Measles: Understanding the Risks, Complications, and How to Prepare your Family

Measles: Understanding Risk, Complications, and How to Prepare Your Family

Measles is once again part of the conversation for many families. As cases and outbreaks occur across the United States, parents understandably have questions about how serious measles is, who is most at risk, and what they can do to protect their children.

My goal is to provide families with context so they can better understand the disease, recognize the potential risks, and make informed decisions about their child’s health.

Understanding Measles

Measles is a highly contagious respiratory illness caused by a virus. It typically begins with fever, cough, runny nose, and red or watery eyes. Several days later, a rash develops that generally begins on the face and spreads downward over the body.

A person with measles can spread the virus beginning approximately four days before the rash appears and continuing for about four days afterward. Because people can be contagious before the characteristic rash develops, measles can spread quickly among people who are susceptible.

Measles should be taken seriously. Many children recover without lasting complications, but complications can occur. Common complications include ear infections and diarrhea. More serious complications can include pneumonia and encephalitis, and in rare cases measles can result in death.

Children younger than five, adults older than 20, pregnant women, and people with weakened immune systems are at increased risk for serious complications.

Putting Risk in Context

When evaluating any illness, it is helpful to consider both the likelihood of an outcome and the potential severity of that outcome. Focusing on only one part of that equation can make it difficult for families to understand risk in context.

Before the measles vaccine became available in 1963, measles circulated widely in the United States. The CDC estimates that approximately 3–4 million Americans were infected each year. Of those cases, approximately 48,000 people were hospitalized and 400–500 died annually.

Medical care has changed substantially since that time, but measles can still cause serious illness today.

In 2025, 2,255 measles cases were reported in the United States. Three measles deaths were reported, and approximately 11% of patients were hospitalized.

These numbers provide useful perspective: most people who develop measles recover, but serious outcomes do occur. Individual risk can also vary based on age, underlying health conditions, immune status, vaccination status, exposure, and access to timely medical care.

Understanding Potential Complications

Some complications of measles are considerably more common than others.

Ear infections and diarrhea are among the more common complications. Pneumonia is a more serious complication and is one of the primary causes of measles-related death.

Approximately 1 in 1,000 people with measles develops acute encephalitis, or inflammation of the brain, which can result in permanent neurologic injury.

A very rare but serious long-term complication is subacute sclerosing panencephalitis (SSPE). SSPE is a progressive and fatal disease of the central nervous system that can develop years after a person has recovered from measles.

Researchers have also identified an effect sometimes referred to as “immune amnesia.” Measles infection can reduce some of the immune protection a person previously developed against other infections, potentially leaving them more susceptible to other illnesses for a period after recovering from measles.

Understanding these possibilities does not mean that every child who develops measles will experience complications. It does mean that families should monitor the illness carefully and maintain communication with their healthcare provider.

Measles Vaccination

The MMR vaccine is highly effective at preventing measles. According to the CDC, one dose is approximately 93% effective at preventing measles and two doses are approximately 97% effective.

Breakthrough infections can occur in vaccinated individuals, although they are uncommon. When measles does occur in someone who has been vaccinated, illness may be modified or milder.

Every family approaches healthcare decisions with its own circumstances, questions, and priorities. Parents who have questions about vaccination should discuss the benefits, risks, timing, potential exposure, and their child’s individual medical history with a qualified healthcare professional.

Supporting Your Child’s Overall Health

Regardless of vaccination status, supporting a child’s overall health remains important.

A strong foundation includes a nutrient-dense, whole-food diet with adequate protein, appropriate hydration, sufficient sleep, regular physical activity, and routine medical care. Families should also pay close attention to changes in their child’s condition during any significant illness.

If you believe your child has been exposed to measles or is developing symptoms, contact your healthcare provider promptly before arriving at an office, urgent care, or emergency department. Because measles is extremely contagious, calling ahead allows the medical facility to take appropriate precautions and reduce exposure to others.

Treatment and Vitamin A

There is currently no FDA-approved antiviral medication specifically for treating measles. Medical care is generally supportive, with complications such as pneumonia or secondary bacterial infections treated as needed.

Vitamin A may be used as part of the medical management of measles in infants and children under the supervision of a healthcare provider. Vitamin A does not prevent measles and is not a substitute for vaccination.

It is also important to recognize that excessive vitamin A can cause toxicity. High-dose vitamin A should therefore be used only with appropriate medical guidance.

Families should contact their healthcare provider if measles is suspected so that recommendations can be individualized based on the child’s age, symptoms, health history, and severity of illness.

Making Informed Healthcare Decisions

Parents are often faced with complicated healthcare decisions, and measles is no exception. Understanding the actual disease, how it spreads, the range of possible outcomes, and the options available for prevention and medical management can help families make thoughtful decisions.

My role as a pediatrician is to provide families with information, clinical guidance, and individualized care. Parents should feel comfortable asking questions and discussing their concerns with their healthcare provider.

In Summary

Measles is a highly contagious infection and deserves thoughtful attention. While many children recover, complications can occur, including pneumonia, encephalitis, immune effects, and, rarely, serious long-term complications or death.

Understanding how measles spreads, recognizing symptoms and potential complications, and knowing when to contact your healthcare provider can help families feel better prepared.

The goal is not fear. It is preparation, education, and informed decision-making.

 

Sources

Centers for Disease Control and Prevention (CDC)

https://www.cdc.gov/measles/hcp/clinical-overview/index.html

https://www.cdc.gov/measles/hcp/vaccine-considerations/index.html

Measles -United States 2025