Measles: Symptoms, Causes, and Treatment

Measles is a serious viral illness that spreads through coughs and sneezes. It starts with fever, cough, and red eyes, followed by a red rash that spreads over the body. While most people recover, measles can sometimes lead to dangerous complications like pneumonia or brain swelling. The MMR vaccine safely prevents measles. If you think you or your child have symptoms, contact a doctor right away.

In plain words

Measles is a serious illness caused by a virus. It spreads easily through coughs and sneezes. Symptoms start with fever, cough, runny nose, and red eyes. A red rash appears a few days later, starting on the face and moving down the body. Measles can lead to serious problems like pneumonia or brain swelling, especially in young children. The best way to prevent measles is by getting the MMR vaccine. If you think you or your child has measles, contact a doctor right away.

What is Measles: Symptoms, Causes, and Treatment?

Symptoms

Early symptoms

High fever (often up to 104°F): Fever is usually the first sign, appearing about 10-14 days after exposure. It often lasts 4-7 days. (2) (5)
Cough and runny nose: A persistent cough and clear nasal discharge develop early in the illness. (2) (5)
Red, watery eyes (conjunctivitis): Eyes may appear bloodshot and be sensitive to light. This is very common with measles. (2) (5)
Koplik spots (tiny white spots in mouth): Small white spots with bluish-white centers appear inside cheeks 2-3 days before the rash. (2) (5)

Serious or emergency symptoms

Red, blotchy rash spreading head to toe: The measles rash appears 3-5 days after first symptoms - flat red spots that may join together as they spread downward. Contact your doctor immediately if this rash appears after exposure to measles. (2) (5)
Difficulty breathing: Trouble breathing or fast breathing could signal serious lung infection (pneumonia) - a common measles complication. Seek emergency care immediately for breathing problems. (2) (5)
Confusion or seizures: These may indicate swelling of the brain (encephalitis), a dangerous complication affecting about 1 in 1,000 measles patients. Call emergency services immediately for confusion, severe headache, or seizures. (2) (5)

Causes

Primary causes

Measles virus infection: The rubeola virus causes measles. It spreads through direct contact with infectious droplets or airborne transmission when an infected person breathes, coughs, or sneezes. (1)

Risk factors

Not being vaccinated

About 90% of unvaccinated people exposed to measles will become infected. The MMR vaccine is the best protection. (7)

International travel

Travel to countries with ongoing measles outbreaks increases risk, especially for unvaccinated individuals. (7)

Weakened immune system

People with conditions like leukemia, HIV/AIDS, or those receiving immunosuppressive treatments have higher risk of severe measles. (7)

Diagnosis

Doctors diagnose measles based on symptoms (especially the characteristic rash) and possible exposure history. They may order blood tests to check for measles antibodies or virus genetic material. Lab testing is important because many illnesses can look like measles. Always tell your doctor if you suspect measles before visiting, so staff can protect other patients.

Blood test for measles antibodies

Checks for immune system response to measles virus to confirm infection. (8)

Throat or nasal swab for PCR testing

Detects genetic material from the measles virus for confirmation. (8)

Treatment

Medication options

Fever reducers

These can help reduce fever and relieve discomfort. Never give aspirin to children with measles due to risk of Reye's syndrome. (3) (6)

Vitamin A supplements

High-dose vitamin A reduces complications and death in children with measles, especially in those who may already be deficient. (3) (6)

Antibiotics (if needed for bacterial complications)

Doctors may prescribe antibiotics if measles leads to secondary bacterial infections like ear infections or pneumonia. (3) (6)

Lifestyle and self-care

Get vaccinated (prevention): The measles vaccine (given as part of MMR vaccine) is highly effective - two doses provide 97% protection. The CDC recommends first dose at 12-15 months, second at 4-6 years. Adults without immunity may also need vaccination. (4)
Stay hydrated and rest: Drink plenty of fluids like water and electrolyte solutions to prevent dehydration from fever. Get plenty of rest to help your body fight the infection. (3) (6)
Isolate to prevent spreading: Stay home from work/school and avoid others for at least 4 days after the rash appears. Measles is highly contagious before and after rash onset. (3) (6)

Always discuss dosing and treatment changes with your own prescriber.

Possible complications

Pneumonia: The most common cause of death from measles, affecting about 1 in 20 children with measles. Can be viral or develop as a secondary bacterial infection. (3)
Encephalitis (brain swelling): Occurs in about 1 in 1,000 cases, often leading to hearing loss or intellectual disability. About 1-2 in 1,000 children with measles will die from encephalitis and its complications. (3)
Severe diarrhea: Can lead to dangerous dehydration, especially in very young children. Requires prompt medical care to replace lost fluids. (3)
Pregnancy risks: Measles during pregnancy increases risk of miscarriage, premature birth, and low birth weight. (3)

When to see a doctor

Routine follow-up

Contact your doctor immediately if you or your child show symptoms of measles, especially after possible exposure. Call ahead to prevent spreading at the clinic. (5)

Seek emergency care

Seek emergency care or call 911 for high fever that lasts more than 3-4 days, difficulty breathing, severe headache with fever, confusion, drowsiness, or seizures. (5)

Frequently asked questions

What is measles?

Measles is a serious, highly contagious viral illness that spreads through coughs and sneezes. It causes fever, cough, red eyes, and a distinctive red rash that spreads from head to toe. While most recover, measles can lead to dangerous complications, especially in young children. (1) (8)

What are the first signs of measles?

Measles usually starts with high fever (often 104°F), cough, runny nose, and red, watery eyes. Tiny white spots (Koplik spots) may appear inside the mouth 2-3 days before the distinctive red rash develops. The rash typically starts on the face and spreads downward. (2) (5)

What causes measles?

The rubeola virus causes measles. It spreads through the air when infected people cough or sneeze, and can linger in the air for up to two hours. You can catch it by breathing contaminated air or touching infected surfaces then touching your eyes, nose, or mouth. (1)

How is measles treated?

There's no direct treatment for the measles virus. Care focuses on relieving symptoms with fever reducers (never aspirin in children), fluids, rest, and sometimes vitamin A supplements. Antibiotics may help with secondary bacterial infections. Hospitalization might be needed for severe cases. (3) (6)

Can measles be cured?

There's no cure for measles - the infection must run its course. Most people recover in 2-3 weeks with proper care. The best approach is prevention through vaccination (MMR vaccine). If you've been exposed, post-exposure vaccination or immune globulin within 72 hours might prevent illness. (3) (6)