Protect Yourself & Others from Measles
Measles is more than a rash and a fever that will clear up in a few days. Measles can cause serious health complications, especially in children younger than 5 years old, people who are immunocompromised and pregnant people.
Measles is highly contagious. If one person has it, as many as nine out of 10 people nearby will become infected if they are not protected.
Measles Symptoms
Measles symptoms appear 7 to 14 days after contact with the virus. Common measles symptoms include:
- High fever (may spike to more than 104° F)
- Cough
- Runny nose (coryza)
- Red, watery eyes (conjunctivitis)
- Rash
Measles can cause serious health complications, especially in children younger than 5 years of age.
Common complications:
- Ear infections
- Diarrhea
Serious complications can include:
- Pneumonia: A lung infection that makes the tiny air spaces in your lungs fill with fluid or pus, which makes it hard to breathe. People with pneumonia might cough a lot, feel tired, have a fever, or feel short of breath.
- Encephalitis: Swelling in the brain usually caused by a virus. Encephalitis can cause symptoms like fever, headache, confusion or feeling very tired. Some people might also have trouble talking, walking or staying awake.
How Does it Spread?
If You Think You've Been Exposed or are Exhibiting Symptoms
To avoid spreading measles, patients who are symptomatic and not in an emergency situation are advised to call their primary care physician or a B2 UrgentCare to schedule a telehealth visit. Symptomatic patients should not visit outpatient clinics.
Isolation is the best way to keep measles from spreading. If you think you’ve been exposed to someone with measles or are exhibiting symptoms, isolate from others from the time of contact until four days after you develop a rash. Since measles is spread through the air, wearing a mask can help to avoid spreading measles to others.
How We Can Prevent Measles
Protect yourself with the vaccine. The best way to protect against measles is with the measles, mumps, and rubella (MMR) vaccine. MMR is safe and effective. Two doses of MMR vaccine are 97% effective at preventing measles; one dose is 93% effective. Children normally get the MMR vaccine at one year and four years of age. If people haven’t been vaccinated against measles as a child, they can get the MMR vaccine as an adult. Getting the MMR vaccine is safer than getting sick with measles, and it protects your family and your community.
Most people who get measles in the United States are unvaccinated. When infected people come into contact with a population that includes unvaccinated people or those with weakened immune systems, the virus can spread. People who travel to areas with known measles cases are at risk of getting the disease if they are not vaccinated. People who travel outside the country to areas where measles is common can bring it into the U.S. Getting the measles vaccine is the best way to protect yourself.
Important Information About the MMR Vaccine
Two doses of the MMR vaccine typically provide long-lasting immunity. Most individuals who received both doses in childhood remain protected throughout their lives. However, immunity can wane over time, and some people may have lower antibody levels, especially if they received only one dose or were vaccinated with the less effective inactivated vaccine used between 1963 and 1967.
Review your vaccination records to see if you received two doses of the MMR vaccine. If records are unavailable or unclear, you can get a blood test (titer) to check for immunity. Alternatively, getting another MMR shot is safe and can boost your protection if you’re unsure about your immunity status. If you have any questions about measles vaccination, please talk to your doctor, pharmacist, or health care provider.
Frequently Asked Questions
General Questions
What is the current situation?
As of April 18, 2025, Gallatin County has five confirmed cases. As of April 29, 2025, the Gallatin City-County Health Department (GCCHD) confirmed two additional measles cases, bringing the total from five to seven cases in our community. Note that these two additional cases have occurred within the same family as the other cases, meaning that there is still no community spread.
Gallatin County currently has five confirmed cases. Gallatin City County Health Department (GCCHD) is responsible for contact tracing, notifying local exposures, and providing guidance on next steps. View more information from GCCHD here.
What is Measles?
Measles, also known as rubeola, is the most contagious infection in the world. It is caused by a virus and spreads easily from person to person.
What is Bozeman Health’s response?
Our Infection Prevention team has been working closely with Gallatin City County Health Department (GCCHD) and other state and federal agencies to prepare. Now that we have cases in Gallatin County, GCCHD is contact tracing, notifying local exposures, and providing guidance on next steps. Bozeman Health has plans in place to limit exposure at our care sites. At the entrance to Deaconess and BSMC emergency departments (ED), patients with measles-like symptoms will be directed to use a mask. ED staff will isolate them in a patient room as quickly as possible.
There is signage at all B2 UrgentCare and MicroCare locations asking patients to refrain from entering, if they have symptoms of measles, and instead but to call and request a measles test be conducted outdoors. Signage at all other care site entrances will encourage patients to call their primary care provider for guidance before entering the building.
Will a measles outbreak be similar to the COVID-19 pandemic?
No, because there is an established vaccine and many of the population is vaccinated, we anticipate that only a small portion of the public will be susceptible to contracting measles. The MMR vaccine provides 97% protection. Health care systems will not be overrun, and it will not cause widespread shutdown in public life. The response from Bozeman Health and the Health Department have been fantastic so far and we feel well equipped to help staff and patients navigate this unfortunate situation.
Measles will spread, but not like COVID-19. But it is still important to take it seriously. Measles spreads very easily and can have serious health outcomes.
However, many health care workers may be experiencing COVID-19 pandemic-related PTSD. Feeling scared is valid, and this outbreak is triggering for many. Bozeman Health’s Human Resources department offers resources to support Bozeman Health employees in the mental health space, through our Employee Assistance Program.
How does measles spread?
Measles spreads through droplets, mainly airborne. The droplets spend two hours in the air, putting people at risk if they’ve been in the room within two hours of the infected person. Measles incubated for seven to 14 days after exposure. People may feel ill as soon as five days, or as late as 21 days. After exposure, isolation should last for four days after onset of rash.
What are the symptoms of measles?
Symptoms begin with cough, runny nose, conjunctivitis, high fevers, little white spots in mouth (called Koplik spots) inside of cheek. A skin rash starts on forehead and moves down. The contagious period starts four days prior to the rash onset and four days after the rash onset. Most people will recover, but poor outcomes can occur.
Who is at risk for contracting measles?
Both unvaccinated adults and children are equally susceptible. Most cases occur among children because vaccination rates are lower in that population. Notably, ages zero to four as their vaccination schedule is incomplete. For the vaccinated population, there is only a 3% chance of contracting.
Are delayed complications possible?
What is the vaccine schedule? How can I get a vaccine?
Per CDC recommendations, children should get two doses of the MMR vaccine, starting with the first dose at 12 to 15 months of age, and the second dose at four to six years of age. There are no vaccine shortages locally or nationally. We don’t anticipate ever experiencing a shortage. Vaccines are available through the Gallatin City County Health Department (GCCHD) or from your primary care provider. The Bozeman Health Highland Park Pharmacy and Big Sky Medical Center Pharmacy do not carry the MMR vaccine.
GCCDH will be hosting vaccine clinics are the Gallatin County Fairgrounds. More information is available here.
Is there an accelerated vaccine schedule?
Gallatin City County Health Department (GCCHD) is not recommending an accelerated vaccine schedule at this time.
The accelerated vaccine schedule for children is to vaccinate at 6 months old. If a child gets the vaccine before one year old, they still get a dose at one year, and then 30 days after. If a child is older than one years and has one shot, they can get a second shot now. There is no need for a third dose. Older children and adults should have one shot, then a second shot 28 days later.
What kind of risks are there for immune suppressed people?
Immune suppressed people who have both doses can get a weaker form of measles.
What should I do if I’ve been exposed?
Exposed people who are vaccinated should monitor for symptoms, isolate, and get tested. Exposed people who are unvaccinated are recommended to get the first MMR dose within three days of exposure, then a second dose 28 days later. If you are exposed to an individual with a known case of measles, contact the Gallatin City County Health Department (GCCHD) and your primary care provider immediately for further guidance.
Can measles mutate?
No, measles does not mutate because of the vaccine.
What is the treatment for measles?
How do I know if I’m immune to measles?
Do I need a booster?
A measles titer test is a blood test that checks for immunity. If your titer does not show signs of immunity, you do not need a booster. You are still considered protected if your titer is low. If your titer test is non-responsive, evidence suggests that you are still protected. But you can receive the booster if you would like. Anyone is welcome to get a booster shot if desired. There are no risks to getting a booster.
What about if I’ve already had measles?
When is measles testing most accurate?
Positive swabs can still be obtained up to 14 days after onset of rash. It is possible to swag in the four days before onset of rash and get a positive test. If you test in that time frame and get a negative test, symptomatic patients should continue to isolate until rash onset, and then up to six days after. After six days and if no rash, you can discontinue isolation. If you still have suspicion due to symptoms, then test again.
How long does it take for children to get immunity after vaccine?
It usually takes the body a few weeks to produce antibodies. Around three weeks for a 6-mon-old to have immunity.
Is outdoor exposure safer than indoor exposure?
Whereas COVID-19 outdoor transmission is very rare, measles can be transmitted easily outdoors. Masking can help.
Children
When can my child get the measles vaccine?
The measles vaccine is given in a two-dose series. The standard schedule recommends giving the first dose at 12 to 15 months of age and the second dose at four to six years of age.
If a measles outbreak were to occur, an earlier immunization schedule can be followed. An outbreak is different than reported cases and will be declared by the Health Department.
In the event of an outbreak, the first dose can be given as early as six months. Then the standard schedule would be followed with another dose at 12 to 15 months of age and a final dose at four to six years. In the event of an outbreak and your child received their first dose of measles vaccine at 12 to 15 months of age, the second dose can be given early as long as it’s been at least one month since the first dose.
How do I protect my baby who is less than six months old?
A baby will have some protection if the mother has been vaccinated because pregnant mothers pass their antibodies to their babies. These antibodies from the mother wane at four to six months of age.
Other ways to protect your baby include:
• Limit exposure to crowds, other children, and people who are sick with a cold or other illness.
• Practice good hand hygiene using soap and water and scrub for 20 seconds. Remind other people to do the same prior to holding your baby.
• Breastfeed. If you are not breastfeeding, bank breast milk can be beneficial.
• Disinfect frequently touched surfaces and toys.
• Do not spend time with people who have not received the measles vaccine.
How do I protect my baby who is six to 12 months old?
What do I do if my unimmunized child has been exposed to measles?
- Call your pediatrician.
- If the exposure happened within the last 72 hours and the child is at least six months old, they can get the measles vaccine.
- If the child is less than six months old, they can receive antibodies called immune globulin within six days of the exposure.
How do I get my child vaccinated?
My child has been exposed to measles - how do I get them tested?
If your child is vaccinated, then the likelihood of contracting measles is very low. In the uncommon instance that a vaccinated person contracts measles, the disease is milder, and the person is less contagious.
If your child has no symptoms then testing is not recommended.
My child has symptoms of measles - what do I do?
Do not go into the clinic or leave your home. Telehealth visits are preferred. Call your pediatrician or the health department and they will guide you on your next steps.
If your child is very sick, call your pediatrician. Do not come into clinic or go to urgent care without calling your provider first. If you think it’s an emergency, then call the emergency room and tell them you are bringing in a child with suspected measles then go to the emergency room.
Still have questions?
Contact your pediatrician or call Bozeman Health Pediatrics at 406-414-4900.
Pregnancy
Can I receive a measles vaccine during pregnancy?
No, pregnant individuals should not receive measles vaccine during pregnancy as it is a live attenuated vaccine. This type of vaccine is not given to pregnant individuals.
Can I receive a measles vaccine postpartum?
Can I receive a measles vaccine while breastfeeding?
Yes, vaccination while breastfeeding is safe.
Is my newborn protected from measles?
In vaccinated mothers, the newborn receives passive immunity during pregnancy and from breastfeeding which offers some immediate protection. Banked breast milk is a good option for babies who aren’t breast fed.
Newborns are typically vaccinated around 12 months of age; however, can be vaccinated as early as six months of age in high-risk situations. Talk to your pediatrician about the timing of vaccination that is best for your baby.
What should I do if I am pregnant and exposed to measles?
If you have been fully vaccinated or are known to be immune to measles, no further testing or treatment is required. If you have not been vaccinated or if you are known to be non-immune to measles, contact your prenatal care provider as soon as possible after an exposure to arrange a telehealth visit.
What treatment will I receive if I am pregnant and exposed to measles?
My child has symptoms of measles - what do I do?
Do not go into the clinic or leave your home. Telehealth visits are preferred. Call your pediatrician or the health department and they will guide you on your next steps.
If your child is very sick, call your pediatrician. Do not come into clinic or go to urgent care without calling your provider first. If you think it’s an emergency, then call the emergency room and tell them you are bringing in a child with suspected measles then go to the emergency room.
Still have questions?
Contact your OB/GYN or call Bozeman Health Women’s Specialists at 406-414-5150.
Vitamin A Use After Diagnosis of Measles
As of April 18, 2025, no pharmacies/ nutrition stores in the Bozeman area carry Vitamin A drops. An order has been placed for Bozeman Health Highland Park Pharmacy and should arrive soon.
Vitamin A is not effective for the prevention of measles and should not be taken unless directed by your provider.
Why is Vitamin A being recommended for my child?
Measles is associated with causing vitamin A levels in the body to decrease. Vitamin A is necessary for immune function and cell integrity. It is important to take vitamin A exactly as directed by your provider for no more than two
days so that they are receiving an effective dose and not taking too much vitamin A which could cause unwanted side effects, such as liver failure. Ask your primary care provider for dosing information.
Vitamin A drops can be purchased over the counter in many pharmacies. Bozeman Health Highland Park Pharmacy and Big Sky Medical Center Pharmacy have Vitamin A drops in stock.
What type of Vitamin A do I need?
There are many different formulations of vitamin A that could also contain other vitamins. It is important to ask your primary care provider or a pharmacist to determine the correct dose needed for your child. A product containing only vitamin A is preferred. The dose needed (as Internal unit “IU”) is based on your child’s age.
The American Academy of Pediatrics recommends vitamin A taken by mouth once daily for two days for all children with measles. Vitamin A dose varies by age:
- ≥ 12 months: 200,000 IU
- 6-11 months: 100,000 IU
- < 6 months: 50,000 IU
Example of product for dosing is below. This one contains 10,000 IU in 0.5 mL.
Doses with this product specifically would be (ask for an oral dosing syringe to get the exact dose needed):
- 200,000 IU= 10 mL
- 100,000 IU= 5 mL
- 50,000 IU= 2.5 mL
(Click image to enlarge)
Older Adults
How do I know if I’m fully immune and do not need a booster?
You received the two-dose series of the MMR vaccination at any point, or
- Have laboratory evidence of immunity, or
- Were born before 1957
Should I get a booster (a single dose of the MMR vaccination)?
Adults vaccinated between 1963-1967 should get a booster, or
- Adults unsure of vaccination history who have a negative laboratory test for immunity.
- If you are unsure of your vaccination status, you can be tested for immunity with a simple lab test, called a titer test. Contact your primary care provider.
Contraindications to the MMR vaccine include:
- Certain immunocompromising conditions
- Being on some immunosuppressive medications
- Pregnancy
- Previous allergies to the MMR vaccination or components of the vaccination
If you are unsure if you have a contraindication, please contact your provider.
or call Bozeman Health Internal Medicine at 406-414-2400.
Download Measles Testing Guidance
Measles Testing Guidance
Measles Isolation Guide
Staying Isolated While Awaiting Measles Test Results
What Does Isolation Mean?
It’s important to stay isolated while waiting for your measles test results. Staying isolated means staying home from work, school, and other activities – and away from others outside of your household. This helps protect your friends, family, and community from potential exposure to the virus that causes measles. Measles spreads very easily through the air when an infected person coughs or sneezes. It can also live on surfaces.
Symptoms Monitoring:
Please monitor your symptoms closely. Typical symptoms of measles include a high fever, cough, runny nose, red eyes, and a rash that spreads across the body, usually starting at the hairline. If your symptoms worsen or you experience difficulty breathing, please contact a healthcare provider right away.
Measles Can Be Prevented Through Vaccination
Preventive Measures While in Isolation:
While in isolation, you should cover your mouth and nose with a tissue when you cough or sneeze and dispose of the tissue properly. Wash your hands frequently with soap and water for at least 20 seconds, especially after coughing or sneezing. If you share a household with vulnerable family members such as infants who are too young to get vaccinated or people who are immunocompromised, try to stay in your own room away from others. You should wear a wellfitting mask if you have to leave the room to go to the bathroom. If possible, open the windows
to increase ventilation and have meals brought to your room by someone who has received two doses of the MMR vaccine.
Duration of Illness:
You should remain isolated until you receive instructions from your doctor or the health department. If your measles test is positive, you will need to continue isolating until you are no longer infectious. This is usually 4 days after the rash has appeared. If your test results are negative, you will no longer need to isolate.
Download Measles Isolation Guide
