Measles Disease: Transmission, Symptoms, Prevention and Treatment

Measles is a highly contagious viral illness causing fever, cough, Koplik spots, and rash—preventable by MMR vaccine and requiring prompt isolation. Check here all about Measles Disease.

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Context: The United States is currently facing a resurgence of Measles with 1046 confirmed cases.

About Measles Disease

Measles is caused by the measles virus (genus Morbillivirus), transmitted via respiratory droplets and airborne particles. It can linger in the air and on surfaces for up to two hours. Measles is a serious, preventable infectious disease. The hallmark symptoms include high fever, cough, runny nose, red eyes, Koplik spots, and a spreading rash. Because of its high transmissibility and potential for severe complications, vaccination, early detection, and rigorous isolation remain essential to protect public health.

Measles is a highly contagious disease caused by the measles virus.
The virus is a single-stranded, enveloped RNA virus.

How does it spread?

Measles spreads very easily. If an unvaccinated person is exposed to someone with measles, there’s a high chance (about 90%) they will contract the disease. A person with measles can spread the virus from about four days before the rash appears until four days after the rash develops.

Transmission: Coughs and sneezes of infected individuals.
- It can also spread through direct contact with nasal or oral secretions.

Symptoms of Measles Disease

Symptoms can lead to serious complications such as ear infections, diarrhoea, pneumonia, death (fatality rate is between 5–10%).

The initial symptoms of measles often resemble a severe cold and typically appear 10-14 days after exposure. These can include:

High fever: Which can reach up to 105°F (40.6°C).
Cough: A dry, persistent cough.
Runny nose: (Coryza).
Red, watery eyes: (Conjunctivitis).
Koplik spots: Small, tiny white spots with bluish-white centres on a red background that appear inside the mouth, usually 2-3 days after the first symptoms and before the rash. These are characteristic signs of measles.

Around 3-5 days from the onset of the first symptoms, a typical blotchy red rash develops. It initially occurs on the face and behind the ears and later spreads downward to the neck, trunk, arms, and legs. The spots can become slightly elevated and tend to merge to produce blotchy patches. The rash normally lasts 4-7 days.

Facts

Measles is a human-only disease and does not infect other animals.
The first effective vaccine was introduced in 1963.
Vaccination reduces the risk of contracting measles by 20 times.
Measles-Rubella Elimination Campaign 2025–26:
- The government has launched the campaign under the ‘ACT NOW’ strategy, aiming to eliminate Measles and Rubella in a manner similar to the successful eradication of Polio and Maternal & Neonatal Tetanus.
- The objective is to achieve 100% immunisation coverage among children by ensuring administration of two doses of the Measles-Rubella (MR) vaccine.
Under the Universal Immunisation Programme (UIP), the MR vaccine is provided free of cost to all eligible children.
- The two recommended doses are administered at: 9–12 months and 16–24 months

Complications of Measles

Though nearly all individuals recover from measles, it may result in life-threatening and serious complications in young children (below 5 years of age), adults aged 20 or older, pregnant women, and individuals with compromised immunity or who are severely malnourished. Some of the complications are:

Ear infection (otitis media)
Pneumonia (lung infection)
Bronchitis, laryngitis, or croup
Diarrhoea and dehydration
Encephalitis (brain inflammation): A serious, though rare complication that may result in permanent brain damage or death.
Blindness
Subacute Sclerosing Panencephalitis (SSPE): A rare, often fatal, degenerative central nervous system disease that may occur years after measles infection.
Pregnancy complications: Pregnancy complications from measles include miscarriage, stillbirth, premature birth, or low birth weight.

Prevention and Treatment of Measles

Prevention

Prevention of measles is best achieved through vaccination. The measles vaccine is administered as the MMR (Measles, Mumps, and Rubella) vaccine or, in certain situations, the MMRV (Measles, Mumps, Rubella, and Varicella) vaccine.

Two doses are commonly given to children: the first between 12 and 15 months of age, and the second between 4 and 6 years of age (before school entry).
Two MMR doses are 97% effective in preventing measles.
“Herd immunity” is important: with a high proportion of the population immunised (usually over 95%), it serves to protect those who are unable to be immunised (e.g., infants, individuals with impaired immune systems).

Treatment

There is no antiviral therapy for measles. Treatment is more supportive, aimed at symptom management and prevention of complications. This includes:

Resting abundantly.
Drinking plenty of fluids to avoid dehydration.
Administration of over-the-counter medications to reduce fever and discomfort (e.g., paracetamol).
In a few instances, particularly in malnourished children, vitamin A supplements can be prescribed by a medical practitioner, since vitamin A deficiency aggravates measles severity.
Antibiotics are administered if bacterial complications such as pneumonia or otitis develop.