Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Provider photo for Charles Hare

Charles Hare, MD

Infectious Diseases

As your doctor, I believe that empowering you with information will allow you to be more proactive in our partnership in maintaining your health. MyDoctorOnline will enable us to communicate better. You can e-mail me, check your lab results, make an appointment, access our many online programs or get information about a particular health topic - any time that's convenient for you.

My Offices

San Francisco Medical Center
Appt/Advice: 415-833-2200

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Measles is a highly contagious disease caused by a virus. An infected person may sneeze or cough droplets into the air. It’s spread when you breathe in these droplets.

Measles causes a red, itchy rash. Before the rash appears, you may have:

  • Fever
  • Red eyes
  • Cough
  • Runny nose
  • Light sensitivity

The MMR vaccine (measles, mumps, and rubella) provides lifetime protection for most people who receive 2 doses.

There is treatment for measles. Home care soothes symptoms. Most people recover at home.

Young babies and older adults may need hospital care to prevent complications.

Additional References:


Measles generally has 2 stages. Most people feel better within 2 weeks after symptoms first begin.

Early Stage

Symptoms usually begin 7 to 14 days after you’re exposed and may include:

  • Mild to moderate fever (100.4°F, or higher).
  • Cough, runny nose, and sore throat.
  • Red eyes that may be sensitive to light.
  • Small grey-white spots in the mouth (Koplik's spots), 2 to 3 days after other symptoms.
Later Stage

About 14 days after exposure to the virus (3 to 5 days after early symptoms appear), you develop an itchy, red rash. You may develop a high fever, over 103°F (39°C).

The rash typically:

  • Starts on the face, near your hairline and behind the ears.
  • Spreads down your neck to your torso, arms, legs, and feet.

This stage lasts 4 to 7 days.

Possible Complications

Complications usually occur in children under age 5 and in older adults, but they can occur at any age. Possible complications are:

  • Severe diarrhea
  • Ear infection
  • Pneumonia, the leading cause of death in young children with measles

Serious brain infection (encephalitis) can develop and cause:

  • Seizures, especially in babies
  • Permanent neurological damage
  • Loss of hearing
  • Death

Pregnant women with measles may:

  • Have a miscarriage
  • Give birth too early
  • Have a low-birth weight baby

Causes and Treatment

Measles is caused by a highly contagious virus. The virus grows in the cells that line the back of the throat and upper airways of the lungs, which is why complications often involve the respiratory system.

An infected person:

  • Can spread it to others about 4 days before the rash appears.
  • Is most contagious just before the rash appears.
  • Remains contagious until 4 days after the rash appears.
  • Can spread measles to others without knowing it.

Measles spreads when an infected person coughs, sneezes, or speaks. Tiny contaminated droplets spray into the air. It also spreads when a person who has not had the measles vaccine:

  • Breathes in contaminated droplets.
  • Touches an infected person or a shared surface.

If you’ve been exposed to measles, we may give you an immune globulin shot or the MMR vaccine. You’ll be less likely to get sick or may have milder symptoms.

Risk Factors

You’re at risk of getting measles if you have not:

  • Received 2 doses of the MMR vaccine.
  • Already had the measles.

Babies younger than 12 months are at high risk because they haven’t yet had the MMR vaccine.

If you haven’t had the MMR vaccine, you have a 90 percent chance of developing the measles just by being in the same room as an infected person.


Your risk for measles is higher if you travel to countries where people aren’t routinely vaccinated. Your safest option is to be fully vaccinated.

California has periodic measles outbreaks. This reminds us that measles can occur anywhere, at any time.


Call the appointment and advice line (1-866-454-8855), 24 hours a day, 7 days a week if:

  • You or your child has measles symptoms.
  • Anyone in your family has been exposed.

Call us about your symptoms before you come in for an appointment.

To diagnose measles, we:

  • Learn about your symptoms.
  • Perform a physical examination.

We may also take:

  • Blood tests, to look for antibodies.
  • Samples from your nose, throat, or urine.

We’ll check to see if you’re developing any complications.

We’re required to report measles to the local Public Health Department. They document cases and manage outbreaks in the United States.


The best way to prevent measles is to get immunized. The MMR vaccine (measles, mumps, and rubella) is safe and provides lifetime protection for nearly 99 percent of people who receive 2 doses.

In the U.S. you are protected against (immune to) measles, if you were:

  • Born before 1957 and had measles as a child.
  • Received 2 MMR vaccine doses as a child.
MMR vaccine

Children get their first dose at 12 months or older. The second dose is given between ages 4 and 6.

Treat minor discomfort such as fever or swelling at the injection site with acetaminophen (Tylenol).

Do not get vaccinated if you:

  • Are pregnant.
  • Have a severely weakened immune system.

Not everyone is protected:

  • Some children are behind on vaccinations.
  • Adults with only 1 MMR dose can have a blood test to learn if they need a second dose.

Home Treatment

Most people recover with home care, including:

  • Drinking plenty of fluids.
  • Getting extra rest.
  • Taking ibuprofen or acetaminophen for fever and sore throat (follow the package instructions).
  • Using a humidifier to ease coughing and runny nose.

Never give a child aspirin unless we prescribe it. Aspirin can cause a rare but serious reaction (Reye’s syndrome).

You can avoid infecting others by:

  • Covering your mouth and nose when coughing or sneezing.
  • Placing used tissues in the trash.

A caregiver should:

  • Empty the used tissue trash bin often.
  • Wash your hands regularly with soap and warm water, or use antibacterial sanitizer.
  • Keep visitors away until the fever breaks and the rash fades.

Young babies and older adults may need hospital care to prevent complications.

Call the appointment and advice line at 1-866-454-8855 if you or your child develops symptoms or has been exposed to measles.

Your Care with Me

If you are having symptoms that concern you, your first contact will typically be with your personal physician, who will evaluate your health and symptoms.

If specialty care is needed, your personal physician will facilitate the process of scheduling an appointment in my department. If appropriate, she or he might call me or one of my colleagues while you are in the office so we can all discuss your care together. If we decide you need an appointment with me after that discussion, we can often schedule it the same day or soon thereafter.

During your office visit, we will discuss your medical and family history and I will perform a physical exam. I will explain the findings of your exam and answer any questions or concerns you may have. We will discuss treatment options and develop a treatment plan that is right for you.

If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.

For general medical advice, our Appointment and Advice line is available 24 hours per day, 7 days per week.

If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line. You will be connected with a nurse who can give you immediate advice.

If you are experiencing a serious problem or an emergency, call 911 or go to the nearest Emergency Room when the clinic is not open.

Coordinating Your Care

Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.

Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate.

When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.

If you come to an office visit
  • At the beginning of your visit, you will receive information about when you are due for your next test, screening, or immunization. We can discuss and schedule any preventive tests that you need. 
  • At the end of your visit, you may receive a document called the “After Visit Summary” that will summarize the issues we discussed during your visit. You can refer to it if you forget what we discussed, or if you just want to recheck your vital signs and weight. You can also view it online under Past Visits.
  • To help you prepare for your visit, please see additional details under Office Visit. 
If I prescribe medications

We will work together to monitor and assess how your medications are working and make adjustments over time. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.

If refills are needed in the future, you can:

  • Order them online or by phone. Order future refills from my home page or by phone using the pharmacy refill number on your prescription label.
  • Have them delivered to you by mail at no extra cost. Or you can pick up your medications at the pharmacy. If no refills remain when you place your order, the pharmacy will contact me regarding your prescription.
If lab testing or imaging is needed

For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the Radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.

If I refer you to another specialty colleague

If we decide together that your condition would also benefit from the care of other types of specialists, our staff will help arrange the appointment(s) with one or more of my specialty colleagues.

If surgery or a procedure is a treatment option

I will recommend that you review educational information and tools to help you prepare for your procedure or surgery. The information will often help you decide whether surgery is right for you. If you decide to have a surgery or procedure, the information will provide details about how to prepare and what to expect.

If we proceed with surgery, I will have my Surgery Scheduler contact you to determine a surgery date and provide you with additional instructions regarding your procedure. Once your surgery is scheduled, a medical colleague of mine will contact you to conduct a preoperative medical evaluation that will assure that you are properly prepared for your surgery.

Convenient Resources for You

As your specialist, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.

My Doctor Online is available at any time that is most convenient for you. From my home page you can:

Manage your care securely
  • View and compose secure e-mail messages.
  • Manage your prescriptions.
  • View your past visits and test results.
  • View your preventive services to see whether you are due for a routine screening or updated immunization.
Learn more about your condition
  • Read about causes, symptoms, treatments, and procedures.
  • Find interactive health tools, videos, and podcasts to help you manage your condition.
  • View programs to help you decide on or prepare for a surgery or procedure.
Stay healthy
  • Locate health education classes and support groups offered at every medical center.
  • Explore interactive programs, videos, and podcasts that focus on helping you stay healthy.
  • View your Preventive Services to see whether you are due for a routine screening or updated immunization.

If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

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