Although measles are often referred to as a typical childhood disease, they don’t exclusively affect children—people can become infected at any age. Measles are mainly known as a childhood illness because, before vaccination was introduced, most people caught it in childhood due to how highly contagious it is. In this article, we’ve summarized everything important about the course of this highly contagious viral disease and explain how you can ease your child’s symptoms and which vaccination protects against infection.

How are measles transmitted?

Measles are most contagious : The viruses are mainly transmitted via a droplet infection when speaking, coughing, or sneezing, and less often through a smear infection via contact. Between 90 and 95 percent of all unvaccinated individuals who come into contact with the viruses will contract measles. The infection rate is particularly high because infected people are contagious three to five days before the characteristic rash appears—that is, possibly before the illness is recognized—and up to four days after it disappears. Additionally, measles viruses can survive in the air for up to two hours.

What are the symptoms of measles?

The initial symptoms of measles appear approximately eight to twelve days after infection. The course of measles is divided into two phases, each accompanied by a spike in fever:

• The pre-stage begins with flu-like symptoms such as fever , a runny nose, sore throat, and a dry, painful cough, along with exhaustion and headaches. In some cases, your child may also experience stomach ache, constipation, or diarrhea , conjunctivitis, or sensitivity to light. Two or three days after the first symptoms, white-red spots on the buccal mucosa become visible (Koplik spots) , and the inner oral and pharyngeal mucous membranes are also noticeably reddened. The fever rises and then subsides again after three to five days.

• At the start of the main stage , the fever intensifies again, as do the other symptoms of the prodrome. In addition, the lymph nodes swell and the typical bright red rash begins to spread from behind the ears across your little explorer’s face and then over the entire body (except for the palms of the hands and soles of the feet). The spots darken after a few days and take on a brownish-purple color before the skin begins to peel after four to seven days and the rash gradually fades. The other symptoms also ease as the spots disappear, and the fever goes down.

These two phases are followed by two to four weeks during which the body is still weakened and the immune system needs time to recover. During this period, your child should continue to rest, as their susceptibility to other infections is increased.

Ideally, measles heal on their own without any problems. However, in some cases—especially in infants and people with weakened immune systems—it can lead to dangerous mixed infections , including an ear or lung infection. A feared complication is inflammation of the brain, which can lead to severe long-term effects or even death.

Treatment of childhood diseases

There is no specific treatment for measles; symptoms can only be relieved and the healing process supported. Nevertheless, you should definitely go to the pediatrician when you notice early symptoms that could indicate measles. The signs of illness are often not so easy to recognize, as they can be difficult to distinguish from rubella, fifth disease, or scarlet fever , and a laboratory test must confirm whether it is actually measles. If an infection is suspected, transmission to unvaccinated people in the immediate environment—especially infants—can still be prevented through early or post-exposure vaccination or by administering so-called immune globulins (ready-made antibodies).

At home, rest and convalescence are especially important for your little explorer. With home remedies such as calf wraps and plenty of fluids, you can help lower the fever and ease your child’s discomfort. However, medication should only be given after consulting a doctor. Once your child has recovered from measles, they are immune to the disease for life.

What is the measles vaccination?

If you have antibodies against measles—either because you have been vaccinated or previously infected—these are automatically transferred to your baby during pregnancy via the umbilical cord . For up to six months after birth, your baby is therefore protected against infection through nest protection . Only in rare cases do infants develop a mild form of measles, known as mitigated measles .

Typically, the measles vaccination is administered together with the vaccine against mumps and rubella in two doses : The first dose is given to your child between the 11th and 14th month of life, and the second at least four weeks later, between the 15th and 23rd month of life. In certain situations, such as early daycare attendance or an upcoming stay abroad, the vaccination can also be brought forward. In that case, it is administered in three doses instead of two. In about five percent of cases, mild symptoms such as fatigue or fever may occur five to ten days after vaccination; sometimes, a mild measles-like rash may also appear. But there’s no need to worry: these are so-called vaccine measles, which are not contagious and are usually harmless. Your pediatrician will support you during the preventive check-up U6 and provide information about the MMR vaccination ( mumps , measles, rubella), answering any questions you may have about the process or possible side effects.

Since the introduction of the measles vaccination, the number of new cases in Germany has decreased significantly – in recent years, it has been below 2,000. However, in other European countries there has been a resurgence in new cases, which led Germany to decide in 2019 to introduce mandatory measles vaccination before entry into kindergarten or school. The law came into effect on March 1, 2020. In Austria and Switzerland, mandatory vaccination is also being discussed.

It’s worth checking your own vaccination status early. This increases the likelihood that, thanks to herd immunity, your little explorer can avoid infection before they can be protected themselves. We hope we’ve been able to answer some of your questions about measles. If you’re still unsure, you can always contact your pediatrician.