Infection & Immunityalso: morbilli, rubeola

Measles is a highly contagious viral illness with high fever, cough, conjunctivitis and a typical blotchy rash. It can cause serious complications such as pneumonia or brain inflammation. Two vaccine doses provide very good, long-lasting protection.

Overview

The measles virus spreads through droplets and tiny airborne particles and is one of the most contagious viruses known: almost all unprotected people who are exposed become ill. People are infectious a few days before the rash appears. Having had measles gives lifelong immunity. Worldwide, measles still kills many children.

Symptoms

About one to two weeks after infection, fever, a runny nose, cough and red eyes that are sensitive to light begin. Whitish spots inside the cheeks (Koplik spots) are typical. A few days later the fever rises again and a reddish-brown, blotchy rash (exanthem) spreads from the head over the whole body. It fades after several days.

Complications

Measles weakens the immune system for weeks to months, making further infections more likely. Common complications are middle ear infection, bronchitis, pneumonia and diarrhoea. Acute brain inflammation (encephalitis) is feared. Very rarely, years later, the always fatal subacute sclerosing panencephalitis (SSPE) develops – mainly after infection in infancy.

Diagnosis

The doctor suspects measles from the symptoms. It is confirmed by antibodies in the blood or by detecting the virus in a throat swab or urine. In Germany, even a suspected case must be reported. Anyone who suspects measles should phone the surgery before visiting so that other patients are not infected.

Treatment

There is no medicine against the measles virus itself. Treatment relieves symptoms: bed rest, plenty of fluids, fever-reducing medicines and darkened rooms for light sensitivity. Bacterial secondary infections are treated with antibiotics. The WHO also recommends vitamin A for children with measles.

Prevention

The German Standing Committee on Vaccination (STIKO) recommends two vaccine doses with a combined measles, mumps and rubella vaccine (MMR, possibly with chickenpox) in the second year of life. Adults born after 1970 with unclear or incomplete vaccination should also be vaccinated. Since 2020, Germany’s Measles Protection Act applies, for example to children in nurseries and schools. After exposure, vaccination within three days can often still prevent or soften the illness. High vaccination rates also protect people who cannot be vaccinated through herd immunity.

Frequently asked questions

How long is measles contagious?

From about four days before to four days after the rash starts. During this time, people with measles should avoid contact with others.

Can you get measles despite vaccination?

After two doses this is very rare. If it does happen, the illness is usually milder.

Do adults need a measles vaccine?

According to STIKO, people born after 1970 who have not been vaccinated, have had only one dose or do not know their status should receive a vaccination. Two doses apply to certain occupations.

Is measles a harmless childhood illness?

No. Measles leads to complications relatively often and can be fatal. It also weakens the immune system for a long time.

Related terms

Test your knowledge: questions on infections, vaccination, child health and more – from beginner to exam level.

Go to the Medical Quiz

Sources

Robert Koch Institute: RKI guide on measles (Germany)
German Standing Committee on Vaccination (STIKO): recommendations, Epidemiologisches Bulletin (current edition)
WHO: Measles – Fact sheet

This entry is for general information only and does not replace medical advice. Last updated: November 2026.

Measles