Symptoms of measles


Measles is a highly contagious infectious disease that usually occurs in childhood and is caused by the measles virus. Once the disease is over, it leaves you with lifelong immunity - you will never get it again. Since the virus only affects humans, the goal of the World Health Organization is to eradicate the virus through a nationwide vaccination. However, due to varying vaccination rates, this goal has not yet been achieved and will continue to cause problems in the future.

Symptoms in Children

With measles a distinction is made between a precursor and a main stage of the disease, in which different symptoms occur. Flu-like symptoms such as tiredness, exhaustion, headache and abdominal pain and a high fever are typical of the preliminary stage. In addition, there is inflammation of the mucous membranes and the upper respiratory tract as well as characteristic changes in the mucous membranes. As part of this inflammation of the mucous membranes, the conjunctiva of the eyes is often affected. As a result, bronchitis, conjunctivitis and the so-called head spots on the inside of the cheek often occur.

Approx. Two weeks after infection, the main stage of the measles rash occurs, which is preceded by reddening of the mucous membrane on the palate one or two days beforehand. The rash appears as spotty-nodular (maculo-papular) described. The exanthema (rash) begins behind the ear, spreads from there over the entire body and goes back after about four to five days. The rash is due to virus-related damage to blood vessels. The blood vessels become more permeable and the skin becomes red. Concomitantly, there is often swelling of the lymph nodes, which is also known as lymphadenopathy.

Read more on this topic at: Measles rash such as Viral rash

Symptoms in adults

Measles is actually considered a childhood disease, but in recent years an increasing shift of the disease into adulthood has been observed. Today almost 40% of measles patients are over 20 years old. This phenomenon can be explained by so-called vaccine picking. When there was no vaccination, you couldn't avoid measles as a child because it is highly contagious. As a result, as an adult, one was already immune. Since the vast majority of children are vaccinated today, the disease no longer inevitably breaks out in childhood in those who are not vaccinated.

The symptoms in adults are the same as in children and the typical course is very similar. However, the disease is more severe in adults than in children, which manifests itself in a faster progression and a significantly higher rate of complications. More details on the complications can be found in the History section.

Read more about: Measles in adults

Symptoms of measles

Rash as a symptom of measles

The measles disease has two phases. First comes the prodromal or initial stage, which lasts about three to seven days. This is followed by the rash stage typical of measles. Exanthema means skin rash. The stage often begins with reddening in the area of ​​the soft palate, i.e. in the area of ​​the oral mucosa. When it appears on the oral mucosa, one does not speak of an exanthem but of an enanthem. Then the spotty, nodular rash also spreads on the skin. The light red dots are about 5 mm in size and flow into one another (confluence). The rash typically starts behind the ears (retroauricular) and spreads all over the body within 24 hours. Only the palms and soles of the feet are not affected. After a few days, the spots are no longer red but turn brown-purple in color, only to fade completely after four to seven days. Skin flaking often occurs at the same time. The patient is considered no longer infectious when the rash is completely gone.

Read more on the topic: Colpic spots

Cough as a symptom of measles

Especially during the first phase of the disease, in which no skin rash has appeared, coughs and runny nose can occur. Inflammation of the conjunctiva with reddening of the eyes is also common. One speaks here of the prodromal or initial stage. It lasts for three to seven days and is followed by the exanthema stage.

Itching as a symptom of measles

Measles is not typically associated with itching. However, in some children it is associated with the rash. For example, applying a lotion several times a day can help relieve itching. Cool compresses with yogurt are also said to have a soothing effect. Especially during the night it may be necessary to put on light cotton gloves for the children to prevent them from scratching their sores due to the itching. If these measures don't help, ask your pediatrician for advice.

You may also be interested in this topic: Itchy Rash - What Disease Is It?

Symptoms of Measles Despite Vaccination?

Shortly after a vaccination, some children develop so-called vaccination measles. About 5-15% of children are affected; the vaccine measles occurs most frequently after the first of the three measles, mumps and rubella combination vaccinations. There is a slight fever, a slight rash and sometimes symptoms in the respiratory tract, such as coughing. However, it is not the real measles, but only a very weakened form. It doesn't have life-threatening complications like real measles. The vaccine measles usually appear in the second week after the vaccination.

Also read our topic: Rash After Vaccination - What Causes It?

Symptoms of meningitis from measles

One of the dreaded complications of measles is inflammation of the meninges and brain (Meningoencephalitis). It develops within a few days after the rash starts. Fever, headache, stiff neck, vomiting and impaired consciousness up to coma occur. Epileptic seizures can also occur. In Germany there are fewer than 10 cases of the disease per year. Only children who have not been vaccinated against measles are affected. Measles meningoencephalitis is fatal in 15-20% of cases and permanent damage to the brain occurs in up to 40%.

Diarrhea as a symptom of measles

Diarrhea is not a typical symptom of measles. However, it occurs as a complication in around 8% of children. The diarrhea is not dangerous. The affected child should drink enough fluids and - as is generally the case with measles - take it easy.

Duration of symptoms of measles

The measles disease is divided into two phases. The first phase, the prodromal stage, lasts about three to seven days. The second phase, the exanthema stage, lasts about four to seven days. The symptoms last for one to two weeks, with cough, runny nose, fever and fatigue being dominant in the first phase and the rash being dominant in the second phase.

incubation period

The word comes from Latin incubare, What hatch means. Under incubation period This means the period between the pathogen penetrating the body and the onset of the first symptoms. This period is due to the fact that only a few pathogens enter the body and cannot have a great effect on their own. This means that they only multiply locally at their place of penetration before they attack the target organs via the bloodstream. There the disease continues to multiply and there is a visible outbreak until that immune system can effectively fight the intruder. The incubation period is characteristic of different pathogens and can vary widely from a few hours to many years. The incubation period for measles is included 8-10 days until the precursor stage and 14 days until the onset of Exanthema.

Course of the disease

Most measles cases run smoothly and in two phases from. The first phase is called Initial / prodromal or in German Precursor stage. When this phase begins, one has usually been infected with the pathogen for 10 to 14 days. It is typical of prodromal stages that the symptoms that occur are quite uncharacteristic of a particular disease. So is also with measles especially over flu-like symptoms like tiredness, exhaustion, headache and Sore throat such as nausea and high fever sued. Typical of measles, however, are Inflammation of the mucous membranes (Conjunctiva of the eyes, Oral cavity and upper respiratory tract). By the end of the stage the fever returns to normal.

The Main or exanthema stage announces itself with another steep rise in fever and the typical skin rash that starts behind the ears and spreads to the rest of the body. In uncomplicated cases, the rash subsides after a few days and recovery is rapid. You are now immune to the measles pathogen for life.

However, not all processes follow this typical scheme. In patients with immunodeficiency atypical courses are not uncommon, for example the rash may be missing, one then speaks of white measles. Since the immune system does not work properly in these patients (through HIV, congenital immune defects, Tumors or Medication) the courses are often more difficult, protracted and more often fraught with complications. However, atypical courses can also occur in other situations, for example in infants who receive maternal antibodies (Loan immunity) or patients who receive antibody preparations from outside. The course of the disease is then weakened.

In addition to the typical and atypical course, complications can occur especially in very young people or adults. There are relatively common complications such as Middle ear or Pneumonia (approx. 6-7%) and relatively rare ones like that Meningoencephalitis (about 0.1%) and the subacute sclerosing panencephalitis (SSPE; <0.1%). The fatality (Lethality) the measles is loud Robert Koch Institute at 1: 1000, with pneumonia (pneumonia) is the leading cause of death. It manifests itself mainly in the form of a breathing disorder up to Shortness of breath.

Meningoencephalitis is an inflammation of the Brain and the Meninges. It begins about three to eleven days after the rash occurs with fever, headache, stiff neck, vomiting and impaired consciousness. It is fatal in 15-20% of cases and permanent damage remains in 20-40% of cases. SSPE is a late complication and can occur up to 10 years after the disease. It has three stages, one with mental disorders and one dementia marked phase. There follows a stage with Muscle spasms and epileptic seizures and finally severe damage to the Cerebrum. This complication is fatal in 95% of cases.

How high is the risk of infection?

The risk of infection with measles is extremely high. The measles virus is transmitted via droplets and thus over the air. The contagiousness through the air can be up to 100 percent be. Since the infectiousness already exists before the onset of the typical exanthema, the transmission can also occur in contact with apparently healthy people. Due to the high level of contagiousness, everyone should be vaccinated against measles. This is also important in order to protect children who are not yet of the age of vaccination against infection.


The diagnosis is made by the typical clinical picture and using a Antibody detection in blood. This Blood test is advisable because the diagnosis based on the clinical picture can be faulty. Because the disease is becoming increasingly rare and there are also many untypical courses that can lead to misdiagnosis.


There is no therapy that combats the cause of measles. The disease merely becomes symptomatic treated. That is, drugs are used that relieve symptoms without addressing the cause.


Prophylactic offers one two vaccinations lifelong protection against measles.

The vaccination is recommended for small children between the ages of 11 and 14 months, but it can also be used in adults without any problems.