Measles Frequently Asked Questions (FAQ)

Measles is a serious, highly contagious disease caused by a virus. The virus is spread easily through the air when an infected person coughs, sneezes, or by direct contact with infected nose or throat secretions.

Symptoms of measles include:

• Fever of 101F (38.3C) or higher
• Cough, coryza (runny nose), or conjunctivitis (red eyes)
• A generalized rash that starts on the head around the hairline and moves down the body, lasting three days or more

Initially, a high fever, runny nose, cough, and red, watery eyes develop, followed by the rash. The rash usually starts on the face, hairline, behind the ears, and neck, and then spreads to the rest of the body. The fever typically begins about 10 days (range 7 to 18 days) after exposure, and the rash appears about 14 days after exposure. Infants and adults are usually sicker than children and teenagers.

In the United States, death from measles has occurred at a rate of about 2 to 3 per 1,000 cases in recent years. These deaths occur mainly in children younger than 5 years of age, primarily from pneumonia and occasionally from encephalitis. Other complications include ear problems, diarrhea, and brain damage.

Measles is very contagious. Someone with measles is contagious from four days before the onset date of the rash through the end of the fourth day after the onset of the rash (the onset date of the rash is called “day zero”). During this time, those infected should stay home and not attend work, school, or social activities unless they are seeking medical care. If seeking medical care, patients should call ahead to the medical facility and local health department to make arrangements to minimize exposures.

Treatment includes bed rest, fluids, and medicine for fever and headache. Antibiotics do not help and will not cure measles or prevent the disease. Vitamin A has some utility in certain situations for certain patients, but it cannot prevent or cure measles and is not a substitute for vaccination. There are no antiviral drugs for treating measles.

The best way to prevent measles is through vaccination. The measles vaccine (the MMR vaccine, because it protects against measles, mumps, and rubella) is routinely recommended for children at 12-15 months of age, with a second dose recommended at 4-6 years of age. One dose of the MMR vaccine is required for those 12 months and older to attend child care facilities, and two doses of MMR are required in Illinois for kindergarten through 12th-grade children. Another combination vaccine called MMRV also helps protect against varicella (chickenpox). Vaccination is recommended as soon as possible upon reaching age 12 months.

Infants 6 through 11 months of age traveling internationally should be given one dose of the MMR vaccine. These children will still need their regularly scheduled two MMR doses at 12 months of age and older.

For those infants aged 6 to 11 months who are traveling to domestic areas with an outbreak, clinicians should look to the vaccination guidance of the state or local health department for the residents of the outbreak-affected community to determine whether vaccination is needed. If given a dose, the child will still need their regularly scheduled two MMR doses at 12 months of age and older.

Most adults born during or after 1957 are recommended to have at least one dose of MMR, or presumptive evidence of immunity. Some groups, such as students at post-high school educational institutions and health care workers, are recommended to have two doses spaced out by at least 28 days or proof of immunity.

Persons born before 1957 are likely immune because they may have had measles.

Women should not get the vaccine if they are already pregnant or if they plan to become pregnant within three months after getting the vaccine.

Begin by looking for your vaccination records. Your primary care clinician may have this information. Another potential source of vaccination records could be your school or college records. Illinois residents can also check their immunization records at the IDPH Vax Verify portal.

If you have had two doses of the MMR vaccine, the Centers for Disease Control and Prevention (CDC) considers you to have presumptive immunity. Two doses of MMR are about 97% effective in preventing measles. Two-dose protection is extremely important in high-risk settings, such as during domestic outbreaks or when traveling internationally. Breakthrough infections, while mild, can occur with a single dose.

If you do not have written documentation of a measles vaccination, you can get a dose of the MMR vaccine. CDC recommendations indicate there is no harm in getting a dose of the MMR vaccine, even if you are already immune.

Vaccination records are the most reliable proof that you are immune or protected from an infection like measles. While not generally recommended, you can also ask your clinician to order a blood test for measles antibodies. If you don’t have vaccination records and your antibody test, or “titers,” are negative, you need to be vaccinated to be protected against measles. However, if you do have proof of vaccination and your titers are negative, you do not need to be revaccinated because of your immune system’s memory response, meaning that your body may not be making enough antibodies to be detected in the laboratory on a blood test but your body still remembers how to make enough antibodies when exposed to the actual measles virus.

Acquired immunity after a measles illness is typically considered to be lifelong.