How is measles spread?

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Last updated: June 22, 2025View editorial policy

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From the Guidelines

Measles is primarily spread through direct contact with infectious droplets or by airborne transmission when an infected person breathes, coughs, or sneezes. The virus can remain active and contagious in the air or on surfaces for up to two hours after an infected person has left the area, as noted in the study published in the Journal of Environmental Sciences (China) 1. Measles is highly contagious, with about 90% of non-immune people developing the disease after exposure to someone infected, according to the Centers for Disease Control and Prevention (CDC) 1.

Key Points About Measles Transmission

  • The virus initially infects the respiratory tract before spreading throughout the body
  • A person with measles can transmit the virus from four days before the characteristic rash appears until four days after the rash erupts, making it particularly challenging to control, as stated in the MMWR Recommendations and Reports 1
  • The best protection against measles is vaccination with the MMR (measles, mumps, rubella) vaccine, which is typically given to children in two doses, first at 12-15 months and again at 4-6 years of age, as recommended by the Advisory Committee on Immunization Practices (ACIP) 1
  • This vaccination provides long-lasting immunity and has significantly reduced measles cases worldwide, with the ACIP considering the newly approved PRIORIX vaccine to be safe, immunogenic, and noninferior to M-M-R II 1

Preventing Measles Transmission

To prevent the spread of measles, it is essential to follow airborne infection–control precautions, implement other infection-control measures, and maintain high measles, mumps, and rubella vaccination coverage, as emphasized in the study published in Morbidity and Mortality Weekly Report 1. By taking these measures, we can reduce the risk of measles transmission and protect vulnerable individuals, particularly those who are not immune to the virus.

From the Research

How Measles is Spread

  • Measles is a highly contagious viral disease transmitted by aerosols through human-to-human contact 2.
  • The disease is spread through the respiratory mode, with fever combined with cough, coryza, or conjunctivitis being the first manifestations of the disease 3.
  • Measles can be transmitted by:
    • Direct contact with infected individuals
    • Indirect contact with contaminated surfaces or objects
    • Through the air when an infected person coughs or sneezes
  • The virus can remain active and contagious on surfaces or in the air for up to two hours 4.
  • Measles is highly transmissible, with a basic reproduction number of 12-18, meaning that one infected person can spread the disease to 12-18 others in a fully susceptible population 5.
  • The disease can spread quickly in areas with low vaccination rates or where people are not immune to the virus 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

History of measles.

Presse medicale (Paris, France : 1983), 2022

Research

Measles pneumonitis.

Advances in respiratory medicine, 2019

Research

Measles.

Lancet (London, England), 2022

Research

What's going on with measles?

Journal of virology, 2024

Research

Measles: a disease often forgotten but not gone.

Hong Kong medical journal = Xianggang yi xue za zhi, 2018

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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