Healthcare Hot Topic: Measles (Rubeola) – What You Need to Know

Measles is a highly contagious viral infection. With recent outbreaks, it’s crucial to understand the risks, symptoms, and how to prevent its spread.

Presented in collaboration with Delaware Beaches Online and Atracare.

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What is Measles?

Measles (rubeola) is a highly contagious viral infection caused by the paramyxovirus. It spreads through respiratory droplets from coughing or sneezing and can survive on surfaces for up to two hours.

Key Facts:

• Not just a rash and fever – Measles can lead to serious health complications, especially in children under 5.
• Extremely contagious – If one person has measles, up to 9 out of 10 unvaccinated people nearby will get infected.
• Still a global threat – Although measles was declared eliminated from the U.S. in 2000, it is still common in many parts of the world. Every year, unvaccinated travelers bring measles into the U.S., increasing the risk of outbreaks.

Who is at Risk?

Anyone who is not vaccinated is at risk for measles. However, some groups face a higher likelihood of severe complications, including:

• Children under 5 years old
• Adults over 20 years old
• Pregnant women (higher risk of miscarriage, preterm labor, and birth complications)
• People with weakened immune systems, such as those with HIV, leukemia, or other immune disorders

Complications of Measles

While many people recover, measles can lead to serious and even life-threatening complications, especially in vulnerable groups.

Common Complications:

• Ear infections (occur in about 1 in 10 children)
• Diarrhea (affects fewer than 1 in 10 people)

Severe Complications:

• Pneumonia – Leading cause of measles-related deaths in young children
• Encephalitis (brain swelling) – Can lead to seizures, deafness, or permanent brain damage
• Subacute Sclerosing Panencephalitis (SSPE) – A rare but fatal brain disorder that can develop years after measles infection
• Pregnancy complications – Increased risk of miscarriage, preterm labor, and low birth weight

Symptoms of Measles

Early Symptoms (3-4 Days Before Rash Appears):

• High fever (101°F or higher) – most contagious period
• Cough, congestion (coryza), and conjunctivitis (red, watery eyes)
• Koplik spots – small white/blue spots with red borders inside the mouth (a telltale measles sign)

Source: About Measles ,Measles Symptoms and Complications

Rash Progression:

• Starts 2-4 days after fever begins
• Spreads from face → behind ears → chest → back → legs → feet
• Maculopapular (flat, red spots) that may blanch early on
• Lasts about 5-7 days, then fades
• High fever peaks 2-3 days after rash starts

How Long is Measles Contagious?

4 days before symptoms appear → 4 days after rash appears

Should an Infected Person Stay Home?

• Yes! To prevent spreading measles:
  ✔ Children should stay home for at least 4 days after rash appears
  ✔ Avoid school, work, and public places
  ✔ More details are available in the Delaware Division of Public Health’s “Managing Infectious Disease in Childcare Settings” 

Treatment for Measles

• There is no specific antiviral treatment for measles, but symptoms can be managed with:
  ✔ Rest & hydration
  ✔ Fever management (acetaminophen/ibuprofen)
  ✔ Vitamin A supplementation (especially for hospitalized children)
  ✔ Treatment for complications (bacterial infections, pneumonia)

How to Prevent Measles

Vaccination is the BEST defense!

• The MMR vaccine protects against measles, mumps, and rubella

• The CDC recommends that all children receive two doses of the MMR (measles-mumps-rubella) vaccine:

  • First dose: 12 through 15 months of age
  • Second dose: 4 through 6 years of age

  Children can receive the second dose earlier if at least 28 days have passed since the first dose.

2025 Immunization Schedules Now Available!

• Immunization schedules are now available online for review.
• They have been recommended by the Advisory Committee on Immunization Practices (ACIP) and made official by the CDC director. 
• For the healthcare providers, the schedules are available at CDC Vaccine Site.
• For Simplified Vaccine Schedules, the CDC has a Family Friendly Version see the Schedule Changes and Guidance.

Key Takeaways

✔Measles is highly contagious but preventable
✔Vaccination is the best way to protect yourself and your community
✔If infected, isolate and seek supportive care
✔ Stay up to date with the 2025 immunization schedules

Get vaccinated. Stay informed. Stop measles in its tracks.