The short answer
The first measles symptoms are a high fever, cough, runny nose and red, watery eyes, usually 7 to 14 days after exposure. Then, 3 to 5 days later, a red, blotchy rash starts at the hairline and spreads down the body. If you think you or your child has measles, call your doctor before you go in, so the office can protect other patients.
- First signs: fever (it can top 104°F), cough, runny nose, pink eye.
- Rash: flat red spots that begin on the face and move down to the feet.
- Contagious: from 4 days before to 4 days after the rash appears.
- Best protection: two MMR doses, which are about 97% effective, according to the CDC.
- 2026 so far: 4,410 confirmed US cases as of October 15, 2026.
4,410
US measles cases in 2026 (as of Oct 15)
96%
Of 2026 cases unvaccinated or status unknown
10%
Of 2026 cases hospitalized
97%
Protection from two MMR doses
In this article
Measles (also called rubeola) is a viral infection, caused by a virus in the morbillivirus family, that spreads through the air and is one of the most contagious diseases known. Because the early measles symptoms look a lot like a bad cold, many people do not suspect measles until the rash shows up. By then, however, they may have already spread it for several days.
This guide walks through measles symptoms in the order they usually appear, what the rash looks like, how the virus spreads, and what the current US numbers show. It also covers the MMR vaccine (the combined measles, mumps and rubella shot), what to do after an exposure, and the warning signs that mean you should get care right away. Everything here comes from the Centers for Disease Control and Prevention (CDC), the federal public health agency, and from MedlinePlus, the National Library of Medicine’s consumer health site.
What Are Measles Symptoms, Day by Day?
Measles symptoms follow a fairly predictable pattern: about one to two weeks of no symptoms, then fever and cold-like signs, then tiny white spots in the mouth, and finally the rash. In other words, the rash is a late sign, not the first one.
| When | What usually happens |
|---|---|
| First 7 to 14 days after exposure | No symptoms yet (the incubation period). CDC says symptoms usually begin 7 to 14 days after infection. |
| First 2–3 days of illness | High fever, cough, runny nose and red, watery eyes. Doctors call the last three the “three Cs”: cough, coryza and conjunctivitis. |
| 2–3 days after symptoms begin | Koplik spots: tiny white spots inside the mouth. |
| 3–5 days after symptoms begin | Rash starts as flat red spots at the hairline, then spreads to the neck, trunk, arms, legs and feet. Fever may spike above 104°F. |
| Rash phase | According to MedlinePlus, the rash may last 4 to 7 days and can itch. |
| 4 days after the rash appears | The contagious window usually closes. CDC advises staying home until the fifth day after the rash starts. |
What are the first signs of measles?
The first signs of measles are a high fever plus a cough, a runny nose and red, watery eyes. MedlinePlus also lists sore throat, muscle aches and sensitivity to light. At this stage, measles is easy to mistake for flu or a cold. So, if you know you were near someone with measles, or your community has an outbreak, mention that when you call your doctor.
What are Koplik spots?
Koplik spots are tiny white spots that can appear inside the mouth, usually on the inner cheeks, two to three days after symptoms begin. CDC’s clinical guidance describes them as a hallmark of measles. Not everyone notices them, though, so their absence does not rule measles out.
What Does the Measles Rash Look Like?
The measles rash starts as flat red spots on the face along the hairline, then spreads downward to the neck, trunk, arms, legs and feet over a few days. Small raised bumps can form on top of the flat spots, and the spots often merge into larger blotches as they spread, according to the CDC.
Where does the measles rash start?
The rash usually begins on the face at the hairline, then moves from head to toe. This top-down spread is one of the clearest clues. Also, the rash tends to arrive with a second spike in fever, so a child who seemed to be improving may suddenly look sicker.
Measles rash pictures: what to look for
If you want to compare a rash with real examples, the CDC keeps a gallery of measles photos, including pictures on lighter and darker skin. On darker skin, the redness can be harder to see, so the raised texture and the head-to-toe pattern matter more. Still, no photo can confirm measles. Instead, a doctor diagnoses it from the exam and, often, a lab test.
Pro tip. Take a dated photo of the rash each day and note when the fever started. That timeline helps your doctor or health department judge whether the pattern fits measles.
Measles in Adults, Kids and Babies
Measles symptoms are basically the same at every age, but the risk of serious illness is not. CDC lists children under 5, adults over 20, pregnant women and people with weakened immune systems as the groups most likely to develop complications.
Measles symptoms in adults
Adults get the same fever, cough, runny nose, red eyes and spreading rash. However, adults over 20 are a higher-risk group, and the 2026 numbers show it: CDC reports that 14% of adults 20 and older with measles this year were hospitalized, compared with 5% of children and teens ages 5 to 19. Because of that, adults with measles symptoms should call a doctor promptly rather than wait it out.
Measles symptoms in kids and babies
In children, the illness often starts with fever, fussiness, cough and pink eye before the rash. Young children carry the highest risk: in 2026, 15% of children under 5 with measles were hospitalized, according to the CDC case page. For babies and toddlers, watch closely for trouble breathing, poor feeding, low energy or a bluish color around the mouth, which CDC lists as emergency signs. For more on keeping little ones safe, see our summer safety tips for kids.
Can you get measles if you are vaccinated?
Yes, but it is uncommon. Two MMR doses are about 97% effective and one dose is about 93% effective, per the CDC. As a result, a small share of vaccinated people can still catch measles, especially after long, close contact. When that happens, CDC says symptoms are generally milder and vaccinated people are less likely to spread it. In 2026, 2% of US cases had one documented MMR dose and 2% had two.
How Does Measles Spread?
Measles spreads through the air when an infected person breathes, coughs or sneezes, and the virus can stay in the air of a room for up to two hours after that person leaves. Up to 90% of close contacts who are not immune will catch it, according to the CDC.
You can also pick it up by touching a contaminated surface and then touching your eyes, nose or mouth. Only humans spread measles; pets do not catch or carry it.
Is measles contagious before symptoms?
Yes. A person with measles can spread it from 4 days before the rash appears through 4 days after. Since the rash comes several days into the illness, people often spread measles while they think they only have a cold. That is why health departments trace contacts so quickly during outbreaks.
| Question | What CDC says |
|---|---|
| How does it spread? | Through the air (coughs, sneezes, breathing) and contaminated surfaces |
| How long does it linger in a room? | Up to 2 hours after the infected person leaves |
| Who catches it? | Up to 9 in 10 close contacts who are not immune |
| Contagious window | 4 days before to 4 days after the rash appears |
| Time from exposure to symptoms | Usually 7 to 14 days (CDC’s exposure page says up to 15) |
Measles 2026: How Many US Cases Are There?
As of October 15, 2026, the CDC counts 4,410 confirmed measles cases in the United States this year, reported by 47 jurisdictions plus 18 cases among international visitors. That is already almost double the 2,289 cases recorded for all of 2025, according to the CDC measles cases and outbreaks page, which updates weekly.
| Measure | 2024 | 2025 (full year) | 2026 (as of Oct 15) |
|---|---|---|---|
| Confirmed cases | 285 | 2,289 | 4,410 |
| Outbreaks (3+ related cases) | 16 | 48 | 42 new |
| Share of cases linked to outbreaks | 69% | 90% | 96% |
| Unvaccinated or unknown status | – | 93% | 96% |
| Hospitalized | – | 11% (244) | 10% (451) |
| Confirmed deaths | – | 3 | 3* |
By age, 17% of 2026 cases are children under 5, 42% are ages 5 to 19, and 41% are adults 20 and older. Meanwhile, measles keeps arriving through travel too, since it still circulates in many countries.
Has the US lost its measles elimination status?
Not officially, as of this writing. The US declared measles eliminated in 2000. However, after the large outbreaks that began in 2025, the Pan American Health Organization (PAHO), the World Health Organization’s regional office for the Americas, said its commission will review US elimination status at its regular meeting in November 2026, according to a March 2026 PAHO update. Your state health department has the most current local outbreak details.
Why Measles Is More Than a Rash
Measles can cause serious complications, from ear infections to pneumonia and brain swelling, which is why doctors do not treat it as just a rash. According to CDC, about 1 in 5 unvaccinated people in the US who get measles ends up in the hospital.
| Complication | How often (CDC) |
|---|---|
| Ear infection | About 1 in 10 children with measles |
| Diarrhea | Fewer than 1 in 10 people with measles |
| Pneumonia | Up to 1 in 20 children; the most common cause of measles death in young children |
| Encephalitis (brain swelling) | About 1 in 1,000 children; can cause seizures, deafness or intellectual disability |
| Death | Nearly 1 to 3 of every 1,000 infected children |
| SSPE (fatal brain disease years later) | Very rare; usually 7 to 10 years after infection |
Measles can also cause what researchers call “immune amnesia.” In short, the virus can damage immune cells that remember past infections, which may leave a person more vulnerable to other germs for months or even a few years. In pregnancy, measles raises the risk of premature birth and low birth weight, CDC notes.
The MMR Vaccine: Who Needs It and When?
CDC recommends two doses of MMR vaccine for children, at 12–15 months and at 4–6 years, and at least one documented dose for most adults. Some adults need two doses. The MMR vaccine protects against measles, mumps and rubella, and two doses are about 97% effective against measles, according to the CDC vaccination page.
MMR schedule for children
- First dose: 12 through 15 months old.
- Second dose: 4 through 6 years old (it can come earlier, at least 28 days after the first).
- MMRV option: children 12 months through 12 years can get MMRV, which adds chickenpox protection.
- Before international travel: babies 6 through 11 months should get an early dose, then the usual two doses after their first birthday.
Do adults need an MMR booster?
Most adults do not need a measles booster if they have one documented MMR dose or other evidence of immunity. That evidence includes written vaccination records, a lab test showing immunity, lab-confirmed past measles, or birth before 1957. CDC states that there is no general catch-up program for a second adult dose, and it does not recommend a third dose during outbreaks, per its guidance for specific groups.
However, CDC does recommend two doses for some adults who lack other evidence of immunity:
- College and other post-high school students
- Healthcare workers
- International travelers
- Close contacts of people with weakened immune systems
- People living with HIV who are not severely immunocompromised
- Anyone health officials identify as at higher risk during an outbreak
One more group deserves a look: fewer than 5% of adults may have received a killed (inactivated) measles vaccine between 1963 and 1967. CDC advises revaccinating anyone who got that vaccine, or a vaccine of unknown type, in those years. If you are unsure about your records, ask your doctor or pharmacist; you can also check your state’s immunization registry. And if you are planning a trip abroad, CDC advises being fully vaccinated at least 2 weeks before you leave, per its travel guidance.
Who should not get the MMR vaccine (or should wait)?
CDC says some people should check with a healthcare provider first or postpone vaccination. These include people who:
- Had an allergic reaction to a previous MMR or MMRV dose, or have severe, life-threatening allergies
- Are or may be pregnant (CDC advises waiting until after pregnancy and avoiding pregnancy for at least 1 month after the shot)
- Have a weakened immune system from disease or treatment
- Recently had a blood transfusion or other blood products
- Have tuberculosis, got another vaccine in the past 4 weeks, or are currently very sick
For most people, side effects are mild: a sore arm, fever, a mild rash or temporary joint stiffness. Serious reactions are rare. In addition, CDC states that scientists in the US and other countries have studied MMR carefully and found no link between the vaccine and autism.
What to Do If You Were Exposed to Measles
If you were around someone with measles, call your healthcare provider right away, before showing up in person. According to the CDC, your provider can check whether you are immune and, if you are not, discuss options that may lower your risk.
- Check your immunity: find your vaccination records or ask your provider about a blood test.
- Ask about MMR within 72 hours: CDC says an MMR dose given within 72 hours of exposure may give some protection or a milder illness.
- Ask about immune globulin within 6 days: for people at high risk of severe disease, such as babies, pregnant women or people with weakened immune systems, a medicine called immune globulin may help.
- Watch for measles symptoms for 21 days: if you are not immune and do not get protection after exposure, CDC says you may be able to spread measles for up to 21 days after contact, so avoid schools, hospitals and childcare centers.
- Call ahead if you get sick: the office can arrange to see you without exposing others.
Watch out. Do not walk into a clinic waiting room or ER unannounced if you think you have measles. Call first, or have someone call for you, so staff can protect babies and other patients who cannot be vaccinated.
When to Call a Doctor or Go to the ER
Call your doctor as soon as you notice measles symptoms or learn you were exposed. Go to an emergency department right away if symptoms get rapidly worse or any of the warning signs below appear, the CDC advises.
- Trouble breathing, or breathing faster than normal
- Pain when breathing or coughing
- Signs of dehydration: dry mouth and nose, peeing less, crying without tears
- A fever or headache that will not stop
- Confusion, less alertness or severe weakness
- In young children: a blue color around the mouth, low energy or trouble feeding
Call 911 for any life-threatening emergency. Also, have someone call the hospital before you arrive so staff can bring you in safely.
How Is Measles Treated?
There is no specific antiviral treatment for measles, so care focuses on easing measles symptoms and catching complications early. According to MedlinePlus, comfort measures include rest, fluids, humidified air and fever relief. Your doctor can tell you which fever reducer is right for your child’s age and weight.
MedlinePlus notes that some children may need vitamin A under medical care, mainly those who do not get enough of it. However, it also warns that vitamin A does not prevent measles and that too much can cause serious harm, including liver damage. So, never give vitamin A for measles without a doctor’s direction. Meanwhile, rest matters for recovery; our guide on {L_INT2} has practical tips for adults recovering from any illness.
Our verdict
Measles symptoms start like a heavy cold: fever, cough, runny nose and red eyes, followed by a rash that moves from the hairline down. Because people spread measles before the rash appears, the most useful thing you can do is know your vaccination status now, not after an exposure.
If you have two documented MMR doses, your protection is strong. If you are not sure, ask your doctor. And if measles symptoms do show up, call ahead before you go in, then watch closely for breathing trouble, dehydration or confusion.
Frequently Asked Questions
What are the first signs of measles?
The first measles symptoms are a high fever, cough, runny nose and red, watery eyes, usually 7 to 14 days after exposure. Tiny white spots called Koplik spots may appear inside the mouth two to three days later. Then the rash begins, typically 3 to 5 days after the first symptoms, starting at the hairline and spreading down the body.
Can you get measles if you are vaccinated?
Yes, but it is uncommon. CDC says two MMR doses are about 97% effective against measles and one dose is about 93% effective. Some vaccinated people still get infected, often after long, close contact. When that happens, symptoms are generally milder and they are less likely to spread the virus. In 2026, about 4% of US cases had one or two documented doses.
Do adults need an MMR booster?
Most adults with one documented MMR dose, lab proof of immunity, or birth before 1957 do not need another dose, according to CDC. However, CDC recommends two doses for college students, healthcare workers, international travelers and close contacts of immunocompromised people who lack other proof of immunity. Adults who got the killed measles vaccine from 1963 to 1967 should be revaccinated. Ask your doctor about your records.
How long is measles contagious?
A person with measles can spread it from 4 days before the rash appears through 4 days after it appears. CDC advises staying home until the fifth day after the rash starts. Because the virus can linger in the air for up to two hours, people can catch measles in a room even after the sick person has left. Up to 90% of non-immune close contacts get infected.
What should I do if I was exposed to measles?
Call your healthcare provider right away, before visiting in person. They can check whether you are immune. If you are not, CDC says an MMR dose within 72 hours of exposure may offer some protection, and immune globulin within 6 days may help people at high risk. Watch for measles symptoms for 21 days, and avoid schools, hospitals and childcare centers during that time.
How many measles cases are there in 2026?
As of October 15, 2026, CDC reports 4,410 confirmed measles cases in the United States in 2026, from 47 jurisdictions plus 18 international visitors. That is nearly double the 2,289 cases in all of 2025. About 96% of 2026 cases were unvaccinated or had unknown vaccination status, and about 10% of patients were hospitalized. CDC updates the count weekly.
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By Elizabeth Brown, health and wellness writer. Sources: CDC, MedlinePlus (National Library of Medicine), PAHO. Last reviewed for accuracy: October 21, 2026.
Disclaimer: This article is for general information only and is not medical advice. It does not replace diagnosis or treatment from a qualified healthcare provider. If you think you or your child has measles or was exposed, contact your doctor or local health department. In an emergency, call 911.
