Measles Job Aid - please read if you are planning to call to discuss measles testing.

Measles is so contagious that if one person has it 90% of the people close to that person who are not immune will become infected. Infected individuals can spread measles to others from 4 days before through 4 days after the rash appears. Measles infection is a vaccine-preventable illness.
The average incubation period for measles is 10-12 days (range: 7-21 days) from the date of the initial exposure until early signs and symptoms appear.

• Early signs and symptoms of measles starts with fever (as high as 105°F) and malaise associated with cough, coryza (runny nose) and conjunctivitis (red/watery eyes), colloquially the three “C’s”.

• 2-3 days after symptoms begin tiny white spots may appear inside the mouth (Koplik spots).

• 3-5 days after symptoms begin, a maculopapular skin rash develops that begins on the face at the hairline and spreads downward to the neck, trunk, arms, legs, and feet. Small raised bumps may also appear on the top of the flat red spots. The spots may become joined together as they spread. As rash appears an individual’s fever may spike.

When considering measles, healthcare providers should take into account the progression of symptoms. The onset of the three “C’s” almost always appears before the onset of a rash and the rash starts on the face and head and spreads towards the extremities. Also, consider other viral exanthems as appropriate.



What do I do if an individual presents with rash and fever?
Query patients about a history of international travel, history of domestic travel to areas with ongoing outbreaks, contact with foreign visitors, transit through an international airport, or possible exposure to a measles patient in the three weeks prior to symptom onset. Suspect measles in patients with compatible clinical presentation and such a history.