Measles is a viral respiratory illness with symptoms that typically appear 7 to 14 days after contact with the virus. Typical symptoms include fever, cough, runny nose, and red, watery eyes. A rash starts on the face 3 to 5 days after the first symptoms and spreads to other parts of the body. 

• Measles can cause serious health complications, especially in children younger than 5 years of age. Common complications are ear infections and diarrhea. Serious complications include pneumonia, encephalitis (swelling of the brain), and death. 
• The measles virus causes long-term damage to the immune system, reducing previously acquired immunity to other infections. This "immune amnesia" means children who have had measles may have an increased risk of illness from other diseases for years following their measles infection. 
• One rare long-term sequela of measles virus infection is subacute sclerosing panencephalitis (SSPE), a fatal disease of the central nervous system that generally develops 7 to 10 years after infection. 

Measles spreads quickly through the air when an infected person coughs or sneezes. If one person has it, up to 9 out of 10 people nearby will become infected if they are not protected. Because of its very contagious nature, it is recommended that people stay home and contact their medical provider if they suspect they have measles. A person with measles can spread the infection up to 4 days before their rash starts through 4 days after it starts. 

The measles, mumps, and rubella (MMR) vaccine is the best protection against measles. “We have a vaccine that is 97% effective against measles after two doses,” said Dr. Ellis Matheson, Public Health Director for Buncombe County Health and Human Services. “I urge everyone to check their vaccination or immunity status and to get vaccinated as soon as possible if needed.”

Populations:

• Children: should get two doses of the MMR vaccine, one at 12 – 15 months of age and another at 4 – 6 years of age, before they enter kindergarten.
• Adults: Adults born in or after 1957 should have at least one dose of a measles-containing vaccine (unless they have other proof of immunity). People born before 1957 have presumptive evidence of immunity against measles. This is due to the large spread of measles before the vaccine was developed. If you are concerned that you may not have immunity, please consult with your medical provider.
  • Two doses of a measles-containing vaccine are recommended for the following adults:
    • Students at post-high school educational institutions
    • Healthcare personnel
    • Household and close contacts of immunocompromised people
    • People with HIV who are not severely immunosuppressed
• People traveling in the U.S. or to other countries:
  • Children older than 1 year of age and adults traveling outside the U.S. or to an area of the U.S. where there is a measles outbreak should have 2 doses of MMR vaccine at least 28 days apart (or other proof of immunity – see below)
  • Infants 6 - 11 months of age who will be traveling outside the U.S. or to an area of the U.S. where there is a measles outbreak should have 1 dose of the MMR vaccine.
  • To protect against measles while traveling, these vaccines need to be completed at least 2 weeks before travel.

• Doctor or healthcare provider's office
• Local pharmacy (check for availability)
• Brunswick County Health Services Immunization Clinic: Call 910.253.2250 to make an appointment
• Uninsured children can be vaccinated at low or no cost through the Vaccines for Children program, which offers free vaccines to children up to the age of 19. 

Two doses of the MMR vaccine are 97% effective at preventing measles. One dose is about 93% effective at preventing measles. 

The MMR vaccine has been used for over 50 years and has an excellent safety record. Most people have no side effects. When they do occur, they are usually mild, such as a sore arm or low-grade fever. 

Generally, the MMR (measles, mumps, and rubella) vaccine is recommended for children one year old and older. 

Due to the increase in measles cases in North Carolina, early vaccination for infants 6-11 months of age living or spending time in an area with ongoing community measles transmission is now recommended. It is also recommended for those with plans to travel internationally or to areas in the U.S. with current measles outbreaks. 

All infants vaccinated before 12 months of age will still need to receive two additional doses of MMR after 12 months of age.

Talk to your primary care provider to determine if early vaccination is right for your infant and ensure they are up to date on their vaccinations for other illnesses.

A person is considered immune to measles if they have written records that show at least one of the following:

• Two (2) doses of measles-containing vaccine* (see below) if they are —
  • A school-aged child (grades K – 12), or
  • An adult who will be in a setting that poses a high risk for measles, including students at post-high school education institutions, healthcare personnel, and international travelers
• One (1) dose of measles-containing vaccine*(see below) if they are —
  • A child older than 12 months of age who has not yet entered school, or
  • An adult who will not be in a high-risk setting for measles transmission (see above)
• Lab confirmation of immunity to measles (such as a positive IgG antibody test or titer)
• Lab confirmation of measles disease (such as testing done at the time of infection)
• They were born before 1957** (see below)

Check your immunity to measles with this simple tool, but always consult with your doctor if you have a question.

*Measles-containing vaccine: Individuals who received a dose of MMR vaccine in 1963–1967 and are unsure which type of vaccine it was or are sure it was an inactivated (killed) measles vaccine, should receive one (1) dose of MMR if low-risk or two (2) doses of MMR if they will be in a high risk setting as defined above.

**If someone was born before 1957, they are considered immune to measles because they lived through several years of measles epidemics before a vaccine was available, making it very likely they had or were exposed to measles. 

• Check with your vaccination provider or the Brunswick County Immunizations Clinic. Your provider can check the North Carolina Immunization Registry.
  • In Brunswick County, contact the Brunswick County Immunization Clinic at 910.253.2250.
• Check school or military records. Most K-12 schools, colleges, and universities keep student vaccine records on file. Records may be on file for a year or two after graduation or transfer.
• Check your family records. You may have kept vaccine records in baby books, camp applications, or old medical records.
• Got a vaccine out of state? Find out if a state has a vaccine database like North Carolina. If so, your previous provider may be able to access your records there.

Note: If you don't have a record of previous vaccinations, you're considered susceptible to disease. You will need to get vaccinated again. It's not harmful to get additional vaccine doses.

1. Stay home
2. Check your immunity to measles with this simple tool. 
3. If you don’t have a copy of your vaccine record, ask your family, call your healthcare provider, or contact your local health department to get it.
   • In Brunswick County, call the Brunswick County Immunization Clinic at 910.253.2250
   • See these other tips on getting your vaccine record. 
4. If you are not immune to measles and have been exposed to someone with measles, call Brunswick County Communicable Disease staff at 910.253.2250 for guidance. A 21-day quarantine from the date of exposure is required for individuals who have been exposed and are not immune to measles.

1. Stay home and away from others.
2. Call your healthcare provider. Do not go to a medical clinic, urgent care, or emergency department without calling first to avoid exposing others. 
   • If you do not have a healthcare provider, call Brunswick County Communicable Disease staff at 910.253.2250.
3. You will be guided on testing, care, and when it is safe to return to work or school.

• Measles titers are not currently recommended by the CDC or NC DHHS unless you are a healthcare worker in an area of exposure and do not have proof of immunity. 
• If you have questions regarding testing for measles immunity, please reach out to Brunswick County Health Services at 910.253.2250.

Yes, but getting measles if you've been vaccinated is rare. If this happens, symptoms are usually milder. One dose of the MMR vaccine is about 93% effective at preventing measles. Two doses are about 97% effective.

Vitamin A cannot prevent measles. The MMR vaccine is the best way to protect against measles. 

Only take vitamin A when directed by a health care provider. Providers may give vitamin A to some people diagnosed with measles as part of their care plan.

About vitamin A:

• Most people get enough vitamin A in their diet through foods like:
  • Vegetables (carrots, bell peppers, and broccoli)
  • Fish and chicken
  • Yogurt
• You can take too much vitamin A, known as toxicity, since it builds up in the body over time. In pregnancy, vitamin A toxicity can cause birth defects. 

Symptoms of vitamin A toxicity:

• Dizziness
• Blurred vision
• Nausea and vomiting
• Headache

Measles typically starts with a cough, runny nose, and red eyes. It often leads to a rash and fever above 101 degrees Fahrenheit. If you think you have measles, get medical care.

Don't delay: Symptoms can get worse over time, leading to complications and even death.

Seek emergency medical care immediately if you have any of these signs:

• A hard time breathing or breathing faster than normal
• Signs of severe dehydration (dry nose and mouth, urinating less than usual)
• Confusion, decreased alertness, or severe weakness

For young children:

• A blue color around the mouth
• Crying without making tears
• Unusually low energy
• Severe loss of appetite

In the event of an emergency, call 911. Let the 911 telephone dispatcher know that you have measles.