Treatments
There is no antiviral medicine that cures measles. Aim to keep your child comfortable and hydrated and watch closely for complications while the illness runs its course, usually over about 10-14 days.
If you think your child has measles, call the clinic before you come in. Measles is so contagious that we need to plan the visit to avoid exposing other families in the waiting room.
Seek care now
Call us right away or seek emergency care if your child:
• Has trouble breathing, is breathing fast, or is wheezing or grunting — a sign of possible pneumonia, the most common serious complication.
• Shows signs of dehydration — dry mouth, no tears when crying, far fewer wet diapers, sunken eyes, or unusual sleepiness.
• Has a very high fever (up to 104°F) that won't come down, or any fever in a baby under 3 months.
• Has a stiff neck, severe headache, confusion, extreme drowsiness, is hard to wake, or has a seizure.
• Seems to improve and then gets worse again. A returning fever or new ear pain can mean a secondary infection.
• Is under 12 months old, is immunocompromised, or was recently exposed to a known measles case — call promptly for advice, as early treatment can sometimes help.
The everyday plan
For a child whose care is being managed at home under your pediatrician's guidance, a few things matter most:
1. Keep fluids going. High fever increases fluid needs. Offer small, frequent sips of water, milk, or an oral rehydration drink; popsicles and smoothies help too. Staying hydrated is the single best home defense against needing hospital care.
2. Manage fever and aches. Weight-based acetaminophen or ibuprofen brings the fever down and helps your child rest. Never give aspirin.
3. Ask about vitamin A. The CDC and the American Academy of Pediatrics recommend vitamin A as part of supportive care for children with measles, given as two doses under a clinician's direction. It is not a cure, does not prevent measles, and too much is harmful — so give it only if and how your pediatrician prescribes it.
4. Rest and isolate. Keep your child home and away from others — especially unvaccinated people, infants, pregnant people, and anyone immunocompromised — until your clinician says it's safe.
What to expect
Days 1-4 (before the rash) — High fever, cough, runny nose, and red, watery eyes that build over a few days. Tiny white Koplik spots may appear inside the mouth two to three days in.
Days 3-5 (the rash) — A blotchy red rash appears at the hairline and face and spreads down the body. Fever often peaks as the rash comes out, and this is usually when children feel the worst.
Day 7 and beyond — The rash fades in the order it appeared and the fever settles; a cough can linger a while. Most children recover fully about 10-14 days from the first symptoms.
Contagiousness and returning to school
Measles spreads through the air and on surfaces, and the virus can hang in a room for up to two hours after an infected person leaves. Children are contagious from about four days before the rash appears through four days after it appears. Per CDC guidance, a child should stay home and away from others until at least four full days after the rash first appeared, and until they are fever-free and feeling well. Because of the public-health impact of measles, your clinic and local health department may give specific isolation instructions. Follow those, and check your childcare or school policy as well.
If treatment isn't working — Call us right away if your child's breathing becomes fast or labored; a high fever returns after improving; they develop ear pain or ongoing vomiting; they become confused, unusually sleepy, or hard to wake; or they show any sign of dehydration. These can signal pneumonia, an ear infection, or (rarely) brain inflammation, and need prompt medical care.
FAQs answered by a pediatric expert
Answered by Matthew Hornik, DO
Pediatrics
