How to Identify a Measles Rash

Measles is a highly contagious, airborne illness on the rise in the U.S., partly because vaccination rates for measles, mumps and rubella (MMR) have declined since 2019, according to the American Medical Association. One of the hallmark signs of this illness is a rash. 

Identifying a Measles Rash 

Stefan Hagmann, M.D., MSc, the chief of Pediatric Infectious Disease at Hackensack University Medical Center, explains that a measles rash involves red, round lesions that start at the hairline and move down the body to the neck, torso, arms, legs and feet. While the rash is typically not painful, it can be itchy. The rash usually lasts about a week and fades in the same order it appeared.

Small bumps may appear on the lesions. Before the rash, you may notice Koplik spots, tiny whitish spots, on the inside of the mouth. 

Other Measles Symptoms

Hagmann says that someone with measles usually has other symptoms before the rash appears. These include: 

• High fever of 101 degrees or more
• Coughing
• Running nose
• Red eyes

Why It’s Important to Identify Measles

There are two reasons why identifying measles is essential:

1. Measles can lead to significant complications, Dr. Hagmann says, including:
• Bacterial infections
• Pneumonia
• Infection of the brain resulting in encephalitis
2. Measles is an extremely infectious airborne virus. “For a long time, with COVID-19, we talked about staying 6 feet apart. But with measles, there is no safe distance,” Dr. Hagmann says.

Before widespread vaccination, measles caused approximately 2.6 million deaths each year, reports the World Health Organization. Even with an accessible vaccine, it's estimated that 136,000 people worldwide died due to measles in 2022. Most of these fatalities were among unvaccinated or under-vaccinated children under the age of 5.

Who Is at Risk for Measles

“Presently, in the U.S.,those who travel and are unvaccinated are at the highest risk,” says Dr. Hagmann. While measles was effectively eliminated from the U.S. in 2000, it remains a problem in other countries with low vaccination rates.

In addition, it resurfaced in the U.S. in communities with a vaccination rate lower than 95 percent. This level of vaccination creates what’s called “herd immunity.” When a community has herd immunity, the spread of the disease becomes unlikely, and the whole community is protected. This is important for babies too young to be vaccinated or those who cannot be vaccinated due to a medical condition or allergy.

How to Prevent Measles

The best defense is vaccination. The MMR vaccine is one of the most effective vaccines available. The CDC recommends that: 

• Children receive their first dose after their first birthday. 
• Children receive their second dose between the ages of 4 and 6. 
• If a child will be travelling internationally, a first dose can be given as young as 6 months of age, and for infants older than 12 months old the second dose can be expedited; you only need to wait four weeks between doses.

Measles is preventable and can cause serious complications that can have lasting effects. “Do what you can to prevent the measles,” says Dr. Hagmann. “This means getting vaccinated.”

Next Steps & Resources:

• Meet our source: Stefan Hagmann, M.D., MSc
• To make an appointment with a pediatrician near you, call 800-822-8905 or visit our website.
• Learn more aboutchildren’s health at Hackensack Meridian Health.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.