Measles is a highly contagious viral infection that is more common among children living in areas without widespread vaccination. It is characterized by fever, cough, coryza, conjunctivitis, a characteristic enanthem (Koplik spots) on the oral mucosa, and a maculopapular exanthem that spreads cephalocaudally. Complications, mainly pneumonia or encephalitis, may be fatal, particularly in medically underserved patient populations. Diagnosis is usually clinical with confirmation by polymerase chain reaction testing. Treatment is supportive; vitamin A is administered to children. Vaccination is effective for prevention.Measles is a highly contagious viral infection that is more common among children living in areas without widespread vaccination. It is characterized by fever, cough, coryza, conjunctivitis, a characteristic enanthem (Koplik spots) on the oral mucosa, and a maculopapular exanthem that spreads cephalocaudally. Complications, mainly pneumonia or encephalitis, may be fatal, particularly in medically underserved patient populations. Diagnosis is usually clinical with confirmation by polymerase chain reaction testing. Treatment is supportive; vitamin A is administered to children. Vaccination is effective for prevention.
Worldwide, measles infects approximately 10 million people and causes approximately 100,000 deaths each year, mostly in children (1, 2, 3). The incidence of infection and the mortality rate are significantly higher in populations with low rates of measles vaccination. Young children, pregnant, malnourished, and immunocompromised people are at higher risk of complications resulting from measles.
Measles has been uncommon in the United States because of routine childhood vaccination, and endemic measles was declared eliminated in the United States in 2000. An average of 71 cases/year were reported to the Centers for Disease Control and Prevention (CDC) from 2000 to 2010 (4).
In 2019, annual incidence in the United States increased to 1274 cases, the highest number reported since 1992 (4). That increase was mainly due to the spread among unvaccinated people. In 2020, during the COVID-19 global pandemic, only 13 measles cases were reported in the United States. From 2020 to 2023, there were a total of 242 confirmed cases, and, in 2024, there were 285 cases (4).
In 2025 (as of May 22), 1046 confirmed cases and 3 deaths have been reported in the United States. There have been 14 outbreaks (defined as ≥ 3 related cases), and 92% of the confirmed cases (961 of 1046) have been outbreak-associated (4). For comparison, in 2024, 16 outbreaks were reported and 69% of cases (198 of 285) were outbreak-associated.
Increasing incidence and number of outbreaks of measles are associated with decreasing vaccination rates, driven by various factors, including vaccine hesitancy and disruptions in vaccination programs (4, 5). In the United States, parental refusal of vaccination of their children has become more frequent, and decreased vaccination rates have resulted in increased rates of vaccine-preventable diseases in children. Vaccination coverage among kindergartners in the United States decreased from 95.2% in the 2019–2020 school year to 92.7% in the 2023–2024 school year (4). The herd immunity threshold (the proportion of a population with immunity to an infectious disease through innate immunity, vaccination, or previous infection that is required to prevent transmission of the disease) for measles in the United States is estimated to be 92 to 95% (6, 7).
General references
1. World Health Organization: The Global Health Observatory; Measles - number of reported cases. Accessed May 9, 2025.
2. World Health Organization: Facts Sheet; Measles. Accessed May 9, 2025.
3. Minta AA, Ferrari M, Antoni S, et al. Progress Toward Measles Elimination - Worldwide, 2000-2023. MMWR Morb Mortal Wkly Rep. 2024;73(45):1036-1042. Published 2024 Nov 14. doi:10.15585/mmwr.mm7345a4
4. Centers for Disease Control and Prevention (CDC): Measles Cases and Outbreaks. Accessed May 9, 2025.
5. Zucker JR, Rosen JB, Iwamoto M, et al. Consequences of Undervaccination - Measles Outbreak, New York City, 2018-2019. N Engl J Med. 2020;382(11):1009-1017. doi:10.1056/NEJMoa1912514
6. Measles vaccines: WHO position paper – April 2017. Note de synthèse de l’OMS sur les vaccins contre la rougeole – avril 2017. Wkly Epidemiol Rec. 2017;92(17):205-227. Published 2017 Apr 28.
7. Funk S, Knapp JK, Lebo E, et al. Combining serological and contact data to derive target immunity levels for achieving and maintaining measles elimination. BMC Med. 2019;17(1):180. Published 2019 Sep 25. doi:10.1186/s12916-019-1413-7
Pathophysiology of Measles
Measles is caused by a paramyxovirus and is a human disease with no known animal reservoir or asymptomatic carrier state. It is extremely communicable; the secondary attack rate is > 90% among susceptible people who are exposed (1). It is one of the most contagious known human viruses (2).
Measles is transmitted mainly during the prodromal or early eruptive stage of the rash. Transmission is typically by large respiratory droplets that are discharged by coughing and briefly remain airborne for a short distance. Transmission may also occur by small, aerosolized droplets that can remain airborne (and thus can be inhaled) for up to 2 hours in closed areas (eg, in a clinic examination room). Transmission by fomites may be possible but is less clinically important than airborne transmission because the measles virus is thought to survive only for a short time on dry surfaces (3).
International or domestic travel to areas where measles is endemic or to where an outbreak is active is a risk factor for measles transmission.
Communicability begins 4 days before and continues until 4 days after the rash appears. Immunocompromised patients may have prolonged secretion of measles virus in their respiratory tract.
Pathophysiology references
1. Centers for Disease Control and Prevention (CDC): Yellow Book: Health Information for International Travel. Measles (Rubeola). 2026.
2. Strebel PM, Orenstein WA. Measles. N Engl J Med. 2019;381(4):349-357. doi:10.1056/NEJMcp1905181
3. Bischoff WE, McNall RJ, Blevins MW, et al. Detection of Measles Virus RNA in Air and Surface Specimens in a Hospital Setting. J Infect Dis. 2016;213(4):600-603. doi:10.1093/infdis/jiv465
Symptoms and Signs of Measles
The typical course of a measles infection is as follows (number of days is approximate and duration may vary) (1, 2):
Exposure
Incubation period: 7 to 21 (average 11 to 12 days) days from exposure to onset of fever
Prodrome: 3 to 7 days from onset of symptoms until rash appears
Koplik spots (enanthem): Appear about 2 days before and persist for 1 to 2 days after onset of rash
Rash (exanthem): Rash is present for 4 to 7 days then begins to fade rapidly.
Recovery (symptoms and rash resolve): 7 days after onset of rash in uncomplicated cases
Infectious period: Infected patients are contagious from 4 days before through 4 days after onset of rash.
After exposure and an average incubation period of 11 to 12 days (range 7 to 20 days [3]), measles begins with a prodrome of fever, coryza, hacking cough, and tarsal conjunctivitis.
Koplik spots of the oral mucosa resemble grains of white sand surrounded by red areolae. These enanthems are pathognomonic and appear in 70% of patients (2). Koplik spots appear during the prodrome before the onset of the exanthem, usually on the oral mucosa opposite the first and second upper molars. They may be extensive, producing diffuse mottled erythema of the oral mucosa.
Koplik spots are classically described as being bright red spots with white or bluish-white centers that may resemble grains of sand. They may occur anywhere in the mouth, often precede the generalized exanthem, and are pathognomonic for measles (rubeola).
Images courtesy of the Public Health Image Library of the Centers for Disease Control and Prevention.
Koplik spots are classically described as being bright red spots with white or bluish-white centers that may resemble grains of sand. They may occur anywhere in the mouth, often precede the generalized exanthem, and are pathognomonic for measles (rubeola).
DR P. MARAZZI/SCIENCE PHOTO LIBRARY
Koplik spots are classically described as being bright red spots with white or bluish-white centers that may resemble grains of sand. They may occur anywhere in the mouth, often precede the generalized exanthem, and are pathognomonic for measles (rubeola).
DR P. MARAZZI/SCIENCE PHOTO LIBRARY
Koplik spots are classically described as being bright red spots with white or bluish-white centers that may resemble grains of sand. They may occur anywhere in the mouth, often precede the generalized exanthem, and are pathognomonic for measles (rubeola).
Images courtesy of the Public Health Image Library of the Centers for Disease Control and Prevention.
Koplik spots are classically described as being bright red spots with white or bluish-white centers that may resemble grains of sand. They may occur anywhere in the mouth, often precede the generalized exanthem, and are pathognomonic for measles (rubeola).
DR P. MARAZZI/SCIENCE PHOTO LIBRARY
Koplik spots are classically described as being bright red spots with white or bluish-white centers that may resemble grains of sand. They may occur anywhere in the mouth, often precede the generalized exanthem, and are pathognomonic for measles (rubeola).
DR P. MARAZZI/SCIENCE PHOTO LIBRARY
The rash appears approximately 3 to 7 days after prodromal symptom onset, usually 1 to 2 days after Koplik spots appear. It begins on the face in front of and below the ears and on the side of the neck as irregular macules, soon mixed with papules. The rash is erythematous but may appear darker in patients with dark skin. Within 24 to 48 hours, lesions appear on the trunk and extremities (including the palms and soles) as they begin to fade on the face. Desquamation may occur after the facial rash fades. Petechiae or ecchymoses may occur with in severe cases.
Measles (rubeola) manifests as a diffuse maculopapular rash that becomes confluent and spreads in a cephalocaudad pattern.
Image courtesy of the Public Health Image Library of the Centers for Disease Control and Prevention.
Measles (rubeola) manifests as a diffuse maculopapular rash that becomes confluent and spreads in a cephalocaudad pattern.
SCIENCE PHOTO LIBRARY
Measles (rubeola) manifests as a diffuse maculopapular rash that becomes confluent and spreads in a cephalocaudad pattern.
CDC/ Betty G. Partin
Measles (rubeola) manifests as a diffuse maculopapular rash that becomes confluent and spreads in a cephalocaudad pattern.
Image courtesy of the Public Health Image Library of the Centers for Disease Control and Prevention.
Measles (rubeola) manifests as a diffuse maculopapular rash that becomes confluent and spreads in a cephalocaudad pattern.
SCIENCE PHOTO LIBRARY
Measles (rubeola) manifests as a diffuse maculopapular rash that becomes confluent and spreads in a cephalocaudad pattern.
CDC/ Betty G. Partin
During peak disease severity, a patient may have a high fever, sometimes exceeding 40° C, with periorbital edema, conjunctivitis, photophobia, a hacking cough, extensive rash, and prostration. Constitutional symptoms and signs parallel the severity of the eruption.
The rash typically begins to fade rapidly about 4 to 7 days after it appears, leaving a coppery brown or hyperpigmented discoloration, followed by desquamation after the rash fades. Around the same time, the fever decreases, and the patient feels more comfortable.
Infected patients are contagious from 4 days before through 4 days after onset of rash.
Patients who are immunocompromised may not have a rash and can develop severe, progressive giant cell pneumonia.
Complications of measles
Complications of measles include the following:
Bacterial superinfection, including otitis media, pneumonia
Immune amnesia
Transient hepatitis
Encephalitis
Acute thrombocytopenic purpura
Subacute sclerosing panencephalitis
In high-resource countries, measles complication rates include otitis media (7 to 9%), pneumonia (1 to 6%), diarrhea (8%), postinfectious encephalitis (approximately 1/1000), and death (approximately 1/1000) (2). Subacute sclerosing panencephalitis is a delayed complication that occurs in approximately 1/10,000 patients with prior measles infection. Complication rates are higher in young children and in patients who are pregnant, malnourished, or immunocompromised. Measles transiently suppresses cell-mediated immunity, leading to immune amnesia and increasing the risk of subsequent infections for months to years.
Bacterial superinfections include pneumonia, laryngotracheobronchitis, and otitis media. Bacterial superinfection is suggested by pertinent focal signs or a relapse of fever, leukocytosis, or weakness.
Pneumonia caused by measles virus infection occurs in up to 6% of patients, even during apparently uncomplicated infection (2). In fatal cases of measles in infants, pneumonia is often the cause of death.
Measles-induced immunosuppression can worsen active tuberculosis and temporarily prevent reaction to tuberculin and histoplasmin antigens in skin tests.
Transient hepatitis and diarrhea may occur during an acute infection.
Postinfectious encephalitis occurs in 1/1000 children, usually 2 days to 2 weeks after onset of the rash (4), often beginning with recrudescence of high fever, headache, seizures, and coma (2). Cerebrospinal fluid usually has a lymphocyte count of 50 to 500/mcL and a mildly elevated protein level but may be normal initially. Encephalitis may resolve in about 1 week or may persist longer, causing morbidity or death.
Acute thrombocytopenic purpura may occur after infection resolves and causes a mild, self-limited bleeding tendency; occasionally, bleeding is severe.
Subacute sclerosing panencephalitis (SSPE) is a rare, progressive, ultimately fatal, late complication of measles. SSPE is a degenerative disease that can manifest up to 7 to 10 (or more) years after measles infection and is typically fatal within several years of symptom onset. The risk of SSPE is much greater in children originally infected with measles at less than 5 years of age (1:1300 cases), and in particular in children infected at less than 12 months of age (1:600 cases) (5).
Atypical measles syndrome is a complication that developed in people who were vaccinated with the original killed-virus measles vaccines that were used in the United States from 1963 to 1967 and until the early 1970s in some other countries (6). These older vaccines altered disease expression in some patients who were incompletely protected and subsequently infected with wild-type measles. Measles manifestations developed more suddenly, and significant pulmonary involvement was more common (7). Confirmed cases have been extremely rare since the 1980s (8). Atypical measles is of note mainly because patients who received a measles vaccine during that time period may report a history of both measles vaccination and measles infection.
Symptoms and signs references
1. Centers for Disease Control and Prevention (CDC): Yellow Book: Health Information for International Travel. Measles (Rubeola). 2026.
2. Strebel PM, Orenstein WA. Measles. N Engl J Med. 2019;381(4):349-357. doi:10.1056/NEJMcp1905181
3. Tanaka H, Takahashi Y, Matsumoto S, et al. Shorter incubation period in symptomatic measles patients who had no history of measles vaccination. Vaccine. 2025;45:126652. doi:10.1016/j.vaccine.2024.126652
4. CDC: Clinical Overview of Measles. Accessed May 5, 2025.
5. Wendorf KA, Winter K, Zipprich J, et al. Subacute Sclerosing Panencephalitis: The Devastating Measles Complication That Might Be More Common Than Previously Estimated. Clin Infect Dis. 2017;65(2):226-232. doi:10.1093/cid/cix302
6. CDC: Measles prevention. MMWR Suppl. 1989;38(9):1–18.
7. Annunziato D, Kaplan MH, Hall WW, et al. Atypical measles syndrome: pathologic and serologic findings. Pediatrics. 1982;70(2):203-209.
8. Melenotte C, Cassir N, Tessonnier L, Brouqui P. Atypical measles syndrome in adults: still around. BMJ Case Rep. 2015;2015:bcr2015211054. Published 2015 Sep 23. doi:10.1136/bcr-2015-211054
Diagnosis of Measles
History and physical examination
Viral detection via reverse transcription–polymerase chain reaction (RT-PCR)
Serologic testing
Measles may be initially suspected in an exposed patient who has coryza, conjunctivitis, photophobia, and cough. Clinicians should have a high level of clinical suspicion when the rash appears in unvaccinated or incompletely vaccinated patients with a history of travel or known exposure.
Diagnosis is based on a finding of Koplik spots, which are pathognomonic, or a characteristic rash in a nonimmune patient with known or suspected exposure.
Laboratory confirmation should be performed. A nasopharyngeal or throat swab is performed for RT-PCR testing; a urine sample is also collected for RT-PCR testing, if feasible (1, 2). A blood sample is drawn for serology. A rise in IgG antibody levels between acute and convalescent sera is highly accurate, but obtaining this information delays diagnosis. IgM levels indicate acute (or recent) infection but may not be detectable until 3 days after onset and may be absent or transiently present in people who have been previously vaccinated (3). All cases of suspected measles should be reported to local health authorities even before laboratory confirmation. (See also CDC: MMRV Testing for Clinicians for up-to-date information regarding testing for acute measles disease and for measles immunity.)
A complete blood count may show lymphopenia and thrombocytopenia but is not necessary for measles diagnosis.
Differential diagnosis includes rubella (German measles), scarlet fever, drug rash, serum sickness (see table Some Causes of Urticaria), roseola infantum, infectious mononucleosis, erythema infectiosum, tick-borne illness, Kawasaki disease, and echovirus and coxsackievirus infections (see table Some Respiratory Viruses). The presenting symptoms and signs may cause diagnostic confusion in areas where measles is very rare.
Some of these conditions can be distinguished from typical measles as follows:
Rubella: A recognizable prodrome is absent, fever and other constitutional symptoms are absent or less severe, postauricular and suboccipital lymph nodes are enlarged (and usually tender), and duration is short.
Drug rash: A rash caused by drug hypersensitivity often resembles the measles rash, but a prodrome is absent, there is no cephalocaudal progression or cough, and there is usually a history of recent drug exposure.
Roseola infantum: The rash resembles that of measles, but it seldom occurs in children > 3 years of age. Initial temperature is usually high, Koplik spots and malaise are absent, and defervescence and rash occur simultaneously.
Diagnosis references
1. Centers for Disease Control and Prevention (CDC): Clinical Overview of Measles. Accessed May 5, 2025.
2. Hübschen JM, Gouandjika-Vasilache I, Dina J. Measles. Lancet. 2022;399(10325):678-690. doi:10.1016/S0140-6736(21)02004-3
3. CDC: Laboratory Testing for Measles. Accessed May 16, 2025.
Treatment of Measles
Supportive care
For children, vitamin AFor children, vitamin A
Antibiotics if bacterial superinfection occurs
Treatment of measles is supportive, including for encephalitis.
Patients with suspected measles should be isolated immediately (1). Patients who are otherwise healthy and can be isolated and managed as outpatients.
Hospitalized patients with measles should be managed with standard, contact, and airborne precautions. Single-patient airborne infection isolation rooms and N-95 respirators or similar personal protective equipment are recommended.
Vitamin A supplementationVitamin A supplementation has been shown to reduce morbidity and mortality due to measles in children in medically underserved areas. Because low serum levels of vitamin A are associated with severe disease due to measles, vitamin A treatment is recommended for all children with measles (are associated with severe disease due to measles, vitamin A treatment is recommended for all children with measles (2, 3). The dose is given orally once a day for 2 days and depends on the child’s age:
≥ 12 months: 200,000 international units (IU)
6 to 11 months: 100,000 IU
< 6 months: 50,000 IU
In children with clinical signs of vitamin A deficiency (eg, reduced night vision, xerophthalmia and dry eyes, dry or keratinized skin and mucous membranes, impaired immunity, growth abnormalities in young children), an additional single, age-specific dose of vitamin A is repeated 2 to 4 weeks later.(eg, reduced night vision, xerophthalmia and dry eyes, dry or keratinized skin and mucous membranes, impaired immunity, growth abnormalities in young children), an additional single, age-specific dose of vitamin A is repeated 2 to 4 weeks later.
Antibiotics are given as appropriate if bacterial superinfection is diagnosed.
Treatment references
1. Centers for Disease Control and Prevention (CDC): Expanding Measles Outbreak in the United States and Guidance for the Upcoming Travel Season. Recommendations for Healthcare Professionals. Accessed May 14, 2025.
2. World Health Organization. (2020). Guide for clinical case management and infection prevention and control during a measles outbreak. 2020.
3. CDC: Yellow Book: Health Information for International Travel. Measles (Rubeola). 2026.
Prognosis for Measles
Mortality for patients with measles is approximately 1 to 3/1000 children in the United States; it is significantly higher (2 to 3%) in medically underserved regions (1, 2) and is approximately 1% worldwide (3, 4).
Infection in infants, lack of access to medical care, severe malnutrition, vitamin A deficiency, and pneumonia as a complication are associated with increased risk of mortality (5, 6).
See also Complications of measles.
Prognosis references
1. Gindler J, Tinker S, Markowitz L, Atkinson W, Dales L, Papania MJ. Acute measles mortality in the United States, 1987-2002. J Infect Dis. 2004;189 Suppl 1:S69-S77. doi:10.1086/378565
2. Lee B, Ying M, Papania MJ, Stevenson J, Seward JF, Hutchins SS. Measles hospitalizations, United States, 1985-2002. J Infect Dis. 2004;189 Suppl 1:S210-S215. doi:10.1086/381555
3. Minta AA, Ferrari M, Antoni S, et al. Progress Toward Measles Elimination - Worldwide, 2000-2023. MMWR Morb Mortal Wkly Rep. 2024;73(45):1036-1042. Published 2024 Nov 14. doi:10.15585/mmwr.mm7345a4
4. Sbarra AN, Mosser JF, Jit M, et al. Estimating national-level measles case-fatality ratios in low-income and middle-income countries: an updated systematic review and modelling study. Lancet Glob Health. 2023;11(4):e516-e524. doi:10.1016/S2214-109X(23)00043-8
5. Strebel PM, Orenstein WA. Measles. N Engl J Med. 2019;381(4):349-357. doi:10.1056/NEJMcp1905181
6. Donadel M, Stanescu A, Pistol A, et al. Risk factors for measles deaths among children during a Nationwide measles outbreak - Romania, 2016-2018. BMC Infect Dis. 2021;21(1):279. Published 2021 Mar 19. doi:10.1186/s12879-021-05966-3
Prevention of Measles
People who have had wild-type measles infection are considered to have lifelong immunity (including adults born before 1957 due to presumed exposure to the virus). An infant whose mother has immunity to measles (eg, because of previous illness or vaccination) receives maternal antibodies transplacentally; these antibodies are typically protective through the first 6 to 12 months of life.
A live-attenuated virus vaccine containing measles, mumps, and rubella (MMR) is routinely given to children in most countries with a robust health care infrastructure. In the United States, the MMR vaccine is recommended for children and is administered in 2 doses: 1 at age 12 to 15 months and 1 at age 4 to 6 years. Receipt of 2 doses of MMR vaccine is considered protective against measles.
MMR vaccination generally provides lasting immunity, and routine vaccination in children has decreased measles incidence in the United States by 99% (1). A large meta-analysis of cohort studies found the effectiveness of the MMR vaccine in preventing measles in children from age 9 months to 15 years was 95% after 1 dose and 96% after 2 doses (2). Worldwide, from 2000 to 2023, an estimated 60.3 million deaths due to measles were prevented by vaccination; however, no region had achieved and maintained measles elimination as of the end of 2023 (3).
The 2-dose MMR vaccine schedule was introduced in 1989; therefore, adults born from 1957 to 1989 may have received only a single dose. For adults in this group, an additional 1 to 2 doses are recommended in those who do not have evidence of immunity and are at high exposure risk (eg, students at post-secondary institutions, health care workers, international travelers, contacts of immunocompromised people, those with HIV infection) (4, 5, 6). In addition, a small number of adults vaccinated from 1963 to 1967 may have received killed (inactive) measles vaccine, are considered unvaccinated, and should be revaccinated.
MMR is a live vaccine and is contraindicated during pregnancy. It is also contraindicated in certain immunocompromised patients and in patients who have had an anaphylactic reaction to a vaccine component or previous vaccine dose (7).
See MMR Vaccine for more information, including indications, contraindications and precautions, dosing and administration, and adverse effects.
Postexposure prophylaxis
Prevention in nonimmune contacts who are not immunocompromised is possible by giving the MMR vaccine within 3 days after exposure.
For susceptible patients who cannot be vaccinated (eg, severely immunocompromised or pregnant patients), human immune globulin containing measles antibody is given immediately (within 6 days). All exposed patients with severe immunodeficiency should be given immune globulin postexposure regardless of immunization status.
Patients who received IM immunoglobulin should be given MMR vaccine 6 months later, and patients who received IV immunoglobulin should be given MMR vaccine 8 months later, if they are ≥ 12 months old and otherwise eligible for live vaccination (5).
In an institutional outbreak (eg, schools), susceptible contacts who refuse or cannot receive vaccination and who also have not received immune globulin should be excluded from the affected institution until 21 days after onset of rash in the last case. Exposed, susceptible health care workers should be excluded after exposure, and decisions about return to work should be guided by public health recommendations and should include consideration of workers' immune status and risk to others in the work setting.
Prevention references
1. McLean HQ, Fiebelkorn AP, Temte JL, Wallace GS; Centers for Disease Control and Prevention. Prevention of measles, rubella, congenital rubella syndrome, and mumps, 2013: Summary recommendations of the Advisory Committee on Immunization Practices (ACIP). [published correction appears in MMWR Recomm Rep. 2015 Mar 13;64(9):259]. MMWR Recomm Rep. 2013;62(RR-04):1–34.
2. Di Pietrantonj C, Rivetti A, Marchione P, et al. Vaccines for measles, mumps, rubella, and varicella in children. Cochrane Database Syst Rev. 2020;4(4):CD004407. doi:10.1002/14651858.CD004407.pub4
3. Minta AA, Ferrari M, Antoni S, et al. Progress Toward Measles Elimination - Worldwide, 2000-2023. MMWR Morb Mortal Wkly Rep. 2024;73(45):1036-1042. Published 2024 Nov 14. doi:10.15585/mmwr.mm7345a4
4. Centers for Disease Control and Prevention (CDC): Expanding Measles Outbreak in the United States and Guidance for the Upcoming Travel Season. Recommendations for Healthcare Professionals. Accessed May 14, 2025.
5. CDC: Yellow Book: Health Information for International Travel. Measles (Rubeola). 2026.
6. CDC: Measles Vaccine Recommendations. Accessed May 30, 2025.
7. National Center for Immunization and Respiratory Diseases. General recommendations on immunization --- recommendations of the Advisory Committee on Immunization Practices (ACIP) [published correction appears in MMWR Recomm Rep. 2011 Jul 29;60:993]. MMWR Recomm Rep. 2011;60(2):1-64.
Key Points
Universal childhood vaccination against measles is safe and effective, and MMR vaccine should be administered unless contraindicated (eg, by pregnancy or severe immunodeficiency).
Incidence of measles is highly variable depending on the vaccination rate in the population.
Measles is highly transmissible, developing in > 90% of susceptible contacts.
Measles causes approximately 100,000 worldwide deaths annually, primarily in children, particularly those residing in medically underserved areas.
Treatment is mainly supportive, but children should also receive vitamin A supplementation.Treatment is mainly supportive, but children should also receive vitamin A supplementation.
Give postexposure prophylaxis to susceptible contacts; use vaccine within 3 days unless contraindicated, in which case give immune globulin within 6 days.
