Measles

Measles is an illness caused by a virus that spreads through the air. It’s one of the most contagious infectious diseases. Among those who aren’t vaccinated, 9 out of ten people who come into contact with someone with the virus will contract the disease. Once infected, symptoms like a rash and fever can progress to serious conditions, including pneumonia and brain swelling. You can protect yourself and your children from getting sick by getting your family vaccinated against measles. Two doses of the vaccine are 97 percent effective at protecting you from the disease.

At Penn Medicine, our specialists in infectious diseases, primary care, and pediatrics provide strategies to prevent the spread of measles. We offer measles vaccination at many of our locations, including through our primary care providers, urgent care centers, and clinics. In the event of a suspected or confirmed measles case, we’re equipped to provide expert care to lower the chances of complications and stop the spread in our community.

If you think you or your child may have been in contact with someone who is infected with the measles virus, call your primary care doctor, your child’s pediatrician, or an urgent care center. Don’t go directly to a health care center without calling first. Your health care team will guide you on how to receive care.

Measles symptoms don’t appear for up to two weeks after exposure to the virus. This is known as the incubation period. Then, flu-like symptoms are followed by a rash. You can spread measles to others four days before and four days after the rash develops.

• One to two weeks after exposure: Early symptoms of measles include a high fever, cough, runny nose, and red eyes. 
• Two to three days after the start of symptoms: Small red spots with white centers appear inside your mouth, known as Koplik’s spots.
• Three to five days after symptoms begin: Koplik’s spots fade, and a red or purple rash develops, starting on your face and spreading down to your chest, back, arms, legs, and feet. The rash doesn’t itch, but it’s usually accompanied by a high fever.
• Potential complications: Measles commonly causes diarrhea and ear infections, especially in children younger than age five. Measles can also lead to serious conditions, including brain infection and swelling (encephalitis), acute bronchitis, viral pneumonia, pregnancy loss in people who are pregnant, and other conditions. In severe cases, measles can lead to death.

If you don’t have complications, recovery begins when the rash fades, usually 10 to 14 days after your symptoms begin. You may have a cough and feel fatigued for weeks afterward. Because a measles infection destroys immune cells in your body, you may be more susceptible to other illnesses even after recovery. 

Though the measles vaccine is 97 percent effective, breakthrough infections are still possible. However, people who have been vaccinated for the measles prior to contracting the virus typically have milder symptoms and fewer complications.

The disease is caused by a virus that spreads through the air via tiny droplets that are expelled when someone who is infected breathes, coughs, sneezes, or talks. The droplets linger in the air for a couple of hours and can land on surfaces. If you’re not immune to measles, you can contract the disease from shaking hands, hugging, or being near someone with the virus. You can also get measles from contact with surfaces that contain the virus and then touching your mouth, nose, or eyes.

Be sure to call your doctor’s office or an urgent care center ahead of time to let the staff know you may have been exposed to the measles virus. They’ll give you instructions on how to safely see a provider for a diagnosis while preventing the spread of the virus to others. 

Your doctor will ask about your symptoms and health history, including whether you’ve received a measles vaccine and if you’ve traveled to places with a measles outbreak. During a physical exam, your doctor will examine your mouth for Koplik’s spots and your face and body for a rash. You may need tests to confirm measles, which may include checking your blood, urine, or samples swabbed from your nose or throat. If you’ve received a measles vaccine but you’re at high risk, your doctor may check your blood for measles antibodies to see if you’re immune to the disease.

If you’ve been diagnosed with measles, avoid contact with others until your doctor says you’re no longer contagious.

No treatment can cure measles, but doctors offer therapies to help you manage your symptoms and prevent complications. Children and adults who haven’t received a measles vaccine can be vaccinated within three days of exposure to try to avoid an infection. Another treatment option may be immune globulin therapy, which needs to be taken within six days of exposure. During this therapy, you’re given antibodies that help your body clear the infection. This is currently recommended by the CDC for high-risk individuals such as those who are immunocompromised, pregnant without a history of immunization or are not immune, or unvaccinated infants.

At home, rest and drink plenty of fluids. You can take medications to relieve pain and lower your fever.

One in five people need to be hospitalized for measles, so it’s important to know the warning signs that require immediate care. If any of these symptoms develop, call 911 or the hospital to let them know you have measles and need emergency care:

• Chest pain
• Trouble breathing
• Neck stiffness
• Severe headaches
• Confusion
• Diarrhea and vomiting with signs of dehydration, like a dry mouth or less urination

People who have measles are at risk for serious complications including brain inflammation and death which can occur months to years after initial infection.  For that reason, anyone with a history of measles infection should be followed closely by a physician with expertise in measles.

Penn Medicine offers convenient access to measles vaccinations at many of our locations. Our pediatricians can provide your child with the measles vaccine during routine check-ups. Children and adults who haven’t received the vaccine on schedule can get vaccinated at their pediatrician’s office, primary care providers’ office, an urgent care center, or at other Penn Medicine clinics in our region.

If you or your child may have been exposed to measles, we can provide a complete evaluation and evidence-based care in a safe environment.