Measles (Rubeola)

Measles (rubeola) is a viral illness. It mostly affects children and adults who have not had the measles vaccine or aren't protected from it anymore. The virus is spread through the air by coughing and sneezing or by direct contact (touching the sick person and then touching your own eyes, nose or mouth). It takes about 1 to 2 weeks after exposure for the illness to develop. The illness usually lasts for 1 to 2 weeks.

Measles symptoms include a severe rash, high fever, cough, runny nose, and red eyes. Measles can also cause ear infections and pneumonia. In rare cases, encephalitis (inflammation of the brain) and death may occur. In pregnant women, measles can cause miscarriage or premature delivery. If a person with measles has been in contact with any pregnant person during the contagious period, the person must contact their healthcare provider.

Home care

  • Keep your child home from school or daycare for at least 4 days after the rash first appears.

  • Keep your child away from anyone who might be pregnant.

  • Fever increases water loss from the body.

    • For children 1 year and older: Give plenty of fluids like water, juice, gelatin, water, non-caffeinated soda, ginger ale, lemonade, or ice pops.

    • For babies younger than 12 months: Continue regular feedings (formula or breast). Between feedings give plain oral rehydration solutions available from grocery and drugstores without a prescription. Ask your pharmacist for a recommendation.

  • It's OK if your child doesn't want to eat solid foods for a few days as long as they drink plenty of fluids.

  • Ask your child's healthcare provider before giving any over-the-counter medicines. Never give children adult medicines.

  • Coughing is a normal part of this illness. A cool mist humidifier at the bedside may be helpful. Don't give over-the-counter cough and cold medicines to children under 6 years unless your doctor has specifically advised you to do so.

  • Periods of sleeplessness and irritability are common. Give your child plenty of time to sleep. 

    • For children 1 year and older:  Have your child sleep in a slightly upright position. This is to help make breathing easier. If possible, raise the head of the bed slightly. Or raise your older child’s head and upper body up with extra pillows. Talk with your healthcare provider about how far to raise your child's head.

    • Babies younger than 12 months: Never use pillows or put your baby to sleep on their stomach or side. Babies younger than 12 months should sleep on a flat, firm surface on their back. Don't use car seats, strollers, swings, baby carriers, or baby slings for sleep. If your baby falls asleep in one of these, move them to a flat, firm surface as soon as you can.

  • Suction the nose of babies with a rubber bulb syringe. You may put 2 to 3 drops of saltwater (saline) nose drops in each nostril before suctioning to help remove secretions. Saline nose drops are available without a prescription.

  • Don't let anyone smoke around your child. Tobacco smoke can make the cough worse and your child sicker.

Preventing spread of the virus

  • Measles is contagious from 3 to 5 days before the rash appears until 4 days after the rash appears. During this 7 to 9-day period, keep children home from school or daycare. Adults should stay home from school or work. A sick person shouldn't use mass transit (buses, trains, airplanes). They should stay away from crowded places and pregnant people until the contagious period has passed.

  • Tell any school, camp, daycare, or other facility that your child may have gone to during the contagious period. Adults with measles should tell their workplace.

  • Any person who has not had measles before and has never been immunized should contact their healthcare provider to discuss if they need a vaccine.

Follow-up care

Follow up with the child's healthcare provider, or as directed.

When to get medical advice

Unless your child's healthcare provider advises otherwise, call the provider right away if any of these occur:

  • Your child has a fever (see "Fever and children" below)

  • Rash turns dark purple

  • Earache, sinus pain

  • Wheezing

  • Repeated diarrhea or vomiting

  • Signs of dehydration: No wet diapers for 8 hours in babies, little or no urine in older children, very dark urine, or sunken eyes.

  • Trouble waking up your child, abnormal movements, or severe headache

  • Symptoms get worse or new symptoms occur

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until he or she is at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell him or her which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° F (38° C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

Call 911

Call 911 for any of the following:

  • Trouble breathing

  • Stiff or painful neck

  • Abnormal fussiness, drowsiness, or confusion

  • Fast breathing:

    • Over 40 breaths per minute for children less than 3 months old

    • Over 30 breaths per minute for children over 3 months old

© 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
Powered by Krames Patient Education - A Product of StayWell