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Measles - Symptoms, Causes, Diagnosis, Treatments and Prevention

Last Updated: Oct 27, 2021

What is Measles?

Measles is a highly communicable illness caused by morbillivirus. This virus replicates in the nose or pharynx of an infected child or adult. If an infected person coughs, sneezes or talks, the droplets spread in the air and other people may inhale them.

The infected droplets may also drop onto surfaces where they remain active and contagious for hours. People get infected by touching these surfaces and then putting the infected fingers in their mouth, nose or rubbing their eyes following contact with the surfaces.

Anyone who hasn’t been immunised or hasn’t had the infection in the past can get the infection. It is found that the infection clears in around seven to ten days. Once you have had measles, your body develops resistance and so you don’t really get re-infected. But, it may at times cause serious complications like encephalitis and pneumonia.

What does measles look like?

The measles looks like flat red spots, although raised bumps may present sometimes. If the bumps appear, it doesn’t have any fluid in it. The spots rash may begin to run together as the rash spreads. The virus grows in the cells lining the throat and lungs.

How dangerous is measles?

Measles is a dangerous and deadly disease. Children under the age of five and people over the age of twenty are more susceptible to complications associated with it. The most significant problems are otitis and diarrhoea. However, severe and major complications attached to this disease are pneumonia and encephalitis.

What are the symptoms of measles?

Measles starts with cold-like symptoms that starts around 10 days after getting infected. This is followed by a rash about a couple of days later. In the majority of patients, the ailment lasts for about seven to nine days.

The initial Symptoms are:

  • Runny or blocked nose
  • Sneezing
  • Watery eyes
  • Puffy eyelids
  • Red and sore eyes that are sensitive to light
  • High grade fever
  • Small greyish-white spots in the mouth
  • Aches and pains
  • Loss of appetite
  • Tiredness, irritability and generalised malaise

After few days you may also experience the following symptoms:

  • Spots in the mouth: Some people develop small greyish-white spots in the mouth a day or two before developing the typical rash. Not everyone gets these spots but if they do develop in addition to other symptoms, they are more diagnostic of the infection. These spots may last for a couple of days before disappearing.
  • Measles rash: These rashes appear in 2 to 3 days after the infection and go away in a week. Measles Rash occurs as flat red-brown spots which can join together to form larger blotchy patches. It generally appears on the head and neck before spreading out to the rest of the body. Itching may be felt by some people. Rash is rare if the person has been immunised. Rashes that appear in measles look similar to roseola or rubella and slapped cheek syndrome.

How long does measles last?

Measles lasts between 10 days to 14 days. After the initial period, you may begin to experience nonspecific symptoms, such as fever, cough, and runny nose. The rash will begin to develop several days later.

How do Measles look?

Usually, rashes break out 4-5 days after you start witnessing the symptoms of Measles. Initially, it looks like a red flat spot on your facial skin, then it begins to spread downwards towards the neckline, arms, legs, and feet. You may also address some small bumps raised on your skin atop of flat red spots.

Are Measles itchy?

The skin rashes caused by Measles may or may not be itchy. Measles peels off the skin like sunburn. The skin might shed during Measles and might give you a miserable feeling.

Where is Measles most common?

Measles continues to be a common illness in several parts of the world. Some of the nations with Measles as a common disease are Europe, Asia, the Middle East, Asia, and Africa. It is estimated that 142,000 Measles-related deaths occur each year. Recently, several nations have witnessed Measles outbreaks. Thailand, Japan, Israel, Vietnam, Ukraine, and the Philippines are some of the travel destinations where cases related to Measles have been experienced.

What is the mode of transmission for measles?

Measles is highly contagious and spreads through coughing or sneezing. This is because the virus lives in the mucosae of nose and throat. The virus lives for about 2 hours in the atmosphere where an infected patient has sneezed or coughed.

If anyone else inhale the contaminated air or touch the infected surface, then they can also get infected from the virus. Measles is contagious and 90% of the people who are close to an infected individual and not immune to the virus can get infected. Measles is a human infection and is not spread by any animal species.

Is measles airborne?

Measles can be spread through the air in the form of respiratory droplets. An infected person can release the virus into the air when they sneeze or cough. These particles can settle down on the objects and surfaces.

If you become infected, you may have come into contact with contaminated objects like door handles, and then you might have touched your face, nose, or mouth.

The virus can live outside of the body for longer than you may think. In fact, it can remain infectious in the air or on the surface touched by the infected person and can last up to 2 hours.

Are the Measles still around?

According to 2018 data, Measles is still the cause of concern. Vaccination, on the other hand, is available to prevent this disease. We still need the vaccination done for our kids. There are a very small number of deaths registered against this disease especially in developed nations including England and Wales. As per the records from the year 2007 to 2018, there are only two or three deaths registered out of 10,000.

How is measles transmitted?

Measles is a highly contagious illness and is caused by morbillivirus. The virus replicates in the nose or pharynx of the patient and spreads through coughing or sneezing by an infected person. This disease occurs among poorly nourished children and adults who have a nutritional deficiency of vitamin A.

Women infected with measles while pregnant may also develop complications and may result in stillbirth or miscarriage or even preterm birth. People who develop measles once are usually immune for the rest of their lives.

Is measles contagious?

Yes, measles is a contagious disease. Measles infection can spread very easily from person to person. An infected person is contagious for up to 4 days before the rash appears. After the rash appears, the person is still contagious.

The main risk factor for catching viruses is not known. Young children, people with weak immunity and pregnant women are at higher risk of developing complications from the measles infections.

Can adults get Measles?

The disease is more likely to happen during childhood but yes, Measles can affect adults too. Mainly people who have not got their vaccination done against Measles are susceptible to it. There is a higher risk of such people catching this disease. It is widely accepted that adults born in 1957 or earlier are naturally immunized against Measles.

What part of the body does Measles affect?

In Measles, the virus enters the body via mouth, nose, or ears. It further evolves and gets into the lungs hampering the immune cells. After that, these affected immune cells then move to the other parts of the body impacting the other cells which later mix up with the blood. The blood then circulates in the body hampering the skin, liver, and nervous system.


What is the incubation period for measles?

Around 90% of susceptible individuals who come in contact with someone with the virus, develop the infection. The virus remains active on a surface for about 2 hours where an infected patient has sneezed or coughed. Measles remain active for at least 4 days before the typical rash appears and stay contagious for the next few days.

When the virus enters the system, replication of virus takes place in the lungs, throat and lymphatic system. The virus also multiplies in the eyes, central nervous system, urinary tract and blood vessels. The virus stays for about 1 to 3 weeks in the system after the initial infection.

What causes measles?

The measles virus is able to live on the surface for several hours, causing the infected particles to remain in the air and as such any person within its vicinity may get infected. Sharing utensils like spoons, towels, brush etc. with an infected person increases the risk of infection.

The World Health Organization (WHO) reported that most of the victims in its reports were children under the age of 5. The disease is found to mostly occur in unvaccinated children.

Some parents have a wrong notion that vaccination can lead to certain side effects in their children. It is not entirely true. Only in the rarest of cases the vaccine has been found to cause deafness, brain damage, coma, deafness and autistic characteristics. Children who lack Vitamin A in their diet are at an increased risk of measles.

Measles in pregnancy

Measles during pregnancy can have significant negative health effects on both mother and fetus. Pregnant women are at high risk of complications from the measles virus such as pneumonia. Measles while pregnancy can lead to the following complications:

  • Miscarriage
  • Low birth weight
  • Preterm labour

Measles can also be transmitted from mother to child if the mother has infected close to her delivery date. This is called congenital measles.

Measles in children

Vaccine of measles isn’t given to the children until they’re at least 12 months old. Before receiving their first dose of vaccine is the time when they have chances to be infected with the measles virus. Babies receive some protection from the measles through passive immunity, which is provided from the mother to child through breastfeeding.

More complications can be seen due to the measles virus for the children under 5 years of age. A child with measles can develop a bacterial infection and may have the following symptoms:

  • Shortness of breath
  • Sharp chest pain which may worsen with every breath
  • Coughing up blood
  • Drowsiness
  • Confusion
  • Convulsions

Diagnosing Measles

An experienced doctor would be able to tell the case by examining rashes on your skin and checking for characteristic symptoms of the disease such as whitish spots in and around the mouth, cough and sore throat. A blood test may be conducted for further affirmation.

As such, there is no prescription medication to treat measles. The symptoms of the virus appear within two or three weeks. The doctor may prescribe medications and supplements to ease the symptoms and help your immune system.

How to treat measles?


Measles infection can be prevented by taking the MMR vaccine (Measles, Mumps, Rubella). If the MMR vaccine is not appropriate, human normal immunoglobulin(HNIG) can be used.

Routine Vaccine: There are 2 vaccines available - The MMR vaccine and the MMRV vaccine. Children can receive their first vaccination at 12 months and their second dose between the age of 3 and 6 years old. Both adults and children can be vaccinated at anytime if they have not been fully vaccinated before. If you are not sure whether you have been vaccinated or not before, getting immunised again will do no harm.

A dose of the MMR vaccine can also be given to anyone over the age of 6 months if they are at risk of getting infected as in:

  • Case of outbreak of measles in your local area
  • Close contact with an infected individual
  • Travelling to an area where the infection is widespread.

2. Human Normal Immunoglobulin(HNIG)

This is basically a mixture of antibodies that have the ability to give short-term but immediate protection from measles. It is recommended to:

  • Babies less than 6 months of age.
  • Pregnant women who are either not immunised or not exposed to the virus.
  • Susceptible individuals like those with HIV or Leukemia.

How long does the measles vaccine last?

2 doses of MMR vaccine is necessary and the person is protected for life and doesn't require a booster dose.

Can the Measles vaccine be given to adults?

Yes, adults who have not been given the vaccination in their childhood can get themselves vaccinated against MMR. Depending on the risk factors involved, at least 1-2 doses should be given. For this, you can consult a general physician.

What are the side effects of measles?

Common Side Effects:

  • Diarrhea and vomiting leading to dehydration
  • Conjunctivitis
  • Middle ear infection (otitis media) which can cause earache
  • Laryngitis
  • Bronchitis, croup and pneumonia
  • Febrile seizures(fits caused by fever)

Uncommon Side Effects:

  • Hepatitis
  • Squint if the virus affects the muscles and nerves of the eyes
  • Meningitis and encephalitis

Rare Side Effects:

  • Optic neuritis(infection of the optic nerve) leading to vision loss
  • Heart and nervous system problems
  • Subacute sclerosing panencephalitis(SSPE),a fatal brain complication which occurs years after the measles infection(occurs in 1 in 25,000 cases)

Complications surrounding Measles

  • Severe complications:

    Some people suffer from severe complications like pneumonia & encephalitis and they may even die because of these complications. Out of these, pneumonia has been the causative factor for death in about 1 out of every 20 children. Also, measles causes encephalitis in about 1 out of 100 patients which further cause convulsions, deaf ear and intellectual disability.

  • Long term complications:

    Subacute Sclerosing Panencephalitis (SSPE) is a rare ailment of the central nervous system that can occur due to measles infection of the brain. It occurs about 7 years after measles infected the person. Approximately five to ten cases per million are reported for Subacute Sclerosing Panencephalitis.

How to prevent measles?

There are few ways to prevent and becoming ill with measles:

  • Vaccination: 2 doses of measles vaccine are effective in preventing the measles infection.
  • Practice good hygiene.
  • Don’t share personal items with the people who may be ill.
  • Avoid coming into contact with people who are sick.
Summary: Measles is a common illness in several parts of the world. To combat the deadly disease, vaccination is important. If you are an adult and you have not got your vaccination done against MMR then, it is the right time to consult the doctor. It is a serious disease that can easily affect the immune system.


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Written ByDr. Shivam Malhotra Sleep Medicine(Training),MBBS Bachelor of Medicine and Bachelor of Surgery,MD - General MedicineGeneral Physician
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