Measles is a serious illness caused by an extremely contagious virus. This virus does more than give you a runny nose or a rash.
The key symptoms of measles are
- Conjunctivitis (pink eye)
- respiratory symptoms including coughing and a runny nose
- white spots inside the mouth
- A progressive skin rash that spreads from the head down the body
- Fever
If you or your child has a runny nose, a cough, pink eye and a fever, immediately isolate yourselves and call your doctor’s office to ask what their procedure is for dealing with measles.
What is it and where does it come from?
How does measles make you sick?
What are the treatments for measles?
Is Measles Dangerous?
Let’s get straight to the matter at hand, is measles dangerous? Yes, it is.
More Than a Rash
The measles death rate is between one and three children per 1000 infections.
While most youngsters will come away with fever, a rash, conjunctivitis and a nasty respiratory infection, a number of kids will end up with neurological impairments. Specifically, measles can cause acute encephalitis, inflammation of the brain’s active tissues, or subacute sclerosing panencephalitis (SSPE). Encephalitis caused by measles can end in blindness and hearing loss. Other symptoms like ear infections, diarrhoea and pneumonia can also land your child in hospital.
Measles causes long-term damage to the immune system that makes all children vulnerable to serious illnesses they have already been vaccinated against.
This virus isn’t just bad for kids, pregnant women are at risk of premature labour, and adults with delicate immune systems can find themselves in trouble.
Why Take the Risk With Measles?
In 2022, 1.9 US minors in every 100,000 were killed in a car accident. If your child catches the measles, their risk of dying is 150 times higher than dying in a car crash. Getting vaccinated is cheaper, easier and longer-lasting than buying a car seat for your child. So why would you buy a car seat or use seat belts, but not try a vaccine with over 50 years of proven results?
What is it?
A Simple Virus
So what exactly is the measles? It’s caused by a Paramyxoviridae virus that spreads fast and wide via aerosolized droplets. The measles virus is very simple, made from just a strand of RNA and a coating covered in sticky proteins that grab on to the cells in your respiratory tract and squeeze inside. Once it’s within a cell, the RNA strand tricks the host into helping it to replicate, turning it into a measles virus factory. This tiny virus only infects primates, for example humans, apes and monkeys.
Because this virus is so simple and so small, it is very efficient at spreading between people. When people are living close together in cities and packed into cars, classrooms and canteens, without some kind of fire break, this virus can rapidly overwhelm populations.
Where Does Measles Come From?
The first known records of measles (also called rubeola) appeared in ninth century Persia. This disease was well known and significant enough that doctors wrote about it in medical guides along with diseases like Small Pox. Measles was a very common childhood disease all across Europe and Asia throughout the following centuries.
Common, however, does not mean benign or harmless. Polio, cholera and bubonic plague were also common before the 20th century. Measles was never an illness that you could just ‘shake off’. In fact, it’s thought that as many as 50% of Hondurans died from measles when Europeans took it to the new world in 1531.
Seeing is Believing
So how did we forget that measles is dangerous? Well, in some ways, measles is a victim of its own success. Because measles spreads so fast and so easily it has never needed to evolve complicated tools to outwit your immune system. This means the introduction of measles vaccines was extremley effective at controlling the virus.
If you make it through a bout of measles and survive, your immune system will recognize it and catch it early before it can spread through your body again. So once you have had measles, unless you have an immune deficiency you will not catch it again. This is also why vaccines work so well to prevent measles and have saved countless lives.
So few people in developed countries have died or suffered life changing disabilities since the late 1970s that we just don’t see the consequences of measles epidemics with our own eyes.
How Does Measles Make You Sick?
So what does the measles virus actually do? What makes it different to other viruses?
Silent Invasion
Measles starts when a sneaky viral particle manages to snag and infiltrate one of the cells that line your airways, or mucous membranes in your nose, eyes, mouth etc. Over the next nine days the virus will silently multiply and spread from one cell to the next, until it spreads to every part of your body.
After around nine days, the virus will start to overwhelm your body and provoke an immune response. Too many resources are being redirected from maintaining your body to making virus particles, so you will start to feel tired and generally rundown.
At this stage your immune system will be slowly ramping up to take on the virus. With every part of your body diverting energy and nutrients to making more measles virus–including white blood cells, however, this is a hard and expensive fight.
Highjackers
One on the ways measles is able to invade so fast is that virus hitches a ride in your white blood cells, AKA lymphocytes. Using your lymphatic system like a superhighway, the virus is able to penetrate anywhere that infection-fighting lymphocytes can go. Which is pretty much everywhere.
On their travels these cells carry measles virus into your lymph nodes, thymus and spleen. Lymph organs are essential parts of our immune response. These are the nurseries where we grow our antibody producing white blood cells. When the measles virus gets into your lymph organs, the specialized pathogen fighting cells we rely on for targeted immune responses are occupied with protecting themselves from the virus. This gives the measles virus freedom to spread and multiply in your body.
Over time, the measles virus overwhelms the lymph organs almost shutting them down. When our lymphatic organs are under attack, our bodies can’t efficiently activate the memory cells that make antibodies. Meaning it takes a lot longer for our bodies to fight off the virus than it should.
Kill to Cure
Once your immune system eventually kicks into gear, inflammation arrives bringing with it fever, coughing, runny nose and inflamed eyes. Over the following days, your symptoms increase. You will start to develop white spots on the inside of your cheeks where your immune cells are attacking and isolating virus factories. Soon after, a red itchy rash will creep down from your ears, spreading across your face and then over your torso and limbs.
These rashes are caused by our immune system’s big guns. When we detect viral particles, our white blood cell nurseries start making specialized cells that seek and destroy infected cells. Basically, our immune system is finding measles factories and killing them to prevent the virus from taking over more cells. Sounds reasonable, right?
Well, here’s the problem, because measles spreads so fast and so effectively in your body, there are an awful lot of virus factories to be destroyed. Those itchy rashes, swollen eyes and irritated lungs are caused by your white blood cells having to destroy your own cells to get rid of the virus.
For most of us measles is a self-limiting illness, this means eventually it burns itself out as our immune system blasts it.
Why is Measles Dangerous?
So far we’ve looked into what measles does. A rash doesn’t sound like such a big deal, so why are doctors so worried about it? On top of the obvious dangers that pneumonia and high fever, measles can cause severe neurological complications.
When Things Get Complicated
Remember how the measles virus has a habit of taking a joy ride around your body in white blood cells? Lymphocytes (white blood cells) are one of very few cell types that can cross the blood brain barrier. Unlike most infectious diseases, measles can get into your brain.
If your immune system starts attacking virus factories located in your skin, you’ll get a rash. A skin rash, however, will go away as skin is quite good at repairing itself. On the other hand, if your immune system wages war on your brain, it can cause all sorts of problems. Encephalitis happens when your brain is desperately trying to fight off an infection, but the inflammation causes as much damage or more than the virus.
Mistaken Identity
What’s more, around one in a thousand people infected with measles, will find that their immune system mistakes regular uninfected neurons for an infected cell. In these patients, the molecular structure of a component of the protective sheath that covers their nerve cells is just similar enough to a protein on the measles virus. This means your lymphocytes confuse neurons in your brain and spinal cord for a virus factory long after the virus has been cleared. Acute disseminated encephalomyelitis or ADEM, causes damage to neurons that can trigger encephalopathy.
In most cases, ADEM can be treated with a course of steroids. ADEM cause a range of neurological symptoms. It can provoke seizures, paralysis of the legs or arms and legs, speech difficulties, loss of control of body movements. It can also cause eye problems including optic neuritis and nystagmus. In severe cases, some children will be left with permanent brain injury, and some will die.
Guerilla Warfare
Other more rare complications are Measles inclusion-body encephalitis (MIBE) and subacute sclerosing panencephalitis (SSPE). Both of these are less common than ADEM and a lot more dangerous. In these cases the measles virus causes long-term damage to brain cells that is very difficult to treat.
The measles virus takes up residence in nerve cells of your central nervous system and camps out. After a while the immune system gets wise to this hide out and starts attacking. This results in a war of attrition that eventually leads to so much destruction that the brain can’t repair itself. The patient will slip into a coma and die.
Immunity Deficit
The other long-lasting effect of measles is the damage it causes to your immune system. When the measles vaccine was introduced in the 1960s, childhood mortality in countries that set up mass vaccination programmes plummeted.
This was not just because of an uptick in post-war living standards or fewer kids dying from measles. Epidemiological studies have pin-pointed the rollout of the measles vaccine programme as the turning point in Denmark, the UK and the USA amongst others.
While in England and Wales, the precipitous drop in childhood mortality started in 1967, in Denmark the effect was not seen until 1990. The measles vaccine was introduced to British children in the early 1960s, while Danish kids weren’t routinely vaccinated against measles until the 1980s. So how would the measles vaccine reduce deaths from all other infectious diseases?
Memento Measles
It turns out that it takes an extended period for your lymph organs to recover from measles. Long after the virus is cleared, your skin rash has faded and your runny nose has dried up, your worn out immune system has to rebuild your defences. For several months, in some cases, years, the memory cells that produced antibodies against viruses or bacteria you had before, can’t keep up.
Not only do you lose your ability to make antibodies quickly, the white blood cells that used to patrol for infection and destroy bacteria, early cancerous cells and virus factories are exhausted too.
When your ability to fight off pathogens is compromised, it makes you more susceptible to repeat infections and it makes regular infections a lot more dangerous. What’s more, the effects of all the vaccines you got before, and all the immunity you had acquired is wiped out until your immune system recovers.
Analysis of lymphocyte populations in blood samples collected from children recovering from measles shows that it can take up to 36 months for non-measles-related antibody cells to return to pre-measles levels. Indeed shortly after a bout of measles, measles is pretty much the only virus you will be immune to.
What seems like a routine measles infection will resolve after a few weeks, but if another pathogen comes calling soon after, your child could be in serious danger. For example, when epidemiologists over laid the data collected on measles vaccine uptake with pertussis deaths, they saw that as measles immunity increased, the number of pertussis deaths dropped.
How Contagious is Measles?
Very. Measles is the most contagious human virus.
The scary thing about the measles virus is just how fast it spreads. It can hang around in the air as long as two hours after an infected person leaves the space. Nine out of ten unvaccinated people who encounter a measles carrier at close quarters will be infected.
To put this in perspective, the infection rate of COVID-19 at the start of the pandemic was R0 1.4–2.4, the R0 of measles is 12–18. That means that the average person who catches measles would infect up to 18 more people.
This makes measles the most contagious virus we know of. Think of it, if each person could infect 18 more people, an entire school could be overwhelmed within a week. In a school with 1000 children, several will be left with lasting illness or disability. Up to three children might die.
The infectious phase can start four days before a rash appears and continues for four days once you have the rash. If you have measles, you must isolate until you are no longer infectious.
Who Gets The Measles?
Well, between 1980 and 2000, in the US and other developed countries with a measles vaccination programme, close to nobody. In the USA, by 2000, it really was nobody.
That’s right, in the year 2000, the USA had eradicated measles.
Zero Cases
Nobody in the USA was infected with measles in the year 2000. This was an enormous achievement by public health workers. Before 1963 when the first measles vaccine was introduced, almost every child caught the measles. Out of three to four million people infected each year as many as 500 people (mostly youngsters) would die, 48,000 would be hospitalized and 1000+ would experience encephalitis, or brain swelling.
In the USA, once the vaccine was launched, the number of cases plummeted from millions to just 22,094 cases in 1974. By 2000 there were zero cases. That’s zero children dead, zero children hospitalized, zero children left with debilitating brain injuries.
Misrememberings, Misunderstandings and Untruths
If somebody you know claims they had measles between 1980 and 2000 in a country with a vaccine programme, and it was no big deal, they are probably mistaken. Let’s be charitable and assume that some of these people have it confused with chicken pox. Chicken pox is also a very contagious virus that comes with a nasty rash, and these days the chicken pox vaccine is often offered at the same time as the MMR.
Some of those people, however, are telling lies. They think you will find their argument more convincing if it happened to somebody you know. The sad fact is that some people are very passionate about their beliefs and will exaggerate or bend the truth to get the result they want.
It’s normal to trust people and to take them at their word, sadly there are some people who take advantage of your good faith. This has led to the unnecessary deaths of children whose parents thought they were doing the right thing.
The Velveteen Rabbit Lives
You might have heard news reports saying that parents are holding measles parties. Do not do this.
It seems that once again, people are confusing measles and chicken pox. In the old days, before we had a vaccine for chicken pox, some parents believed that getting their kid infected with chicken pox as a toddler would mean they would suffer less. We now know that infecting your child with chicken pox is a bad idea as it makes them vulnerable to shingles. The vaccine is cheap, effective, prevents shingles too and won’t make your child sick.
It has never been a normal practice to deliberately infect your child with measles. Indeed, if you read children’s books from the early 20th century, you will notice that a lot of the characters spend significant amounts of time in quarantine with measles, scarlet fever or rubella.
What Does Measles Look Like?
If you or your child has a runny nose, a cough, pink eye and a fever, immediately isloate yourselves and call your doctors office to ask what their procedure is for dealing with measles.
The key symptoms of measles are
- Conjunctivitis (pink eye)
- respiratory symptoms including coughing and a runny nose
- white spots inside the mouth AKA Koplik’s spots
- A progressive skin rash that spreads from the head down the body
- Fever
Spotting The Signs
Here are examples of what the skin rash looks like. These photos were distributed by the CDC.
“Captured on the 5th day of this illness, this photograph depicted a posterior view of the back of a patient with a case of measles, highlighting the characteristic erythematous rash that had manifested, and spread over this region. Note how the rash appeared to be a raised crop of irregularly shaped coalescing spots.” Photo credit- CDC/ Heinz F. Eichenwald, MD, 1958
Here is an example of the white rash you will find in the mouth. This is a photo of the roof of a child’s mouth. The tiny white spots are Koplik’s spots. They appeared three days into infection before the skin rash appeared.
How Do I Get Diagnosed?
If you suspect you might have a case of measles on your hands, call your doctor and ask what to do. If you have symptoms and there is an outbreak in your area, you might be told to stay home and isolate until four days after the rash appears. In some situations the doctor will arrange for you to get a nose/mouth swab, a blood test or a urine test so that they can test for the virus.
If you are diagnosed with measles based on your symptoms or test results, your local public health unit will get in touch with you so that they can do contact tracing. It’s important that they track down people who have been exposed so that they can contain the epidemic, and so that people who become sick but can’t report it themselves can be checked on.
Treatments For Measles
There’s no treatment for infection with measles. You just have to wait it out and hope that you or your child don’t develop a life-threatening complication.
Ease The Symptoms
There are things you can do to treat the symptoms, for example drink lots of fluids or use medication to reduce your fever. If you develop serious complications for instance ADEM, there are treatments such as steroids that can help control the symptoms.
If you or your child experience complications, you should call ahead to the emergency room or your GP so that they can advise you on what to do. Calling ahead is essential because it gives them time to arrange to receive you safely. Measles spreads very fast in hospitals where they are a people with poor immunity.
How To Avoid Measles
A Shot In The Arm
Simply put, get your kids (and yourself) vaccinated. Measles is so contagious that vaccines are the only way humans have ever managed to get this virus under control.
Quarantine and isolation can work in very tiny outbreaks, but like COVID-19 it starts to be infectious before you know you have it.
As we discovered during the pandemic, quarantine and isolation can put a huge strain on families. We all know of people who had to go to work with an active COVID-19 infection. Why place all your trust in your kid’s school mates to isolate when you could get a shot and stay safe for life?
The best way to avoid measles and its complications is to stick to your kid’s vaccination schedule.
Bibliography
Berche P. History of measles. La Presse Médicale. 2022;51(3):104149. doi:10.1016/j.lpm.2022.104149
Bitnun A, Shannon P, Durward A, et al. Measles inclusion-body encephalitis caused by the vaccine strain of measles virus. Clin Infect Dis. 1999;29(4):855-861. doi:10.1086/520449
CDC. Measles (Rubeola). Measles (Rubeola). January 22, 2025. Accessed March 18, 2025. https://www.cdc.gov/measles/index.html
Kondamudi NP, Waymack JR. Measles. In: StatPearls. StatPearls Publishing; 2025. Accessed March 18, 2025. http://www.ncbi.nlm.nih.gov/books/NBK448068/
Laksono BM, de Vries RD, McQuaid S, Duprex WP, de Swart RL. Measles Virus Host Invasion and Pathogenesis. Viruses. 2016;8(8):210. doi:10.3390/v8080210
Mina MJ, Metcalf CJE, de Swart RL, Osterhaus ADME, Grenfell BT. Long-term measles-induced immunomodulation increases overall childhood infectious disease mortality. Science. 2015;348(6235):694-699. doi:10.1126/science.aaa3662
Perry RT, Halsey NA. The Clinical Significance of Measles: A Review. The Journal of Infectious Diseases. 2004;189(Supplement_1):S4-S16. doi:10.1086/377712
Measles is a serious illness caused by an extremely contagious virus. This virus does more than give you a runny nose or a rash. The key symptoms of measles are If you or your child has a runny nose, a cough, pink eye and a fever, immediately isolate yourselves and call your doctor’s office to ask what their procedure is for dealing with measles. What is it and where does it come from? How does measles make you sick? What are the treatments for measles? Let’s get straight to the matter at hand, is measles dangerous? Yes, it is. The measles death rate is between one and three children per 1000 infections. While most youngsters will come away with fever, a rash, conjunctivitis and a nasty respiratory infection, a number of kids will end up with neurological impairments. Specifically, measles can cause acute encephalitis, inflammation of the brain’s active tissues, or subacute sclerosing panencephalitis (SSPE). Encephalitis caused by measles can end in blindness and hearing loss. Other symptoms like ear infections, diarrhoea and pneumonia can also land your child in hospital. Measles causes long-term damage to the immune system that makes all children vulnerable to serious illnesses they have already been vaccinated against. This virus isn’t just bad for kids, pregnant women are at risk of premature labour, and adults with delicate immune systems can find themselves in trouble. In 2022, 1.9 US minors in every 100,000 were killed in a car accident. If your child catches the measles, their risk of dying is 150 times higher than dying in a car crash. Getting vaccinated is cheaper, easier and longer-lasting than buying a car seat for your child. So why would you buy a car seat or use seat belts, but not try a vaccine with over 50 years of proven results? So what exactly is the measles? It’s caused by a Paramyxoviridae virus that spreads fast and wide via aerosolized droplets. The measles virus is very simple, made from just a strand of RNA and a coating covered in sticky proteins that grab on to the cells in your respiratory tract and squeeze inside. Once it’s within a cell, the RNA strand tricks the host into helping it to replicate, turning it into a measles virus factory. This tiny virus only infects primates, for example humans, apes and monkeys. Because this virus is so simple and so small, it is very efficient at spreading between people. When people are living close together in cities and packed into cars, classrooms and canteens, without some kind of fire break, this virus can rapidly overwhelm populations. The first known records of measles (also called rubeola) appeared in ninth century Persia. This disease was well known and significant enough that doctors wrote about it in medical guides along with diseases like Small Pox. Measles was a very common childhood disease all across Europe and Asia throughout the following centuries. Common, however, does not mean benign or harmless. Polio, cholera and bubonic plague were also common before the 20th century. Measles was never an illness that you could just ‘shake off’. In fact, it’s thought that as many as 50% of Hondurans died from measles when Europeans took it to the new world in 1531. So how did we forget that measles is dangerous? Well, in some ways, measles is a victim of its own success. Because measles spreads so fast and so easily it has never needed to evolve complicated tools to outwit your immune system. This means the introduction of measles vaccines was extremley effective at controlling the virus. If you make it through a bout of measles and survive, your immune system will recognize it and catch it early before it can spread through your body again. So once you have had measles, unless you have an immune deficiency you will not catch it again. This is also why vaccines work so well to prevent measles and have saved countless lives. So few people in developed countries have died or suffered life changing disabilities since the late 1970s that we just don’t see the consequences of measles epidemics with our own eyes. So what does the measles virus actually do? What makes it different to other viruses? Measles starts when a sneaky viral particle manages to snag and infiltrate one of the cells that line your airways, or mucous membranes in your nose, eyes, mouth etc. Over the next nine days the virus will silently multiply and spread from one cell to the next, until it spreads to every part of your body. After around nine days, the virus will start to overwhelm your body and provoke an immune response. Too many resources are being redirected from maintaining your body to making virus particles, so you will start to feel tired and generally rundown. At this stage your immune system will be slowly ramping up to take on the virus. With every part of your body diverting energy and nutrients to making more measles virus–including white blood cells, however, this is a hard and expensive fight. One on the ways measles is able to invade so fast is that virus hitches a ride in your white blood cells, AKA lymphocytes. Using your lymphatic system like a superhighway, the virus is able to penetrate anywhere that infection-fighting lymphocytes can go. Which is pretty much everywhere. On their travels these cells carry measles virus into your lymph nodes, thymus and spleen. Lymph organs are essential parts of our immune response. These are the nurseries where we grow our antibody producing white blood cells. When the measles virus gets into your lymph organs, the specialized pathogen fighting cells we rely on for targeted immune responses are occupied with protecting themselves from the virus. This gives the measles virus freedom to spread and multiply in your body. Over time, the measles virus overwhelms the lymph organs almost shutting them down. When our lymphatic organs are under attack, our bodies can’t efficiently activate the memory cells that make antibodies. Meaning it takes a lot longer for our bodies to fight off the virus than it should. Once your immune system eventually kicks into gear, inflammation arrives bringing with it fever, coughing, runny nose and inflamed eyes. Over the following days, your symptoms increase. You will start to develop white spots on the inside of your cheeks where your immune cells are attacking and isolating virus factories. Soon after, a red itchy rash will creep down from your ears, spreading across your face and then over your torso and limbs. These rashes are caused by our immune system’s big guns. When we detect viral particles, our white blood cell nurseries start making specialized cells that seek and destroy infected cells. Basically, our immune system is finding measles factories and killing them to prevent the virus from taking over more cells. Sounds reasonable, right? Well, here’s the problem, because measles spreads so fast and so effectively in your body, there are an awful lot of virus factories to be destroyed. Those itchy rashes, swollen eyes and irritated lungs are caused by your white blood cells having to destroy your own cells to get rid of the virus. For most of us measles is a self-limiting illness, this means eventually it burns itself out as our immune system blasts it. So far we’ve looked into what measles does. A rash doesn’t sound like such a big deal, so why are doctors so worried about it? On top of the obvious dangers that pneumonia and high fever, measles can cause severe neurological complications. Remember how the measles virus has a habit of taking a joy ride around your body in white blood cells? Lymphocytes (white blood cells) are one of very few cell types that can cross the blood brain barrier. Unlike most infectious diseases, measles can get into your brain. If your immune system starts attacking virus factories located in your skin, you’ll get a rash. A skin rash, however, will go away as skin is quite good at repairing itself. On the other hand, if your immune system wages war on your brain, it can cause all sorts of problems. Encephalitis happens when your brain is desperately trying to fight off an infection, but the inflammation causes as much damage or more than the virus. What’s more, around one in a thousand people infected with measles, will find that their immune system mistakes regular uninfected neurons for an infected cell. In these patients, the molecular structure of a component of the protective sheath that covers their nerve cells is just similar enough to a protein on the measles virus. This means your lymphocytes confuse neurons in your brain and spinal cord for a virus factory long after the virus has been cleared. Acute disseminated encephalomyelitis or ADEM, causes damage to neurons that can trigger encephalopathy. In most cases, ADEM can be treated with a course of steroids. ADEM cause a range of neurological symptoms. It can provoke seizures, paralysis of the legs or arms and legs, speech difficulties, loss of control of body movements. It can also cause eye problems including optic neuritis and nystagmus. In severe cases, some children will be left with permanent brain injury, and some will die. Other more rare complications are Measles inclusion-body encephalitis (MIBE) and subacute sclerosing panencephalitis (SSPE). Both of these are less common than ADEM and a lot more dangerous. In these cases the measles virus causes long-term damage to brain cells that is very difficult to treat. The measles virus takes up residence in nerve cells of your central nervous system and camps out. After a while the immune system gets wise to this hide out and starts attacking. This results in a war of attrition that eventually leads to so much destruction that the brain can’t repair itself. The patient will slip into a coma and die. The other long-lasting effect of measles is the damage it causes to your immune system. When the measles vaccine was introduced in the 1960s, childhood mortality in countries that set up mass vaccination programmes plummeted. This was not just because of an uptick in post-war living standards or fewer kids dying from measles. Epidemiological studies have pin-pointed the rollout of the measles vaccine programme as the turning point in Denmark, the UK and the USA amongst others. While in England and Wales, the precipitous drop in childhood mortality started in 1967, in Denmark the effect was not seen until 1990. The measles vaccine was introduced to British children in the early 1960s, while Danish kids weren’t routinely vaccinated against measles until the 1980s. So how would the measles vaccine reduce deaths from all other infectious diseases? It turns out that it takes an extended period for your lymph organs to recover from measles. Long after the virus is cleared, your skin rash has faded and your runny nose has dried up, your worn out immune system has to rebuild your defences. For several months, in some cases, years, the memory cells that produced antibodies against viruses or bacteria you had before, can’t keep up. Not only do you lose your ability to make antibodies quickly, the white blood cells that used to patrol for infection and destroy bacteria, early cancerous cells and virus factories are exhausted too. When your ability to fight off pathogens is compromised, it makes you more susceptible to repeat infections and it makes regular infections a lot more dangerous. What’s more, the effects of all the vaccines you got before, and all the immunity you had acquired is wiped out until your immune system recovers. Analysis of lymphocyte populations in blood samples collected from children recovering from measles shows that it can take up to 36 months for non-measles-related antibody cells to return to pre-measles levels. Indeed shortly after a bout of measles, measles is pretty much the only virus you will be immune to. What seems like a routine measles infection will resolve after a few weeks, but if another pathogen comes calling soon after, your child could be in serious danger. For example, when epidemiologists over laid the data collected on measles vaccine uptake with pertussis deaths, they saw that as measles immunity increased, the number of pertussis deaths dropped. Very. Measles is the most contagious human virus. The scary thing about the measles virus is just how fast it spreads. It can hang around in the air as long as two hours after an infected person leaves the space. Nine out of ten unvaccinated people who encounter a measles carrier at close quarters will be infected. To put this in perspective, the infection rate of COVID-19 at the start of the pandemic was R0 1.4–2.4, the R0 of measles is 12–18. That means that the average person who catches measles would infect up to 18 more people. This makes measles the most contagious virus we know of. Think of it, if each person could infect 18 more people, an entire school could be overwhelmed within a week. In a school with 1000 children, several will be left with lasting illness or disability. Up to three children might die. The infectious phase can start four days before a rash appears and continues for four days once you have the rash. If you have measles, you must isolate until you are no longer infectious. Well, between 1980 and 2000, in the US and other developed countries with a measles vaccination programme, close to nobody. In the USA, by 2000, it really was nobody. That’s right, in the year 2000, the USA had eradicated measles. Nobody in the USA was infected with measles in the year 2000. This was an enormous achievement by public health workers. Before 1963 when the first measles vaccine was introduced, almost every child caught the measles. Out of three to four million people infected each year as many as 500 people (mostly youngsters) would die, 48,000 would be hospitalized and 1000+ would experience encephalitis, or brain swelling. In the USA, once the vaccine was launched, the number of cases plummeted from millions to just 22,094 cases in 1974. By 2000 there were zero cases. That’s zero children dead, zero children hospitalized, zero children left with debilitating brain injuries. If somebody you know claims they had measles between 1980 and 2000 in a country with a vaccine programme, and it was no big deal, they are probably mistaken. Let’s be charitable and assume that some of these people have it confused with chicken pox. Chicken pox is also a very contagious virus that comes with a nasty rash, and these days the chicken pox vaccine is often offered at the same time as the MMR. Some of those people, however, are telling lies. They think you will find their argument more convincing if it happened to somebody you know. The sad fact is that some people are very passionate about their beliefs and will exaggerate or bend the truth to get the result they want. It’s normal to trust people and to take them at their word, sadly there are some people who take advantage of your good faith. This has led to the unnecessary deaths of children whose parents thought they were doing the right thing. You might have heard news reports saying that parents are holding measles parties. Do not do this. It seems that once again, people are confusing measles and chicken pox. In the old days, before we had a vaccine for chicken pox, some parents believed that getting their kid infected with chicken pox as a toddler would mean they would suffer less. We now know that infecting your child with chicken pox is a bad idea as it makes them vulnerable to shingles. The vaccine is cheap, effective, prevents shingles too and won’t make your child sick. It has never been a normal practice to deliberately infect your child with measles. Indeed, if you read children’s books from the early 20th century, you will notice that a lot of the characters spend significant amounts of time in quarantine with measles, scarlet fever or rubella. If you or your child has a runny nose, a cough, pink eye and a fever, immediately isloate yourselves and call your doctors office to ask what their procedure is for dealing with measles. The key symptoms of measles are Here are examples of what the skin rash looks like. These photos were distributed by the CDC. “Captured on the 5th day of this illness, this photograph depicted a posterior view of the back of a patient with a case of measles, highlighting the characteristic erythematous rash that had manifested, and spread over this region. Note how the rash appeared to be a raised crop of irregularly shaped coalescing spots.” Photo credit- CDC/ Heinz F. Eichenwald, MD, 1958 Here is an example of the white rash you will find in the mouth. This is a photo of the roof of a child’s mouth. The tiny white spots are Koplik’s spots. They appeared three days into infection before the skin rash appeared. If you suspect you might have a case of measles on your hands, call your doctor and ask what to do. If you have symptoms and there is an outbreak in your area, you might be told to stay home and isolate until four days after the rash appears. In some situations the doctor will arrange for you to get a nose/mouth swab, a blood test or a urine test so that they can test for the virus. If you are diagnosed with measles based on your symptoms or test results, your local public health unit will get in touch with you so that they can do contact tracing. It’s important that they track down people who have been exposed so that they can contain the epidemic, and so that people who become sick but can’t report it themselves can be checked on. There’s no treatment for infection with measles. You just have to wait it out and hope that you or your child don’t develop a life-threatening complication. There are things you can do to treat the symptoms, for example drink lots of fluids or use medication to reduce your fever. If you develop serious complications for instance ADEM, there are treatments such as steroids that can help control the symptoms. If you or your child experience complications, you should call ahead to the emergency room or your GP so that they can advise you on what to do. Calling ahead is essential because it gives them time to arrange to receive you safely. Measles spreads very fast in hospitals where they are a people with poor immunity. Simply put, get your kids (and yourself) vaccinated. Measles is so contagious that vaccines are the only way humans have ever managed to get this virus under control. Quarantine and isolation can work in very tiny outbreaks, but like COVID-19 it starts to be infectious before you know you have it. As we discovered during the pandemic, quarantine and isolation can put a huge strain on families. We all know of people who had to go to work with an active COVID-19 infection. Why place all your trust in your kid’s school mates to isolate when you could get a shot and stay safe for life? The best way to avoid measles and its complications is to stick to your kid’s vaccination schedule. Berche P. History of measles. La Presse Médicale. 2022;51(3):104149. doi:10.1016/j.lpm.2022.104149 Bitnun A, Shannon P, Durward A, et al. Measles inclusion-body encephalitis caused by the vaccine strain of measles virus. Clin Infect Dis. 1999;29(4):855-861. doi:10.1086/520449 CDC. Measles (Rubeola). Measles (Rubeola). January 22, 2025. Accessed March 18, 2025. https://www.cdc.gov/measles/index.html Kondamudi NP, Waymack JR. Measles. In: StatPearls. StatPearls Publishing; 2025. Accessed March 18, 2025. http://www.ncbi.nlm.nih.gov/books/NBK448068/ Laksono BM, de Vries RD, McQuaid S, Duprex WP, de Swart RL. Measles Virus Host Invasion and Pathogenesis. Viruses. 2016;8(8):210. doi:10.3390/v8080210 Mina MJ, Metcalf CJE, de Swart RL, Osterhaus ADME, Grenfell BT. Long-term measles-induced immunomodulation increases overall childhood infectious disease mortality. Science. 2015;348(6235):694-699. doi:10.1126/science.aaa3662 Perry RT, Halsey NA. The Clinical Significance of Measles: A Review. The Journal of Infectious Diseases. 2004;189(Supplement_1):S4-S16. doi:10.1086/377712
Is Measles Dangerous?
More Than a Rash
Why Take the Risk With Measles?
What is it?
A Simple Virus
Where Does Measles Come From?
Seeing is Believing
How Does Measles Make You Sick?
Silent Invasion
Highjackers
Kill to Cure
Why is Measles Dangerous?
When Things Get Complicated
Mistaken Identity
Guerilla Warfare
Immunity Deficit
Memento Measles
How Contagious is Measles?
Who Gets The Measles?
Zero Cases
Misrememberings, Misunderstandings and Untruths
The Velveteen Rabbit Lives
What Does Measles Look Like?
Spotting The Signs
How Do I Get Diagnosed?
Treatments For Measles
Ease The Symptoms
How To Avoid Measles
A Shot In The Arm
Bibliography
