I honestly never thought I would have to write an article about measles. When I was in training, we learned all about measles, studied old case files, learned about the miracle vaccines. But it wasn’t a disease that we saw often. In fact, during my 4 years of medical school and 3 years of residency, I only saw 2 cases, both of whom were from other countries where vaccination was not common. Those 2 that I saw were not even my patients. Whenever a measles case came in, virtually everyone went to see the patient because it was so rare, and the attendings wanted us all to be able to recognize it. Unfortunately, it is not rare anymore. Let’s talk more about this important topic.
What Is Measles?
Measles is a highly contagious and dangerous viral infection that spreads through respiratory droplets when an infected person breathes, coughs, or sneezes. The virus can remain in the air or on surfaces for up to two hours, making exposure easy in shared indoor spaces and even in outdoor spaces that are crowded. It is not just a rash; it can be a life-threatening infection, especially for babies and young children, and pregnant women. Although measles was once rare in the United States, recent declines in vaccination rates have caused multiple large outbreaks across the US.How Contagious Is It?
Measles is one of the most contagious illnesses known.
- Up to 90% of unvaccinated people exposed to the virus will become infected.
- People are contagious four days before the rash appears and four days after it begins.
- This means individuals often spread measles before they realize they are sick.
What Are the Symptoms?
Early symptoms usually appear 7-14 days after exposure and may resemble a typical viral illness. Symptoms start with:
- Fever
- Cough
- Runny nose
- Red, watery, uncomfortable eyes
- Fatigue
After 2-3 days, you can see:
- Koplik spots – A unique early sign of measles. They are tiny white or bluish spots inside the cheeks. These appear 1-2 days before the rash and can help clinicians recognize measles early.
How Does the Measles Rash Appear?
The measles rash starts 3-5 days after the first symptoms. The rash typically:
- Begins at the hairline
- Appears as red, blotchy, flat patches
- Spreads downward to the face, trunk, arms, and legs
- Is often accompanied by a spike of high fever (104-105°)
- Small, raised bumps sometimes start to appear on the flat, red patches
By the time the rash appears, the person has already been contagious for several days.
When Should You Seek Medical Care?
Contact your healthcare provider if you or your child has:
- Fever with cough, runny nose, or red eyes
- A spreading rash
- Exposure to someone with confirmed measles
- Symptoms after recent international travel – where measles rates can be higher than in the US.
Next week, we’ll discuss the possible complications of measles and how to protect your family.
If you have any questions about measles, please log into your account and send us your question. We are here to help.
Dr. Anita Bennett MD – Health Tip Content Editor