Measles Exposure: Symptoms, MMR Vaccine Questions, and What to Do Before You Come to the Office

Why you should call before coming in

Measles is not handled like a routine cold visit. If you think you or your child may have measles, or if you were told you were exposed, call before coming to the office in Upland or Rancho Cucamonga.

Calling first helps the care team:

• Decide whether you need urgent care, a same-day evaluation, vaccination advice, or monitoring at home.
• Give instructions for arrival if an in-person visit is needed.
• Reduce the chance of exposing babies, pregnant patients, people with weakened immune systems, and others in the waiting room.
• Coordinate testing or public health steps when appropriate.

If symptoms are severe, do not delay emergency care. Have someone call the emergency department before you arrive and say that measles is possible.

What measles symptoms usually look like

Measles often begins before the rash appears. Early symptoms can look like a respiratory infection, which is one reason calling ahead matters.

Common early symptoms include:

• Fever, sometimes high
• Cough
• Runny nose
• Red, watery eyes, also called conjunctivitis or “pink eye”
• Feeling very tired or unwell

Tiny white spots inside the mouth, called Koplik spots, may appear a few days after symptoms begin.

The measles rash usually appears 3 to 5 days after the first symptoms. It often starts as flat red spots on the face near the hairline, then spreads downward to the neck, trunk, arms, legs, and feet. Small raised bumps may also appear. Fever can rise when the rash appears.

Symptoms usually begin about 7 to 14 days after infection. CDC guidance for exposed people also notes that symptoms may appear 7 to 15 days after contact with the virus.

How measles spreads

Measles spreads through the air when an infected person breathes, coughs, or sneezes. The virus can remain in the air for up to 2 hours after a person with measles leaves the room.

A person with measles can spread it before they know they are sick. CDC describes the contagious period as starting 4 days before the rash appears and continuing through 4 days after the rash appears.

Measles is highly contagious. If a person has measles, many close contacts who are not immune may become infected. This is why suspected measles needs special instructions before an office visit.

What to do after a possible measles exposure

If you were near someone with confirmed measles, or someone with fever and rash who may have measles, call a healthcare professional right away. Do not wait for a rash to appear.

Be ready to share:

• The date, time, and place of possible exposure
• Whether you were in the same room, home, classroom, workplace, clinic, airport, plane, or event space
• Your symptoms, if any
• Your vaccination records, if available
• Whether you are pregnant, immunocompromised, or caring for an infant
• Recent international travel or contact with someone who traveled

A healthcare professional can help decide whether you are already considered immune, whether vaccination is appropriate, and whether any extra precautions are needed.

MMR vaccine questions after exposure

MMR stands for measles, mumps, and rubella. It is the main vaccine used to prevent measles.

After a measles exposure, timing matters:

• If a person is not immune and receives MMR vaccine within 72 hours of the first measles exposure, it may provide some protection or make illness milder.
• Some people at higher risk for severe measles may be considered for immune globulin, a medicine made from antibodies, within 6 days of exposure.
• MMR vaccine after exposure is not harmful for people who are eligible to receive it.

Do not assume you need a vaccine immediately without calling first, especially if you are pregnant, immunocompromised, severely ill, or unsure whether you already have immunity.

Who is usually considered protected against measles

CDC lists several types of evidence that can show immunity to measles. These include written documentation of adequate vaccination, lab evidence of immunity, lab confirmation of prior measles infection, or birth before 1957 for most adults.

For routine vaccination:

• Children are recommended to receive 2 doses of MMR: the first at 12 to 15 months and the second at 4 to 6 years.
• Adults without evidence of immunity generally need at least 1 documented MMR dose.
• Some adults need 2 documented doses if they do not have other evidence of immunity. This includes international travelers, healthcare personnel, students in post-high-school education, close contacts of immunocompromised people, and certain people at increased risk during an outbreak.
• International travelers should review MMR protection before travel. Infants 6 through 11 months may need an early MMR dose before international travel, followed by the routine series after the first birthday.

If you cannot find your vaccine record, a healthcare professional can help decide whether to look for records, do a blood test for immunity in some situations, or vaccinate if appropriate.

Who should not get MMR vaccine, or should wait

MMR is a live vaccine, which means some people should not receive it.

People should talk with a healthcare professional before MMR vaccination if they:

• Are pregnant or may be pregnant
• Have a weakened immune system from a medical condition or treatment
• Had a severe allergic reaction after a previous MMR or MMRV vaccine dose, or have a severe life-threatening allergy to a vaccine component
• Recently received blood products or a blood transfusion
• Have had another vaccine in the past 4 weeks
• Are moderately or severely ill at the time of vaccination
• Have a condition that causes easy bruising or bleeding
• Have tuberculosis

Breastfeeding alone is not a reason to avoid MMR vaccination, according to CDC guidance.

When measles symptoms need emergency care

Call 911 or go to the emergency department right away for severe symptoms. If measles is possible, have someone call before arrival.

Emergency warning signs include:

• Trouble breathing or breathing faster than normal
• Pain with breathing or coughing
• Signs of dehydration, such as very little urination, dry mouth, or no tears when crying
• Fever or headache that will not stop
• Confusion, decreased alertness, severe weakness, or unusual sleepiness
• Blue color around the mouth, low energy, or trouble feeding in a young child

Measles can lead to complications such as ear infection, diarrhea, pneumonia, and, rarely, inflammation of the brain called encephalitis. Babies and young children, adults older than 20, pregnant people, and people with weakened immune systems have higher risk for complications.

In San Bernardino County

San Bernardino County Public Health urges residents to stay up to date with measles vaccines. For an MMR dose, the county points residents to MyTurn.ca.gov and to its federally qualified health centers. For current local information, see the county’s measles page.

What to do if you only have vaccine questions

If you feel well and do not have a known exposure, MMR questions are usually not an emergency. You can review your vaccine record and schedule a routine visit through request a routine visit if you need help deciding whether you or your child is up to date. An annual check-up is also a good time to review your vaccines.

If you have symptoms or a possible exposure, call instead of scheduling a routine visit online. The next step may be different when measles is possible.

We see patients for this at our Upland and Rancho Cucamonga offices. Request a visit or call either office.