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Measles infection

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 3 Jun 2025
Last updated: 11 Feb 2025

Summary

Definition

History and exam

Key diagnostic factors

  • potential exposure to measles
  • unvaccinated/incompletely vaccinated individuals
  • fever
  • cough
  • coryza
  • conjunctivitis
  • Koplik's spots
  • maculopapular rash
Full details

Risk factors

  • exposure to measles virus
  • no prior immunisation against measles
  • failure to respond to measles vaccine
Full details

Diagnostic investigations

1st investigations to order

  • measles-specific IgM and IgG serology (ELISA)
  • oral fluid
Full details

Investigations to consider

  • acute and convalescent sera for measles-specific IgG
  • measles RNA detection by PCR
  • antigen detection by fluorescent antibody or PCR techniques
  • isolation of virus in tissue culture system
Full details

Treatment algorithm

ACUTE

all patients

Contributors

Authors

Elizabeth Barnett, MD

Professor of Pediatrics

Boston University School of Medicine

Boston Medical Center

Boston

MA

Disclosures

EB receives clinical trial funds from Pfizer (COVID, PCV20, and RSV vaccines) and GSK (MMRV vaccine). She receives royalties from Elsevier (Immigrant Medicine), AAP (Nelson's antimicrobial therapy), and honoraria from AAP (Red Book). She participated in an Advisory Board (Sobi, RSV).

Peer reviewers

Sharon Nachman, MD

Professor of Pediatrics

Division Chief Pediatric Infectious Disease

State University of New York at Stony Brook

Stony Brook

NY

Disclosures

SN declares that she has no competing interests.

Linda Nield, MD, FAAP

Professor of Pediatrics

West Virginia University School of Medicine

Morgantown

WV

Disclosures

LN is an author of a reference cited in this topic.

Aisha Sethi, MD

Assistant Professor of Medicine

Associate Residency Program Director

University of Chicago

Chicago

IL

Disclosures

AS declares that she has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

McLean HQ, Fiebelkorn AP, Temte JL, et al; Centers for Disease Control and Prevention. Prevention of measles, rubella, congenital rubella syndrome, and mumps, 2013: summary recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2013 Jun 14;62(RR-04):1-34.Full text  Abstract

UK Health Security Agency. Measles: the green book, chapter 21. Dec 2019 [internet publication].Full text

Centers for Disease Control and Prevention. Child and adolescent immunization schedule: recommendations for ages 18 years or younger, United States, 2025. Nov 2024 [internet publication].Full text

Centers for Disease Control and Prevention. Adult immunization schedule: recommendations for ages 19 years or older, United States, 2025. Nov 2024 [internet publication].Full text

Committee on Infectious Diseases, American Academy of Pediatrics. Measles. In: Kimberlin DW, Banerjee R, Barnett ED, et al, eds. Red Book: 2024-2027 Report of the Committee on Infectious Diseases. 33rd ed. Itasca, IL: American Academy of Pediatrics; 2024.Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Measles infection images

  • Differentials

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  • Guidelines

    • Recommended child and adolescent immunization schedule for ages 18 years or younger, United States, 2025
    • Recommended adult immunization schedule for ages 19 years or older, United States, 2025
    More Guidelines

  • Patient information

    Measles, mumps, and rubella: should my child have the MMR vaccine?

    More Patient information
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