Measles is a highly contagious viral illness. More than 90% of susceptible persons will become infected after exposure. Measles is spread through respiratory droplets, especially when a person with measles coughs or sneezes. Measles can be spread from 4 days before to 4 days after the rash occurs.
Symptoms of measles begin about 10 to 12 days after exposure. Initial symptoms (prodrome) last about 2 to 4 days and include fever, which increases in a stepwise fashion, followed by cough, runny nose, and conjunctivitis (eye inflammation). Koplick spots (rash on the mucous membranes of the mouth) may also occur either before or after the typical measles rash. The measles rash is maculopapular (reddish with small pumps). It begins at the hairline and then gradually spreads downward and outward.
Even after exposure, measles can be prevented if the person is given measles vaccine (MMR vaccine) within 72 hours of the exposure. In addition, immune globulin may prevent or decrease the severity of measles if given within 6 days of exposure. However, once symptoms are present the only treatment is supportive care to relieve symptoms and treat complications.
Although in the past measles, mumps and rubella were available
as individual (single antigen) vaccines, the manufacturer is no longer
making these individual vaccines. Instead measles, mumps, and rubella
vaccines are given as combined MMR vaccine or as MMRV vaccine (combined
MMR vaccine and varicella vaccine).
Product: M-M-R II® (Measles, Mumps, and Rubella)
Manufacturer: Merck & Co
Year licensed: 1971
Product: ProQuad® (Measles, Mumps, Rubella, and Varicella)
Manufacturer: Merck & Co
Year licensed: 2005
* MMR vaccine contains egg protein,
neomycin, and gelatin (see package insert). However, allergy to eggs in
not a contraindication or precaution to MMR vaccine.
*When MMR antigens are given in combination with other antigens (e.g., variciella)
in one vaccine, the other antigens in the vaccine may cause other side
effects. For more information about these possible side effects, go to
the varicella pages on the Vaccines section of this website.
This vaccine is a 0.5-mL dose shot given subcutaneously (in the fatty layer of tissue under the skin). Give children the first dose at 12 to 15 months of age and the second dose at 4 to 6 years of age. Give MMR to children who have not received the second dose by their 11- to 12-year-old visit. There should always be at least 4 weeks between the first and second dose.
ProQuad®, the quadruple vaccine, is indicated for children 12 months to 12 years of age if a second dose of measles, mumps, and rubella vaccine is to be administered.
Adults born before 1957 are assumed to be immune to measles by natural infection. Give adults born in 1957 or later, who do not have medical restrictions, at least one dose of MMR vaccine during their lifetime. Give two lifetime doses of MMR vaccine to certain adults born in 1957 or later including healthcare workers, those who travel overseas, or those who attend college, or post-secondary educational institutions. These adults should receive two doses of MMR or have other evidence of measles immunity (lab test or physician-diagnosed measles).
A second dose of MMR is also recommended for adults who have been recently exposed to measles or who are in an outbreak setting, were previously vaccinated with killed measles vaccine, were vaccinated with an unspecified measles vaccine between 1963 and 1967, or plan to travel internationally.
M-M-R II® is administered to military basic trainees, unless they have positive blood tests or documented evidence of two prior vaccinations. For other adults and children, DoD follows guidelines of the Advisory Committee on Immunization Practices (ACIP). In general, ACIP prefers use of M-M-R II® to monovalent (Attenuvax®) or bivalent vaccines, to optimize immunity to all three diseases.