Measles in Missouri – What Should You Know?

JEFFERSON CITY, Mo. – The number of cases of measles reported in Missouri this year is the same for all of 2024 so far (2). However, nationally this year is unusual. Thirty-one of the states have experienced cases -- including 14 outbreaks – and there are already more than three times the number of cases nationally than in all of 2024. 92% of the nation’s cases are outbreak-related, and public health officials in and outside of Missouri are seeing cases and exposures occur due to both domestic and international travel.

“Missouri is not immune to experiencing a significant outbreak similar to what we have seen in other states this year,” said Dr. George Turabelidze. “Measles is caused by one of the most contagious viruses. We have several under-vaccinated communities in Missouri, and all it takes is one case in an area with these vulnerable individuals to cause an outbreak.”

Below are commonly asked questions regarding measles and vaccination.

How contagious is measles?

One person with measles can easily pass it on to 9 out of 10 people who are unvaccinated or do not have immunity. It spreads through the air when a person with measles coughs or sneezes, and the virus can live in the air for up to 2 hours. A person with measles is contagious from 4 days before the rash appears until 4 days after the rash appears.

Is measles dangerous?

Yes. Measles can be very dangerous, especially for children under 5 years old and people with compromised immune systems.

Pneumonia occurs in up to 6% of reported cases and accounts for 60% of deaths attributed to measles.
Encephalitis (brain infection) may also occur, which can lead to brain damage.
Other complications include middle ear infection and convulsions.
There is no specific treatment for measles and some people may die, even with the best care.

Most people think of measles as a childhood disease, but anyone can get measles if they are not protected.

How do I protect myself and my family?

Vaccination offers the best protection against measles. In use in the United States since the 1970s, the measles, mumps, and rubella (MMR) vaccine is safe and effective at preventing disease. One dose of the MMR vaccine provides 93% protection against measles. The second dose increases protection to 97% for a lifetime.

Who should seek vaccination?

The current recommendation for MMR vaccination is as follows:

Children 12 -15 months of age should have one dose of the MMR vaccine.
Children 4-6 years of age should have two doses of the MMR vaccine.
Adults who received an inactivated measles vaccine between 1963 and 1967, or those who are unsure which type of measles vaccine they received, are recommended to receive a dose of the MMR vaccine.
Adults who do not have evidence of immunity should receive at least one dose of the MMR vaccine.
Individuals who are considered high risk, such as health care workers and students attending colleges or vocational schools, should receive two doses of MMR vaccine separated by at least 28 days.
International travelers:

Infants 6-11 months of age should receive one dose of MMR vaccine.
Children 12 months and older should receive two doses of MMR vaccine separated by 28 days.
Adults with documentation of one dose of MMR vaccine should receive a second dose.
Adults with no documentation should receive two doses of MMR vaccine separated by 28 days.

Who would have evidence of measles immunity?

Evidence of immunity may be applicable to those:

Born before 1957 (presumed to be immune due to prior exposure to measles).
With written documentation of vaccination with:
- One or more doses of a measles-containing vaccine administered on or after 12 months of age for children and adults not at high risk.
- Two or more doses of a measles-containing vaccine for school-age children, college students, adults at high risk or international travelers.
With laboratory evidence of immunity (a positive measles titer or confirmed laboratory diagnosis of measles).

What happens when someone gets measles, or is exposed to someone with measles?

Measles symptoms usually appear in two stages, starting 1-2 weeks after a person has been exposed to the virus.

The first stage starts with a runny nose, cough and a rising fever and the eyes may become red and sensitive to light.
The second stage begins about 3-7 days later and includes a high temperature (103-105°F) and a red blotchy rash.

The rash usually begins on the face and then spreads over the entire body.
Little white spots may also appear on the gums and inside of the cheeks.
The rash lasts about 4-7 days.

Some people may have serious complications like pneumonia or encephalitis (swelling of the brain). Some may even die.

An exposure occurs when a person is in the same enclosed space (e.g., room, office, waiting room, building) with someone who has measles, or occupies this space within 2 hours after the infected person has left. Depending upon the situation, people without proof of immunity that have been near someone with measles will need to take steps to avoid contact with others for 21 days after their last exposure, especially where persons are unvaccinated or at high risk for measles.

How should I go about getting myself or a family member vaccinated?

MMR is a recommended vaccine that is covered by most private insurance companies.

Parents should check with their insurance provider if they have questions about coverage.
Most local public health agencies or community health centers can provide this vaccination, or parents can contact their health care provider.
Children without health insurance may be eligible to receive an MMR vaccine under the Vaccine for Children Program.

What should businesses, schools and communities do to prepare?

Properly covering coughs and sneezes and good handwashing should be encouraged. Individuals should also be advised to stay home if they are sick. If measles is suspected in a student or employee, the individual should seek medical care but not until they have first notified their health care provider so care can be taken to limit further spread. Suspected measles should be reported to the local public health agency so proper guidance can be provided to those potentially exposed.

View general measles response guidance for non-health care settings.

View tips for preventing spread in school and childcare settings.

View more information, including county immunization rates, at Health.Mo.Gov/Measles.

DHSS branding downloadable here.

Mission of the Missouri Department of Health and Senior Services (DHSS):

To promote health and safety through prevention, collaboration, education, innovation and response.

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