Understanding Measles: What You Need to Know
Health and Well Being
March 24, 2025
Understanding Measles: What You Need to Know

Measles is a highly contagious viral infection that primarily affects the respiratory system. Despite being declared eliminated in the United States in 2000, recent outbreaks have highlighted the importance of awareness and vaccination.

How Measles Spreads

Measles spreads through respiratory droplets when an infected person coughs or sneezes. Measles is not a seasonal virus. However, measles is often spread over times of high travel (like spring break) or in situations where unvaccinated persons are in close quarters (like summer camp).

The virus can remain alive on surfaces and in the air for up to two hours, making it exceptionally contagious. Approximately 90% of vulnerable individuals (those not vaccinated or previously infected) will contract measles if exposed.

Symptoms of Measles

Measles isn’t just a harmless rash — it can be serious, especially for babies and young children. After being exposed to measles, symptoms usually show up 7 to 14 days later and often begin with:

  • High fever (which can spike over 104°F)
  • Cough
  • Runny nose (also called coryza)
  • Red, watery eyes (conjunctivitis)

Early Signs: Koplik Spots (2–3 Days In)

About two to three days after symptoms start, tiny white spots (called Koplik spots) may appear inside the mouth. These are a telltale sign of measles.

The Measles Rash (3–5 Days In)

The classic measles rash usually shows up three to five days after the first symptoms. It starts with flat, red spots that appear at the hairline and then spread downward to the neck, chest, arms, legs, and feet.

  • Small raised bumps may form on top of the flat red spots.
  • As the rash spreads, the spots may begin to merge together.
  • When the rash appears, a person's fever may spike to more than 104° Fahrenheit.

Complications can arise, especially in young children and immunocompromised individuals, including pneumonia, encephalitis (brain swelling), and, in rare cases, death.

Potential Long-Term Effects of Measles

Most think of measles as a childhood illness you get over in a week or two — but did you know it can have long-term effects even after you recover? While many people bounce back just fine, measles can sometimes lead to lasting health issues, especially if complications arise.

  • Weakened Immune System ("Immune Amnesia")
    • Studies show that measles can wipe out your body's immune memory, making you more vulnerable to other infections for months to years after the illness. This increases the risk of catching bacterial infections like pneumonia or even other viruses that your body had previously fought off.
  • Hearing Loss
  • Respiratory Complications
    • Severe pneumonia (a common measles complication) can lead to lung scarring or reduced lung function, especially in young children or people with weakened immune systems.
  • Brain Inflammation and Neurological Issues
    • Encephalitis (brain swelling) occurs in about 1 in 1,000 measles cases, which can cause seizures, permanent brain damage, or developmental delays in children.
    • A rare but fatal condition called subacute sclerosing panencephalitis (SSPE) can develop years after measles infection (often 7–10 years later). SSPE leads to progressive brain degeneration and is always fatal. It is most common in patients who contracted measles before the age of 2.
  • Pregnancy Complications

Pregnant women with measles face significantly increased risks compared to those without the disease. These include:

  • Higher chance of having a low birth weight baby (3.5 times more likely)
  • Increased risk of spontaneous abortion (5.9 times more likely)
  • Greater risk of intrauterine fetal death (9 times more likely)
  • Higher maternal mortality rate (9.6 times more likely)

Current Measles Cases in the U.S. and Texas

As of early March 2025, more than 300 measles cases were reported by 15 jurisdictions: Alaska, California, Florida, Georgia, Kentucky, Maryland, New Jersey, New Mexico, New York City, New York State, Pennsylvania, Rhode Island, Texas, Vermont, and Washington, with Texas experiencing its largest in over three decades, according to the CDC.

The largest population being affected are children between the ages of 5 and 19 (42%), followed by young children under the age of 5 (34%). 21% of cases have occurred in those over the age of 20. The majority of those infected have been unvaccinated (95%), while 3% of those infected have received one Measles, Mumps, and Rubella (MMR) vaccine dose and 2% have received both MMR vaccine doses. 17% of all cases have required hospitalization.

There has been 1 confirmed death from measles, and 1 death under investigation.

Vaccination and Booster Recommendations

The Measles, Mumps, and Rubella (MMR) vaccine is the most effective way to prevent measles. Two doses provide about 97% protection against the virus.

The Centers for Disease Control and Prevention (CDC) recommends:

  • Children: First dose at 12-15 months and a second dose at 4-6 years.
  • Adults: Those born after 1957 without evidence of immunity should receive at least one dose of MMR.
  • International Travelers: Individuals 6 months and older should ensure they are appropriately vaccinated before traveling.

For most people, two doses of the MMR vaccine provide lifelong immunity. Booster doses are generally not necessary unless there's a specific risk factor or outbreak situation. For instance, public health officials recommend that some adults consider getting revaccinated, particularly those born after 1957 who received their measles vaccine before 1968. Early versions of the vaccine used an inactivated (killed) virus, which wasn’t as effective. Because of this, the CDC advises anyone vaccinated before 1968 to get at least one dose of the live attenuated measles vaccine for better protection.

However, breakthrough infections (when someone becomes infected after they have been vaccinated) can occur, especially in communities experiencing an outbreak where high levels of measles virus are circulating.

Staying Informed and Protected

Given the recent outbreaks, it's crucial to verify your vaccination status and that of your family members. If you or your children are unvaccinated or unsure of your vaccination status, contact your doctor or local pharmacy to discuss getting the MMR vaccine. Vaccination not only protects you but also helps safeguard those who cannot be vaccinated, such as infants and individuals with certain medical conditions.

By staying informed and ensuring vaccinations are up-to-date, we can work together to prevent the spread of measles in our community.

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