Cause: Measles virus, a paramyxovirus, genus Morbillivirus.
Illness and treatment: Measles, also known as rubeola, is a highly contagious viral respiratory illness. Common symptoms typically include:
- High fever, which may reach up to 105ºF
- Cough
- Conjunctivitis (red, watery eyes)
- Runny nose (coryza)
These symptoms are followed by a distinctive red, blotchy (maculopapular) rash that usually begins at the hairline and spreads downward to the trunk, arms, and legs. The spots coalesce as the rash spreads. The rash usually lasts about 5 to 6 days. Fever and rash often occur together, with the fever peaking when the rash appears.
Measles can be serious, especially for babies, pregnant people, and people with weak immune systems.
Complications from measles are more common in children younger than 5 years old and adults over 20 years old. Serious complications may include:
- Severe diarrhea
- Ear infections
- Pneumonia
- Acute encephalitis (brain swelling)
- Death
Measles infection can also cause "immune amnesia," a condition in which the virus damages immune memory cells and reduces previously acquired immunity. This may leave individuals more vulnerable to other infections for months or even years after recovering from measles.
There is no specific antiviral treatment for measles. Care is supportive and focuses on relieving symptoms and preventing complications.
Sources: Humans are the only reservoir for the measles virus. Measles is highly contagious, spreading through airborne particles and respiratory droplets when an infected person breathes, talks, coughs, or sneezes.
The measles virus can remain suspended in the air or on surfaces for about 2 hours after an infected person leaves an enclosed area, depending on airflow and ventilation. Because of this, people can become infected even after the contagious person is no longer present.
Additional risks: Any person who has not received a measles vaccine is at risk of getting measles if they are exposed. Some people have a higher risk of measles complications, including:
- Infants under 12 months and young children who have not been vaccinated.
- Unvaccinated pregnant people and their unborn babies.
- People with weakened immune systems, whether from illness or medical treatment.
- Malnutrition increases the risk of severe measles complications and death.
Prevention: Vaccination is the best protection against measles. The MMR vaccine protects against measles, mumps, and rubella.
- One dose is 93% effective at preventing measles
- Two appropriately spaced doses are about 97% effective at preventing measles.
- Vaccination also helps protect infants, pregnant people, and individuals with weakened immune systems who may be more vulnerable to severe disease.
- For people who may have been exposed and are susceptible to measles, prompt public health follow-up and post-exposure prophylaxis may help reduce severe illness and prevent further spread.
Washington State Trends: Measles is now rarely reported in the United States because of widespread vaccination. In Washington, most cases are linked to international travel or exposure to travelers returning from areas experiencing active measles outbreaks.
The Measles Cases in Washington State web page is an updated resource to track measles cases identified in Washington State.
The Public Measles Exposure Locations in Washington State Map shows public locations in the state where people who had measles visited while they were contagious. Exposure locations are marked on a state map with orange dots, with details on each location shown on the right-hand side. The map displays exposure dates, times, and addresses for each location. Subscribe to get email alerts for reported exposures.
Purpose of Reporting and Surveillance
- To identify measles cases.
- To prevent the spread of measles.
- To identify groups of unimmunized children and adults.
Legal Reporting Requirements
- Health care providers and health care facilities: immediately notifiable to local health jurisdiction.
- Laboratories: immediately notifiable to local health jurisdiction; submission required – isolate and specimen associated with positive culture or with positive NAT or NAAT result, within 2 business days; submission on request – specimen associated with positive IgM or other specimen, within 2 business days.
- Local health jurisdictions: immediately notifiable to Washington State Department of Health (DOH) Communicable Disease Epidemiology (CDE).
Resources
For Providers
- Measles Assessment Checklist for Providers (PDF)
- MMR Specimen Testing Protocol at WA PHL (PDF)
- Measles Poster for Clinics (PDF)
- Measles Post-Exposure Prophylaxis (PEP) for Non-Symptomatic Susceptible Contacts (PDF)
- Preventing Measles (Rubeola) in Healthcare Settings (PDF)
Vaccine Information
- Vaccine Information (DOH, Office of Immunization)
- MMR Vaccine FAQ for Healthcare Providers and LHJs (PDF)