Measles

WHAT IS MEASLES

Measles is a highly contagious viral infection. Anyone who is not protected against measles is at risk. Two doses of MMR vaccine provide the best protection against measles.

See below on this page for:

• Signs and symptoms
• Current case information
• Prevention recommendations
• Local testing information
• Treatment information
• Other resources

HISTORY OF MEASLES

Measles became a nationally notifiable disease in 1912. In the first decade of reporting, an average of 6,000 measles-related deaths were reported each year. 

In the decade before vaccine development, nearly all children got measles by the time they were 15 years old. It is estimated 3 to 4 million people in the United States were infected each year. Among reported measles cases each year, an estimated:

• 400 to 500 people died
• 48,000 were hospitalized
• 1,000 suffered encephalitis (swelling of the brain)

A vaccine was first licensed in the US in 1963. In 1968, an improved measles vaccine began to be used, and continues to be used today -- combined with mumps and rubella (MMR vaccine) or with mumps, rubella, and varicella (MMRV). By 1981, the number of reported measles cases was 80% less compared with the previous year.

Measles was declared eliminated from the US in 2000 - this meant the absence of the continuous spread of disease was greater than 12 months. From 2001-2013, there were an average of 88 US cases per year.

Source

MEASLES IN 2025

See Current Cases, below

SYMPTOMS

Measles isn't just a little rash. Measles can be dangerous, especially for babies and young children.

7–14 days after a measles infection: first symptoms show

Measles symptoms appear 7 to 14 days after contact with the virus. Measles typically begins with:

• High fever (may spike to more than 104°)
• Cough
• Runny nose (coryza)
• Red, watery eyes (conjunctivitis)

2–3 days after symptoms begin: Koplik spots

Tiny white spots (Koplik spots) may appear inside the mouth two to three days after symptoms begin.

3–5 days after symptoms begin: measles rash

Measles rash appears 3 to 5 days after the first symptoms. It usually begins as flat red spots that appear on the face at the hairline. They then spread downward to the neck, trunk, arms, legs, and feet.

• Small raised bumps may also appear on top of the flat red spots.
• The spots may become joined together as they spread from the head to the rest of the body.
• When the rash appears, a person's fever may spike to more than 104° Fahrenheit.

COMPLICATIONS

Common complications from measles are: 

• Ear infections occur in about 1 out of every 10 children with measles.
• Diarrhea is reported in less than 1 out of 10 people with measles.

Who is at risk

Measles can be serious in all age groups. However, there are several groups that are more likely to suffer from measles complications:

• Children younger than 5 years of age
• Adults older than 20 years of age
• Pregnant women
• People with weakened immune systems, such as from leukemia or HIV infection

Severe complications in children and adults

Some people may suffer from severe complications, such as pneumonia (infection of the lungs) and encephalitis (swelling of the brain). They may need to be hospitalized and could die.

• Hospitalization.About 1 in 5 unvaccinated people in the U.S. who get measles is hospitalized.
• Pneumonia.As many as 1 out of every 20 children with measles gets pneumonia, the most common cause of death from measles in young children.
• Encephalitis.About 1 child out of every 1,000 who get measles will develop encephalitis (swelling of the brain). This can lead to convulsions and leave the child deaf or with intellectual disability.
• Death.Nearly 1 to 3 of every 1,000 children who become infected with measles will die from respiratory and neurologic complications.
• Complications during pregnancy. If you are pregnant and have not had the MMR vaccine, measles may cause birth prematurely, or have a low-birth-weight baby.

Long-term complications

Subacute sclerosing panencephalitis (SSPE) is a very rare, but fatal disease of the central nervous system. It results from a measles virus infection acquired earlier in life.

About SSPE

• SSPE generally develops 7 to 10 years after a person has measles, even though the person seems to have fully recovered from the illness.
• Since measles was eliminated in 2000, SSPE is rarely reported in the United States.
• Among people who contracted measles during the resurgence in the United States in 1989 to 1991, 7 to 11 out of every 100,000 were estimated to be at risk for developing SSPE.
• The risk of developing SSPE may be higher for a person who gets measles before they are 2 years of age.

NATIONAL

As of June 25, 2025, a total of 1,277 confirmed measles cases were reported by 37 jurisdictions: Alaska, Arkansas, Arizona, California, Colorado, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Missouri, Montana, Nebraska, New Jersey, New Mexico, New York City, New York State, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, and Washington. Click here for up-to-date information on national cases.

Cases have also been identified in the 3 Canadian provinces bordering Montana - Alberta, Saskatchewan, and British Columbia.

MONTANA

Prior to 2025, no measles cases had been reported in Montana since 1990. 

As of July 8, 2025, Montana has had a total of 26 cases of measles reported in five counties. 

Click here for up-to-date information on Montana cases.

CASCADE COUNTY

As of July 16, 2025, one case of measles has been confirmed in Cascade County.

The individual is a vaccinated adult.

The measles exposure occurred at the following locations in Great Falls on the dates noted: 

• Walmart (10th Avenue South): July 6, 7, 8, and 14

• Rib & Chop House (3rd Street North): July 12

• Great Falls Clinic Walk-In (15th Avenue South): July 12

If you were at these locations on the listed dates and times (refer to the table above), monitor for symptoms such as fever, cough, runny nose, and rash for 21 days after your potential exposure. 

Updated information will be added here if any Cascade County cases are confirmed or additional public exposures occur.

The best way to protect against measles is to get the measles, mumps, and rubella (MMR) vaccine. Children may get the measles, mumps, rubella, and varicella (MMRV) vaccine instead, which protects against chickenpox too.

Most people who are vaccinated with MMR & MMRV are considered protected for life. Vaccines and high rates of vaccination have made these diseases much less common in the United States.

Questions about immunizations: 406-791-9242.

AVAILABLE VACCINES

There are two vaccines that protect against measles, mumps, and rubella. Both MMR and MMRV vaccines may be given at the same time as other vaccines. 

MMR

• Contains a combination of measles, mumps, and rubella vaccines.
• Two MMR vaccines are available for use in the United States: M-M-R II and PRIORIX. Both are recommended similarly and considered interchangeable.

MMRV

• Contains a combination of measles, mumps, rubella, and varicella (chickenpox) vaccines.
• This vaccine is only licensed for use in children who are 12 months through 12 years of age.

VACCINATION RECOMMENDATIONS

Both MMR and MMRV vaccines may be given at the same time as other vaccines. Your healthcare provider can give you more information about each and which to get. 

MMR

Children need 2 doses of MMR vaccines: 

• 1st dose: 12–15 months old
• 2nd dose: 4-6 years old

Older children, adolescents, & adults—Also need 1 or 2 doses of MMR vaccine if they don't have evidence of immunity. A Doses should be separated at least 28 days apart.

Anyone traveling internationally or to a measles-endemic area—Should be fully vaccinated before traveling. Infants 6–11 months old should get 1 dose of the MMR vaccine before travel. Then they should get 2 more doses after their first birthday.

People at increased risk for mumps during a mumps outbreak—An additional dose of MMR may be needed. Public health authorities will notify you if you are at increased risk and should receive this extra dose. If you already have 2 doses of MMR, it's not necessary to seek out vaccination; unless the authorities tell you that you are part of this group.

MMRV

Children 12 months through 12 years of age may be given 2 doses of MMRV vaccine. Each dose is usually given at:

• 1st dose: 12–15 months old
• 2nd dose: 4-6 years old (can also be given 3 months after 1st dose)

AFTER EXPOSURE TO MEASLES, MUMPS, OR RUBELLA

If you don't have immunity against these diseases and become exposed to them, talk with your doctor about getting MMR vaccine. It is not harmful to get MMR vaccine after being exposed to measles, mumps, or rubella. Doing so may possibly prevent later disease.

If you get MMR vaccine within 72 hours of initially being exposed to measles, you may get some protection; or have milder illness. In other cases, you may be given a medicine called immunoglobulin (IG) within 6 days of being exposed to measles. This provides some protection against the disease or illness is milder.

Unlike with measles, MMR has not been shown to be effective at preventing mumps or rubella in people already infected.

WHO SHOULDN'T GET VACCINATED

Some people should not get the MMR vaccine, or they should wait. People should check with their healthcare provider about whether they should get the vaccine if they:

• Has had an allergic reaction after a previous dose of MMR or MMRV vaccine, or has any severe, life-threatening allergies.
• Are or may be pregnant. Wait to get MMR vaccine until after you are no longer pregnant. Avoid getting pregnant for at least 1 month after getting MMR vaccine.
• Have a weakened immune system due to disease or medical treatments; or have a family member with a history of immune system problems.
• Have ever had a condition that makes them bruise or bleed easily.
• Have recently had a blood transfusion or received other blood products. You might be advised to postpone MMR vaccination for 3 months or more.
• Have tuberculosis.
• Have gotten any other vaccines in the past 4 weeks.
• Are feeling unwell or severely ill. Your doctor can advise you.

Additionally, people should wait to get the MMRV vaccine and tell their provider if they: 

• Have a history of seizures, or has a parent, brother, or sister with a history of seizures.
• Are taking or plans to take salicylates (such as aspirin).

SAFETY AND EFFICACY

MMR vaccine is very safe and is effective at preventing measles, mumps, and rubella. Vaccines, like any medicine, can have side effects. These are usually mild and go away on their own.

There is no link between the MMR vaccine and autism. Scientists in the United States and other countries have carefully studied the MMR vaccine. None has found a link between autism and the MMR vaccine.

It is safe for breastfeeding women to receive MMR vaccination. Breastfeeding does not interfere with the response to MMR vaccine; and the baby will not be affected by the vaccine through breast milk.

While MMR provides effective protection against mumps for most people, immunity against mumps may decrease over time for some people. They may no longer be protected against mumps later in life.

Some vaccinated people may still get measles, mumps, or rubella if they are exposed to the viruses. It could be that their immune system didn’t respond as well as they should have to the vaccine; their immune system’s ability to fight the infection decreased over time; or they have prolonged, close contact with someone who has a virus. However, disease symptoms are generally milder in vaccinated people. They are also less likely to spread the disease to other people.

POSSIBLE SIDE EFFECTS

Most people don't have any side effects from the vaccine. The side effects that do occur are usually mild, and may include:

• Soreness, redness, or swelling where the vaccine was given
• Fever
• Mild rash
• Temporary pain and stiffness in the joints

More serious side effects are rare. These may include high fever that could cause a seizure.

FINDING A VACCINE

Contact CCHD at 406-454-6950 to schedule a MMR or MMRV vaccination. CCHD can also check your Montana shot records to confirm whether you have already been vaccinated.

Vaccination may also be available at your doctor's office or through another healthcare provider.

If you are having measles symptoms or think you have been exposed to someone with measles, call CCHD at 406-791-9242. You will be provided with instructions to get tested safely without exposing others. 

Please do not enter any testing facility without calling ahead first, so that precautions can be taken to avoid exposing other patients and staff.

If you need urgent medical care, call the Benefis ER at 406-731-8300 and let them know you are coming in so they can be prepared to see you without exposing other patients.

Care options after measles exposure

If people older than 6 months of age are exposed to measles and are not immune by previous illness or vaccination, they can get a measles vaccine for up to three days after contact with the virus. For up to six days after exposure, children up to 11 months old who are exposed to measles and are not immune by previous illness or vaccination can get a shot of proteins, called antibodies, that help the body clear an infection. This shot is called immune globulin.

Measles care tips

Get plenty of rest and eat nutritious foods as you're able. To help prevent fluid loss, called dehydration, focus on drinking fluids. Water, broth or drinks with minerals, called rehydration solutions, may help replace fluids. Talk with your healthcare professional before giving rehydration fluids to infants.

For fever with achiness, medicines available without a prescription may help. Read the labels carefully or ask your healthcare professional or pharmacist about the right dose. Do not give aspirin to children or teenagers. Aspirin has been linked to Reye's syndrome, a rare, life-threatening condition, in children and teenagers who have the flu or chickenpox. 

Care for measles complications

If you get a bacterial infection, such as pneumonia or an ear infection, with the measles, you might need an antibiotic. But antibiotics don't treat measles.

Measles can lead to inflammation of the airways. The inflammation lowers the body's ability to take in oxygen. If this happens, you may need extra oxygen or breathing help.

A healthcare professional may give children vitamin A as part of treatment for measles. The dose of vitamin A depends on the child's age. Children with low levels of vitamin A who get measles are more likely to be very sick than are children with recommended levels.

Vitamin A supplements do not prevent measles. Getting a measles vaccine is the most effective and safest way to prevent measles. Children should not be given vitamin A as a treatment or supplement unless recommended by a healthcare professional. If a vitamin A supplement is recommended, take only the recommended amount. Taking too much vitamin A can cause major harm.

These treatments are well researched and help people with measles feel better, manage complications and prevent death.