How do I know if it’s Measles?


What are the symptoms of measles? When does the rash appear?

Dr. Greene's Answer

Measles is a highly contagious disease, and is spread from person to person through the air. During roughly the first 10 days following exposure, there is dramatic viral and immunologic activity taking place inside the body, with virtually no outward sign of illness.

Next comes the prodromal period in which symptoms of a cold (tiredness, runny nose, cough, and perhaps red eyes) with an added high fever (~39.5 C or 103 F) appear. These symptoms gradually increase over about 4 days.

During these 4 days, you will see white spots in the mouth. These are called Koplik spots, and are the hallmark of measles. They usually start on the inside of the cheek opposite the lower molars, then spread within 12 hours to cover most of the inside of the cheeks and lower lip. Many things can cause white spots in the mouth; Koplik spots always appear on a bright red, granular background.

The typical measles rash begins about 14 days after exposure (or 4 days after appearing ill). The fever is still at its height when the rash appears (in contrast to an infection called Roseola). The measles rash starts as spots, which then begin to blend together. The rash begins around the ears and on the forehead at the hairline. Over three days, it spreads sequentially to cover the face, neck, trunk, arms, buttocks, and legs. Over this same three-day period, the Koplik spots disappear, and the fever begins to fall. The rash disappears over another three or four days in the same order in which it started. As the rash fades, it looks coppery, then brownish, with fine white flakes.

The diagnosis is usually based on the presence of Koplik spots, the presence of the fever with the three C’s — cough, conjunctivitis, and coryza (cough, red eyes, and a very runny nose), and the sequential progression of the rash. The diagnosis may be confirmed by a blood test.

For uncomplicated measles, there is no specific treatment. Some studies suggest that vitamin A lessens the severity of measles. The cough is often severe, and some children benefit from cough medicines. Particularly during the period of the fever, plenty of fluids should be given. Avoid exposure to other ill children in the first weeks following measles, since some of the normal defenses are temporarily damaged.

In recent years, the number of measles cases in the United States has increased. The majority of those affected were unvaccinated or incompletely vaccinated for measles. Roughly 10% of those who contracted measles required hospitalization. This is a powerful reminder of the importance of measles vaccination in children.

Medical Review on: February 12, 2009
About the Author
Photo of Dr. Alan Greene
Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.
Get Dr. Greene's Wellness RecommendationsSignup now to get Dr. Greene's healing philosophy, insight into medical trends, parenting tips, seasonal highlights, and health news delivered to your inbox every month.
Add your comment

Recent Comments

I’m 41 I have been sick two rounds of antibiotics still breathing is bad had a spot in mouth made my whole tung swell and hurt 101 fever not a lot of bumps but I wake and I been sraching my legs is morning and night and stomach is not the best if you get measles does it go away by it self or is there meds you if my spelling is bad it’s because I have L.D.

Does measles rashes start on legs?

I have begun to get little red bumps every day a few more and few more…do I see a dermatologist or regular Dr.? I sometimes itch and looks like it is spreading. I don’t feel bad or have runny nose or any flu like symptoms……I believe I had measles when I was a child. I am now 50…..I once got scabies when I was in my twenties shaking hands with ppl the Dr said is how one contracts it. It itches but, not like that….do I see a Dr. or Dermatologist….

I have began to get little red bumps everyday a few more and few more…do I see a dermatologist or regular Dr.? I sometimes itch and looks like it is spreading. I dont feel bad or have runny nose or any flu like symptoms……

My two year old grandbaby start off with infected knots on her leg ,but,bottom put of her stomach I heal her with drawing sab now she then broke out with lil red bumps all over her back and stomach it looks like measles but she don’t have no fever she still it good every now and then she may complaint about her leg ,foot ,hand hurt and she do have a white spot in her mouth that and she be itching and scratching she still have a good spirit and still be playing I would like to know what that rash is on her

please my baby of 11mnt has terrible temprature nd hv give her some medication but she vomit it..pls am scared

My 3 almost 4yr old has had first immunisation shot due for second in 2 months. He woke up with what looks like measles all over except on face and neck, had no other symptoms though. Is it more likely something else?

Sir I had measles when I was a child for continue 4 years again I got measles after 2o years is it possible.

Thanks a lot Dr. Greene for your great advice, we are
immensely benefited. I have a daughter with a month old and I was in great dilemma
before visiting this website. Thanks a lot again, please take care. Have a
great day.