Measles, also called rubeola, is a contagious disease that mainly strikes children. We often think of the measles rash as a key symptom of the disease. But measles symptoms usually start three to five days before the rash appears, according to the Centers for Disease Control and Prevention (CDC).
The CDC estimates that 3 to 4 million people in the U.S. developed measles every year before the vaccine for measles was available. With the widespread use of the measles vaccination, which was introduced in the U.S. in the 1960s, measles outbreaks have plummeted. But the U.S. saw 1,282 cases in 2019, the largest number of cases since 1992, the CDC reports. Most of those cases struck communities where people were not vaccinated.
Still it’s rare to see measles. “I’ve never seen a case of measles, and that’s a big deal because I’m a consultative dermatologist, so dermatologists in my area send me their cases,” said Dr. Jenny Murase, associate clinical professor of dermatology at the University of California, San Francisco, and a member of the American Academy of Dermatology. “I see all the weird stuff — and I’ve never seen measles.”
Measles vaccines have been highly effective at controlling the disease. When the two-dose MMR vaccine is administered to children in accordance with the U.S. vaccination schedule, it’s generally considered to protect against measles for life without requiring an additional booster dose, according to the CDC.
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Symptoms of measles
What are symptoms of measles? Someone might not show symptoms of measles for nine to 12 days, according to the American Osteopathic College of Dermatology (AOCD). After that, people may develop other symptoms.
Additional symptoms may include:
- Fever
- Cough
- Nasal discharge
- Sneezing
- Conjunctivitis (pink eye)
Small white spots might appear inside the mouth, according to the World Health Organization (WHO). A widespread rash follows in several days, usually starting on the scalp and behind the ears and spreading to cover the body.
The rash typically starts out as flat red spots, sometimes with small raised bumps, according to the CDC. They can merge together as they spread down over the body.
Measles is serious. It can lead to dangerous complications such as blindness, encephalitis, diarrhea and dehydration, ear infections or pneumonia, the WHO says.
“I think people forget how serious measles is in children,” said Dr. Melissa Piliang, a dermatologist at the Cleveland Clinic and a member of the American Academy of Dermatology. “People can die from measles. It’s important to seek help, especially if you know your child hasn’t been vaccinated.”
Causes of measles
Measles is caused by a virus that infects the respiratory tract and spreads from there to the rest of the body. You can catch measles through the air — it can live there for up to two hours — or through direct contact with the virus.
The CDC says it’s one of the most contagious diseases — it will spread to 90% of susceptible people who have close contact with a person who has measles.
Diagnosing measles
Measles is hard to diagnose early, because the initial symptoms could be caused by a lot of different conditions. It’s usually not diagnosed until the rash appears.
“If you have a suspicion that you might have measles or you have a blistery, itchy rash and you feel crummy, you should be getting evaluated,” said Piliang. “It’s infrequent in the community, but it definitely does happen.”
Treatment for measles
The best treatment for measles is prevention. Measles used to take the lives of 500 people per year in the U.S. before immunizations were introduced, according to the AOCD. With safe, effective vaccinations for measles, cases have dropped by 99%.
For people who do develop measles, doctors may recommend high doses of vitamin A, according to the AOCD. Bed rest, pain medications and medicines that reduce fever can also help.