Health Encyclopedia

Why Measles Remains a Threat

Once an almost inevitable childhood illness for an American child, measles (rubeola) has reached an all-time low in this country. But children still need immunization, because measles is still a major threat in other parts of the world. Each year, nearly 200,000 people worldwide die of measles.

In the United States, the cases that do occur are because of imported measles. Many of these cases occur among adults and children returning from visits to foreign countries.

Most U.S. children have been vaccinated, but the vaccine is only 95 to 98 percent effective. That means some children exposed to measles can still get the disease.

The vaccine — usually a combination measles-mumps-rubella (MMR) vaccine — is given at ages12 to 15 months. A booster is given at ages 4 to 6, or at ages 11 to 12 (if not given earlier). The booster helps ensure that most children are protected. 

Measles should not be confused with rubella, which is known as "German measles." Rubella is caused by a different virus that often causes no symptoms. It's also much shorter and milder than measles. However, a woman who gets rubella early in pregnancy can pass it to her unborn child, causing potentially serious complications.

Measles spreads quickly through coughing, sneezing, or talking. Nearly everyone who is exposed to the measles virus will probably develop measles if he or she is not immunized.

Although measles is chiefly known for its red rash, its true danger lies in its complications. The virus can lead to bronchitis, pneumonia, and ear infections. If the virus moves to the brain, it can cause swelling known as encephalitis. Infants face a higher risk for complications than older children.

Most people born before 1957, before the vaccine was introduced, are considered immune. The infection was so widespread then that most people got the disease. Anyone born after 1957 should be vaccinated.

Measles symptoms

Symptoms appear 7 to 14 days after exposure. A person with measles is contagious for up to 4 days before symptoms appear, until 4 days after the rash appears. Symptoms include:

  • Fever, which may become very high when the skin rash appears.

  • Runny nose

  • Pink, watery eyes (conjunctivitis)  

  • Dry cough

  • Diarrhea

  • Tiny white spots on the mouth lining (called Koplik spots)

  • Skin rash of dull red, slightly raised spots (usually appears 4 or 5 days after symptoms start); the rash starts on the face and spreads down the body to the feet

What you can do

  • Make sure your child is immunized.

  • If your child contracts measles, keep him or her home, away from other children, until your doctor gives the OK to return to school.

  • Encourage your child to rest. It's not necessary to stay in bed.

  • Give your child plenty of clear liquids — water and juice are good choices.

  • For fever, you can give your child acetaminophen or ibuprofen. Because of the risk of Reye's syndrome, children and teens with a fever should not take aspirin or aspirin-containing products.

  • No matter your age, discuss with your doctor the need for a measles vaccination if you work at an educational institute, a health care setting, or are planning international travel.