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 woman during the contagious period, the woman must contact her 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 any woman 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 popsicles.

    • 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 he or she drinks plenty of fluids.

  • Ask your child's healthcare provider before giving any over-the-counter 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 4 days before the rash appears until 4 days after the rash appears. During this 8- to 10-day period, keep children home from school or daycare. Adults should stay home from school or work. A sick person should not use mass transit (buses, trains, airplanes) and stay away from crowded places 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 seek medical advice

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

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

  • Rash turning 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.

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

Call 911

Call 911 for any of the following:

  • Trouble breathing

  • Stiff or painful neck

  • Unusual 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

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