Feeling like there’s always one more thing to worry about as a parent?
You’re not alone. Between feeding, sleep schedules, and teething, your plate is already full. And now, hearing about a measles outbreak might have you wondering if your baby is at risk—and what you can actually do about it.
We totally get the worry. That’s why we went straight to the experts to get you clear, comforting answers. From spotting measles symptoms to understanding the measles vaccine schedule, here’s everything you need to know to feel more at ease—and keep your little one safe.
We consulted Dr. Karen Klawitter, MD, a board-certified pediatrician with over 25 years of experience, to guide us through your top questions about measles, measles symptoms, and how to protect your baby during a measles outbreak.
Should parents request early MMR vaccination during a measles outbreak?
Dr. Karen: The usual measles vaccine schedule recommends the vaccine be given between 12 and 15 months of age, with a second dose between the ages of four and six. During a measles outbreak or if you’re traveling to an area with an outbreak, parents should request an early MMR vaccine for babies as young as six months of age (keeping in mind this does not negate receiving the standard doses as described above). For those children who have received one dose of vaccine, a second one should be considered before age four years, as long as it has been 28 days between doses.
What does measles look like? How does the measles rash differ from other rashes?
Dr. Karen: The measles rash starts on the face and moves downward. It is distinguished by flat red- brown spots that typically begin on the face and hairline and move downward toward the feet, often coming together to form blotchy patches. This rash usually starts seven-14 days after measles exposure and 3-5 days after the onset of other prominent symptoms, including fever, runny nose, cough, and red watery eyes. This rash spreads gradually as the disease progresses, does not itch, and lasts about four to seven days.
The measles rash differs from other rashes.
- With chicken pox, the rash is characterized by itchy, fluid-filled blisters. These lesions go through stages as they develop and start on the face, back, and then chest. The rash typically lasts about a week and is considered contagious until all the lesions are crusted over.
- With roseola, this viral rash is most common in kids 6-12 months, and often starts following a few days of high fever. It appears as a pink, red flat rash, often beginning on the trunk. It commonly does not involve the lower extremities and is self-limiting, resolving in a few days.
- With fifth disease (slapped cheek disease), this viral rash often starts as a bright red, slightly raised rash on the cheeks and then spreads as a lacey pink-red rash to the trunk and extremities. Rash may be precipitated by mild URI symptoms. Once the rash appears, the virus is no longer contagious. The rash can last 7-10 days and can come and go for weeks.
- Teething rashes can look similar to measles rashes, but are more localized, and these babies do not have fevers.
What are the first measles symptoms parents should look for?
Dr. Karen: The early symptoms of measles include cold-like symptoms like cough, runny nose, red, watery eyes, and fevers as high as 103-104 degrees. Additionally, these kids may develop Koplik spots, small white spots inside the mouth, along the inner lining of the cheeks. Symptoms typically start 7-14 days after exposure to the measles virus.
How long should a baby stay home after a potential measles exposure?
Dr. Karen: The measles incubation period is 7-21 days after exposure, and a person is considered contagious four days before the rash starts to four days after it erupts. If a baby is exposed to measles and not vaccinated, the recommendation is that the child be quarantined for 21 days to prevent any possible spread. If the child is already showing symptoms, they should remain isolated for four days after the onset of the rash.
What should parents do if an unvaccinated adult wants to visit their baby during a measles outbreak?
Dr. Karen: Parents need to prioritize the baby’s safety first and discourage the unvaccinated adult from visiting. Consider delaying the unvaccinated adult visit until the baby is at least 6 months old to get at least one MMR vaccine. If the adult refuses, then minimize infant exposure to that adult— avoid direct and close contact, encourage face masks for the adult, and emphasize good handwashing. Communicate the highly contagious nature of measles to the adult and the risks to the baby. If the adult is ill, they should not visit until they are well again.
Can a baby get measles even if they’re partially vaccinated or recently breastfed?
Dr. Karen: Yes, complete protection is not achieved until two doses of the MMR vaccine, which is 97% protective against measles. A single dose of MMR provides about 85 % protection against measles. Breast-fed infants do have some partial immunity against measles, but this is very limited and usually wanes by the time the baby is 6-8 months old.
How do pediatricians assess measles risk for babies in daycare or public spaces?
Dr. Karen: Pediatricians need to assess several factors, including vaccine status of the babies (babies under 6months of age are most at risk), nature of exposure history (those with suspected or confirmed measles, and recent travel to outbreak areas) and potential for airborne transmission (measles is highly contagious and spreads thru the air — infected person coughing, talking etc – and it can linger in the air for up to two hours even if the infected person has left the area).
Are there any long-term effects of measles in infants?
Dr. Karen: Yes, 1 out of 1000 cases will develop encephalitis (swelling of the brain) – which can lead to seizures, deafness, developmental delays, or even death due to respiratory (pneumonia) or neurologic complications. Subacute sclerosing panencephalitis ( SSPE) is a rare, late-onset complication of measles infection. This is a degenerative and fatal neurologic disease presenting 7-11 years after the primary measles illness. It is most common in children who develop measles before the age of two years. Finally, there is something called immune amnesia after having the measles. Measles can reduce immune memory (up to 30 %) to other illnesses, leaving them vulnerable to other infections previously protected against. This generalized weakened immune system can last months or even years in some children.
Meet the expert
Dr. Karen Klawitter, MD – JustAnswer Pediatrician
Dr. Karen Ann Klawitter is a board-certified pediatrician with over 25 years of experience in diverse healthcare settings. A Loyola Stritch School of Medicine graduate, Dr. Klawitter completed her pediatric residency at Wright-Patterson AFB Medical Center. She currently provides global pediatric consultations via JustAnswer and serves at Community Health Northwest Florida.
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