In November 2024, Brazil regained the measles’s certificate of elimination, lost in 2019 after an outbreak that hit the country. Now, however, new cases have begun to emerge, lighting the warning sign among health authorities. In the first four months of this year alone, 416 cases of the disease were reported and five confirmed, according to the Ministry of Health. Last year, 2,260 suspicions were reported, and there were five confirmations.
So far, recorded cases are considered sporadic and there is no record of deaths. Two occurred in Rio de Janeiro in twin babies who were not yet old to receive the vaccine. In the Federal District, an adult woman was diagnosed after probable contamination during an international trip. Another case was registered in Porto Alegre, also related to a trip abroad. The most recent in Sao Paulo involves a 31 -year -old man whose origin of the infection is under investigation.
In a note sent to the Einstein agency, the Ministry of Health says that “sporadic cases such as these do not compromise the certification of Brazil as a free country of measles’s endemic circulation, granted by PAHO/WHO in November 2024. Although measles still circulate in some regions of the world, the rapid response of health authorities has been essential to prevent local transmission”. The portfolio also reported that it has supported states with measles cases, with the sending of technical teams for surveillance and vaccination actions.
In the world, confirmed measles cases exceeded 359,000 in 2024, according to the Pan American Health Organization (PAHO). This, added to gaps, led to outbreaks located in six countries of the Americas, with 2,313 cases notified so far in 2025. Three deaths have been confirmed and one is under investigation.
“Measles is one of the most contagious diseases in the world,” warned Jarbas Barbosa, director of PAHO at a press conference held in late April. “And countries have been difficult to maintain recommended coverage of 95% of the triple viral vaccine (measles, mumps and rubella), leaving us susceptible to imported cases,” he added.
In the United States alone, the number of measles cases fired in 2025, with 884 records confirmed until April 24, according to (CDC). Of this total, 93% are linked to outbreaks in certain regions of the country. The jump is expressive compared to the previous year, when 285 cases were accounted for in total.
Europe and Africa also live a warning scenario, with the consistent increase of infections in several countries. “The world has been experiencing a gradual increase in measles records. Each year, the number of cases globally increases, with Europe and Africa always being the epicentra and, currently, the region of the Americas-concentrated the cases in outbreaks in the United States, mainly. But Argentina and Brazil also reported cases, he says the pediatric infectologist Renato Kfouri, vice president of Brazilian Society of Immunizations. (SBIM).
In an increasingly globalized world, international trips remain one of the main roads for reintroducing diseases that were eradicated or under control in certain countries. And measles is a classic example of this dynamic: because it is highly contagious, the virus spreads quickly in populations with low vaccination coverage.
“Among all infectious diseases, measles may be the one that has the greatest transmissibility. We often say that he does not spare susceptible individuals. If he finds someone not vaccinated and has never had the disease, the chance of contagion is huge. Therefore, in low vaccination scenarios, measles is always the first to resurface and spread easily,” warns Kfouri.
Then learn more about the disease and how to protect yourself against it.
1. What is the disease?
Measles is a highly contagious viral infection that affects humans exclusively. “By this feature, it would easily be eradicated by vaccination if there was adhesion by much of the population,” points out infectologist Emy Akiyama Gouveia of Hospital Israelita Albert Einstein. The disease occurs worldwide and remains an important cause of death in children under 5 years.
2. How is the virus transmitted?
Measles is caused by a respiratory transmission virus, which spreads through droplets expelled when speaking, coughing or sneezing. Its ease of dissemination and very high contagion rate worries experts: A single infected person can transmit the disease to up to 18 others that are not vaccinated.
For the purpose of comparison, at the height of the transmission, the Sars-Cov-2 coronavirus, responsible for the pandemic, had an average transmission rate of about 3.8 people per infected, almost five times less than measles. “When a case is detected, if there is a susceptible pocket, the virus spreads very efficiently. The disease is considered a marker how fragile is the vaccination coverage of a particular region,” explains pediatric infectologist Daniel Jarovsky, secretary of the São Paulo Pediatric Society Department.
3. What are the symptoms?
After contact with the virus, the average incubation period ranges from six to 21 days (on average, 13 days), when the pathogen enters the eyes or airways of the susceptible person. This is the so -called latency period, in which the virus is replicating the body without even causing the disease.
Then begins the prodrome period, characterized by nonspecific symptoms such as cough, runny nose, conjunctivitis and high fever (up to 40 degrees) – very similar to a flu. This phase lasts around two to four days and may persist for up to eight days.
The next step of the infection is the emergence of the eanchusama, or “koplik blemishes”, typical lesions that appear in the mucosa of the mouth, near the molars, and should be sought before the spots of the skin. They last between 12 and 72 hours, and begin to disappear with the beginning of the exhausting phase, characterized by the emergence of skin spots/eruptions themselves.
These spots appear two to four days after the beginning of the fever, starting down the face and spreading from top to bottom and from the center to the periphery of the body. Palms of the hands and foot plants are usually spared.
“Approximately 48 hours after the injuries appeared the patient begins to have improvement. The lesions change to a more brownish color, and may occur,” describes Gouveia. “The cough can occur for up to two weeks and the worsening of fever between the 3rd and 4th days of the emergence of skin lesions indicates the possibility of complications of the disease.”
Measles transmission can occur up to five days before the rash development (skin eruptions). “That is, the person has a typical picture of flu syndrome and eventually is not in isolation, attending school or even health services,” warns Einstein’s infectologist. The transmission continues up to four days after the appearance of skin blemishes. “A positive person [para a doença] In this period it can affect 90% of people who are susceptible in their surroundings, ”says Emy Gouveia.
4. What are the possible complications?
More than 90% of measles cases are considered benign. However, the disease causes an immunosuppression effect that significantly compromises the body’s defenses. This weakening of the immune system makes the patient more vulnerable to other secondary opportunistic infections, increasing the risk of complications even after the acute phase of the disease.
Among the most common are pneumonitis (viral pneumonia caused by the virus itself), otitis media, intense diarrhea and secondary bacterial pneumonia. In more severe paintings, the disease can lead to permanent damage, such as loss of vision by corneal lesions.
There is also a risk of potentially fatal neurological complications, such as subacute sclerotic panencephalitis, a degenerative condition that may arise years after infection and leads to death very fast. There is also acute spread encephalomyelitis, which affects the brain and spinal cord.
6. How is vaccination?
The triple viral vaccine is the main means of prevention against measles. It contains attenuated living viruses, stimulating the immune system to produce a protective response without causing the disease.
In the National Immunization Program (PNI), the immunization strategy focuses on the pediatric population and is indicated in two doses, one at 12 and another at 15 months. Teenagers and adults who have never been vaccinated or have an incomplete vaccination scheme should also be immunized: up to 29 years, the recommendation is to receive two doses with a month interval; And between 30 and 59 years, a dose. In outbreak situations, the vaccination of children between 6 and 12 months and over 59 years can be evaluated.
According to the Ministry of Health, in 2023, vaccination coverage was 90.02% in the first dose and 67.42% in the second. By 2024, the numbers rose to 95.33% in the first dose and 79.86% in the second, with a coverage goal of 95%. The folder did not report data for this year.
The main purpose of the vaccine is to prevent the infection as it brings a very robust antibody response. But no vaccine is 100% protective – a vaccinated person may infect, but will probably develop a mild or even atypical form of the disease.
“For its composition of attenuated viruses, the vaccine is contraindicated for immunosuppressed people in general,” warns Jarovsky. But vaccination of the general population contributes to the protection of these people with contraindication to the vaccine, the so -called “herd immunization”, which should be maintained above 85 to 95% vaccination coverage.
When applied at the correct ages, the measles vaccine ensures a lifetime immunity. However, as not every vaccine is 100% effective, it would be important to expand and achieve the goals of vaccination coverage in Brazil and worldwide.
7. Beyond the vaccine, how to protect yourself?
Vaccination is the main way to protect yourself against measles, so it is important to check your vaccination portfolio. “It is worth the old premise: If a person is sick and needs to expose himself to the community, such as going to the doctor, for example, he should use a surgical mask to protect people from their surroundings, thus avoiding the spread of any infectious disease,” says Gouveia.
For those who travel, a tip is to check if the country that will visit is presenting measles outbreak and evaluate the vaccination state of all the people who will go together. Schedule yourself to be fully vaccinated against measles at least six weeks before the trip. If your trip is in less than two weeks and you are not protected, you should still take a dose, which already offers 93% protection against the disease.
To date, measles cases registered in Brazil are considered imported and, according to the authorities, are not linked to local transmission chains. The explanation, according to experts, is that these punctual episodes did not find people susceptible around – a reflection of the protection given by vaccination.
“This is the big challenge: to maintain a highly vaccinated population to prevent these isolated cases, inevitable in a world with so much mobility, evolve into outbreaks,” says infectologist Renato Kfouri.
For him, the “homework” of health authorities is clear: to recognize early cases, maintain active surveillance, isolate confirmed patients, vaccinate contactors and, if necessary, perform active search for possible infected. “Only then do we avoid the accumulation of susceptibles that can create an environment conducive to the spread of the virus,” concludes the vice president of SBIM.
