Measles (rubeola) is a highly contagious viral disease caused by the measles virus and is one of the most contagious infectious diseases known. It spreads through airborne transmission when an infected person breathes, talks, coughs, or sneezes. The virus can remain suspended in the air and remain infectious for up to two hours after an infected person leaves an area. More than 90% of susceptible (non-immune) people exposed to measles will become infected.

Common Symptoms typically develop within 7-21 days after exposure and often occur in two phases.

Early Symptoms can include fever of greater than 101 degrees, cough, runny nose, red eyes (conjunctivitis), and small white spots inside the mouth or Koplik spots.

Late symptoms include a red, blotchy rash beginning on the face and spreading downward over the body.

While many patients recover from measles, some experience severe complications, such as pneumonia, encephalitis, deafness, or other serious infection due to damage to the immune system. 

Virginia is currently experiencing its largest measles outbreak in decades. As of July 30, 2026, Virginia reported 177 confirmed measles cases, with most cases associated with an outbreak that began in the Piedmont region.  The outbreak has been driven primarily by transmission among susceptible individuals who have not been vaccinated with the MMR vaccine.  The best protection is two doses of the MMR vaccine series that provides long-lasting protection and remains the most effective prevention measure.

More information and more current measles cases can be found on the Virginia Department of Health website.

Fully vaccinated individuals:

Routine PPE is generally not required if immunity is confirmed through vaccination. Staying current on MMR vaccination is the primary protection measure.

Unvaccinated or Immunocompromised Individuals:

If entering an area with active transmission:

• Avoid exposure whenever possible.
• Avoid large gatherings in outbreak areas.
• Consider wearing a well-fitting respirator (N95 or equivalent), particularly in indoor crowded settings.
• Verify vaccination status with a healthcare provider.

VDH specifically advises unvaccinated individuals and those with symptoms to avoid large gatherings in outbreak areas.

Personnel in laboratories handling samples from Measle positive patients or the Rubeola (measles) virus directly, should continue to follow BSL-2  guidance which includes:

• Wear laboratory coats or gowns
• Wear gloves
• Perform any aerosol-generating procedures inside of a Biosafety Cabinet

Because measles is transmitted through the air, decontamination focuses on both air management and surface cleaning.

Restrict Access:

• Immediately limit entry to the area.  
• If possible, leave the room vacant to allow airborne particles to clear (~2 hours)

The measles virus can remain airborne for up to two hours after an infected person leaves. Keep the room unoccupied during this period whenever feasible.

Surface Disinfection:

Because measles is an enveloped virus, it is relatively easy to kill with standard household products: 

• Diluted Household Bleach:  Mix 1 part regular household bleach to 9 parts water
• EPA-registered wipes and sprays:  Products like Clorox Disinfecting Wipes and Lysol Disinfectant Spray are effective. 
• Hydrogen Peroxide:  A 3% hydrogen peroxide solution can be applied directly to surfaces

Clean and disinfect commonly touched surfaces, such as door handles, chairs, desks, bathrooms, etc.  

For Research with Rubeola Virus:

For laboratories handling samples from Measle positive patients or the Rubeola (measles) virus directly, use EPA-registered hospital-grade disinfectants according to the manufacturer's instructions regarding wet contact time and application instructions.

Examples of disinfectants include:

• Oxivir
• Virex II 256
• Cavicide
• Super Sani-cloth wipes
• Sani-cloth Plus
• Bleach-based disinfectants (e.g. sodium hypochlorite products)
• Quaternary ammonium compound disinfectants.