Signs and Symptoms

The symptoms of measles generally appear about seven to 14 days after a person is infected.

Measles typically begins with

  • high fever,
  • cough,
  • runny nose (coryza), and
  • red, watery eyes (conjunctivitis).
Koplik Spots

Mouth of a patient with Koplik spots, an early sign of measles infection.

Three to five days after symptoms begin, a rash breaks out. It usually begins as flat red spots that appear on the face at the hairline and spread downward to the neck, trunk, arms, legs, and feet. Small raised bumps may also appear on top of the flat red spots. The spots may become joined together as they spread from the head to the rest of the body. When the rash appears, a person’s fever may spike to more than 104° Fahrenheit.



Transmission

Measles is a highly contagious virus that lives in the nose and throat mucus of an infected person. It can spread to others through coughing and sneezing. Also, measles virus can live for up to two hours in an airspace where the infected person coughed or sneezed. If other people breathe the contaminated air or touch the infected surface, then touch their eyes, noses, or mouths, they can become infected. Measles is so contagious that if one person has it, up to 90% of the people close to that person who are not immune will also become infected.

Infected people can spread measles to others from four days before through four days after the rash appears.

Measles is a disease of humans; measles virus is not spread by any other animal species.

Complications

Measles can be a serious in all age groups. However, children younger than 5 years of age and adults older than 20 years of age are more likely to suffer from measles complications.



Common Complications

Common measles complications include ear infections and diarrhea.

  • Ear infections occur in about one out of every 10 children with measles and can result in permanent hearing loss.
  • Diarrhea is reported in less than one out of 10 people with measles.

Severe Complications

Some people may suffer from severe complications, such as pneumonia (infection of the lungs) and encephalitis (swelling of the brain). They may need to be hospitalized and could die.

  • As many as one out of every 20 children with measles gets pneumonia, the most common cause of death from measles in young children.
  • About one child out of every 1,000 who get measles will develop encephalitis (swelling of the brain) that can lead to convulsions and can leave the child deaf or with intellectual disability.
  • For every 1,000 children who get measles, one or two will die from it.

Measles may cause pregnant woman to give birth prematurely, or have a low-birth-weight baby.

Long-term Complications

Subacute sclerosing panencephalitis (SSPE) is a very rare, but fatal disease of the central nervous system that results from a measles virus infection acquired earlier in life. SSPE generally develops 7 to 10 years after a person has measles, even though the person seems to have fully recovered from the illness. Since measles was eliminated in 2000, SSPE is rarely reported in the United States.

Among people who contracted measles during the resurgence in the United States in 1989 to 1991, 4 to 11 out of every 100,000 were estimated to be at risk for developing SSPE. The risk of developing SSPE may be higher for a person who gets measles before they are two years of age.



Since measles is still common in many countries, unvaccinated travelers bring measles to the U.S. and it can spread. Protect yourself, you family, and your community with the measles-mumps-rubella (MMR) vaccine, especially before traveling internationally.


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