Measles (Rubeola) in Children

What is measles in children?

Measles (rubeola) is a respiratory illness caused by a virus. It causes a red, blotchy rash. It's also known as 10-day measles or red measles. It's a very contagious.

The measles virus lives in the mucus in the nose and throat. It's spread from one child to another through contact with fluid from the nose and throat. It's also spread by an infected child coughing and sneezing. 

What causes measles in a child?

Measles is caused by a virus. It's mostly seen in the winter and spring.  

Which children are at risk for measles?

Children are more at risk for measles if they have not had the measles vaccine and are in contact with anyone who has measles. A person is contagious about 4 days before the rash breaks out, so a child may have contact with the virus without knowing it.  

What are the symptoms of measles in a child?

It may take 7 to 14 days for a child to develop symptoms of measles after contact with the virus. A child is contagious about 4 days before the rash breaks out and 4 days after the rash develops. A child may pass the virus to others before you know they have it.

The early phase of the illness lasts between 1 and 4 days. Symptoms are like those of an upper respiratory infection. The most common symptoms include:

• Runny nose

• Hacking cough

• Pink eye (conjunctivitis) 

• Fever

After 2 or 3 days of the above, other symptoms include:

• Severe diarrhea 

• Small spots with white centers (Koplik spots) on the inside of the cheek

• Deep, red, flat rash that starts on the face and spreads down to the torso, arms, legs, and feet

The red rash starts as small lesions that combine into one big rash. After 3 to 7 days, the rash will start to go away. It will fade in the same order it appeared. It then leaves a brown-colored area and peeling skin.

The symptoms of measles can be like other health conditions. Make sure your child sees their healthcare provider for a diagnosis.

How is measles diagnosed in a child?

The healthcare provider will ask about your child's symptoms and health history. They may also ask about your family's health history. They will give your child a physical exam. The physical exam will include looking at the rash. The measles rash is different from other rashes. Your child may also have tests, such as blood or urine tests, to confirm the diagnosis.

How is measles treated in a child?

Treatment will depend on your child's symptoms, age, and general health. It will also depend on how severe the condition is. Antibiotics are not used to treat this illness.

The goal of treatment is to help ease symptoms. Treatment may include:

• Making sure your child drinks more fluids

• Giving acetaminophen or ibuprofen for fever and discomfort

Your child's healthcare provider may tell you to give your child vitamin A in 2 doses to help prevent eye damage and blindness. If your child is younger than 1 year old or admitted to the hospital with respiratory problems, your child's healthcare provider may recommend an antiviral treatment called ribavirin.

Talk with your healthcare providers about the risks, benefits, and possible side effects of all medicines. Don't give ibuprofen to a child younger than 6 months old unless your healthcare provider tells you to. Don't give aspirin to children or teens. Aspirin can cause a serious health condition called Reye syndrome, which can cause liver and brain damage.

If your child was exposed and has not had a measles vaccine, your child's healthcare provider may give the MMR vaccine within 72 hours. Or the provider may give immune globulin (IG) within 6 days of measles exposure. These are to help prevent the disease.

Talk with your child's healthcare provider about the risks, benefits, and possible side effects of all medicines.

What are possible complications of measles in a child?

The most serious complications from measles include:

• Ear infection

• Lung infection (pneumonia)

• Croup

• Inflammation of the brain (encephalitis)

• Blindness

How can I help prevent measles in my child?

The measles vaccine is usually given as part of a combination vaccine with mumps and rubella. It's called the MMR vaccine. The MMR vaccine is very safe and works well. It's given in 2 doses. The first dose is given between ages 12 months to 15 months. A second dose is given between ages 4 and 6 years. The second dose needs to be given at least 4 weeks after the first dose. During an outbreak, your child may need another booster shot.

Other ways to prevent the spread of measles include:

• Keeping children home from school or daycare for 4 days after the rash appears

• Checking that all of your child's friends and caregivers have been vaccinated

When should I call my child's healthcare provider?

Call the healthcare provider if your child has:

• Symptoms that don't get better, or get worse

• New symptoms

Key points about measles in children

• Measles (rubeola) is a very contagious respiratory illness caused by a virus. It causes a red, blotchy rash.

• Children are more at risk for measles if they have not had the measles vaccine and are in contact with anyone who has measles.

• It may take between 7 to 14 days for a child to develop symptoms of measles after contact with the virus.

• The red rash starts as small lesions that combine into one big rash. After 3 to 7 days, the rash will start to go away. It then leaves a brown-colored area and peeling skin.

• The measles vaccine is usually given as part of a combination vaccine with mumps and rubella. It's called the MMR vaccine. The MMR vaccine is given in 2 doses.

Next steps

Tips to help you get the most from a visit to your child's healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

• Ask if your child's condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child's healthcare provider after office hours. This is important if your child becomes ill and you have questions or need advice.