaccine. It is called the MMR and is usually given when the child is 12 to 15 months old and then again between 4 and 6 years of age.

What are the symptoms of measles?

After exposure to the disease, it can take between 8 to 12 days for a child to develop symptoms of rubeola. Children are contagious 1 to 2 days before the onset of symptoms and 3 to 5 days after the rash develops. This means that children can be contagious before they even know they have measles.

During the early stages of measles (which lasts between 1 to 4 days), symptoms usually resemble those of an upper respiratory infection. Each child may experience symptoms differently, however. Common symptoms may include:

  • Hacking cough
  • Redness and irritation of the eyes
  • Fever
  • Small red spots with white centers on the inside of the cheek (these usually occur two days before the rash on the skin appears)
  • A deep, red, flat rash that starts on the face and spreads down to the trunk, arms, and legs. The rash starts as small distinct lesions, which then combines to form one big rash. After 3 to 4 days, the rash will begin to clear, leaving a brownish discoloration and skin peeling

The most serious complications from measles include the following:

  • Ear infections
  • Pneumonia
  • Croup
  • Inflammation of the brain

The symptoms of rubeola may resemble other skin conditions or medical problems. Always consult a physician for a diagnosis.

How can parents protect children from the measles?

Measles is a viral infection that’s highly contagious and serious for small children, but it is also 97 percent preventable by a vaccine.

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. Infants ages 6 through 11 months of age who are travelling internationally should receive one dose of MMR vaccine. 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. If you cannot find records, receiving an extra dose of the MMR vaccine is not harmful and can be discussed with your child’s doctor.

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.


Linda Fu Linda Fu, MD, MS, was a general pediatrician at Children’s National.

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