Measles Signs and Symptoms
- Symptoms typically appear 10-14 days after exposure
- Classic symptoms include a four-day fever and the three Cs (cough, coryza, conjunctivitis)
- Fever can reach up to 40°C (104°F)
- Kopliks spots, small white spots inside the mouth, are diagnostic for measles
- Measles rash starts on the ears, spreads to the head and neck, and then covers the body
Measles Complications
- Common complications include diarrhea, middle ear infection, and pneumonia
- Measles can suppress the immune system, leading to bacterial superinfections
- Subacute sclerosing panencephalitis is a rare but lethal complication
- Infants, adults over 20 years, pregnant women, and those with compromised immune systems are at high risk
- Case fatality rate ranges from 0.3% to 28% depending on the region and healthcare quality
Measles Cause and Transmission
- Measles is caused by the measles virus, a highly contagious RNA virus
- The virus is spread through coughing, sneezing, and direct contact with secretions
- Measles virus belongs to the Morbillivirus genus within the Paramyxoviridae family
- Measles is an airborne disease that spreads easily through coughs and sneezes
- Direct contact with mouth or nasal secretions can also transmit the virus
- The disease is extremely contagious, with a high transmission rate
- People are infectious to others from four days before to four days after the rash appears
- Measles primarily affects developing areas of Africa and Asia
Measles Prevention and Impact
- Measles vaccine is highly effective and safe
- Vaccination has resulted in an 80% decrease in measles deaths between 2000 and 2017
- About 85% of children worldwide have received their first dose of the vaccine
- Measles affects about 20 million people annually, causing significant morbidity and mortality
- Global vaccination programs have reduced measles deaths from 2.6 million in 1980 to 73,000 in 2014
Measles Diagnosis, Laboratory Testing, and Treatment
- Clinical diagnosis based on fever, malaise, cough, coryza, and conjunctivitis
- Observation of Kopliks spots is diagnostic
- Other conditions with similar symptoms include parvovirus, dengue fever, Kawasaki disease, and scarlet fever
- Laboratory confirmation is recommended
- Measles IgM antibodies or measles virus RNA can be detected for confirmation
- Measles diagnosis can be done through measles IgM antibodies or measles virus RNA detection
- Reverse transcription polymerase chain reaction assay is used for RNA detection
- Saliva can be collected for salivary measles-specific IgA testing
- Salivary testing is not ideal due to the presence of other fluids and proteins
- Saliva contains fewer antibodies than blood samples, making testing difficult
- There is no specific antiviral treatment for measles
- Medications aim to treat superinfections, maintain hydration, and provide pain relief
- Vitamin A is given to young children and severely malnourished individuals to boost antibody responses and decrease complications
- Supportive treatment includes ibuprofen or paracetamol for fever and pain relief
- Vitamin A is recommended to decrease the risk of blindness, but does not prevent or cure the disease
Measles is a highly contagious, vaccine-preventable infectious disease caused by measles virus. Symptoms usually develop 10–12 days after exposure to an infected person and last 7–10 days. Initial symptoms typically include fever, often greater than 40 °C (104 °F), cough, runny nose, and inflamed eyes. Small white spots known as Koplik's spots may form inside the mouth two or three days after the start of symptoms. A red, flat rash which usually starts on the face and then spreads to the rest of the body typically begins three to five days after the start of symptoms. Common complications include diarrhea (in 8% of cases), middle ear infection (7%), and pneumonia (6%). These occur in part due to measles-induced immunosuppression. Less commonly seizures, blindness, or inflammation of the brain may occur. Other names include morbilli, rubeola, red measles, and English measles. Both rubella, also known as German measles, and roseola are different diseases caused by unrelated viruses.
| Measles | |
|---|---|
| Other names | Morbilli, rubeola, red measles, English measles |
 | |
| A child showing a day-four measles rash | |
| Specialty | Infectious disease |
| Symptoms | Fever, cough, runny nose, inflamed eyes, rash |
| Complications | Pneumonia, seizures, encephalitis, subacute sclerosing panencephalitis, immunosuppression, hearing loss, blindness |
| Usual onset | 10–12 days after exposure |
| Duration | 7–10 days |
| Causes | Measles virus |
| Prevention | Measles vaccine |
| Treatment | Supportive care |
| Frequency | 20 million per year |
| Deaths | 140,000+ (2018) |
Measles is an airborne disease which spreads easily from one person to the next through the coughs and sneezes of infected people. It may also be spread through direct contact with mouth or nasal secretions. It is extremely contagious: nine out of ten people who are not immune and share living space with an infected person will be infected. Furthermore, measles's reproductive number estimates vary beyond the frequently cited range of 12 to 18. The NIH quote this 2017 paper saying: "[a] review in 2017 identified feasible measles R0 values of 3.7–203.3". People are infectious to others from four days before to four days after the start of the rash. While often regarded as a childhood illness, it can affect people of any age. Most people do not get the disease more than once. Testing for the measles virus in suspected cases is important for public health efforts. Measles is not known to occur in other animals.
Once a person has become infected, no specific treatment is available, although supportive care may improve outcomes. Such care may include oral rehydration solution (slightly sweet and salty fluids), healthy food, and medications to control the fever. Antibiotics should be prescribed if secondary bacterial infections such as ear infections or pneumonia occur. Vitamin A supplementation is also recommended for children. Among cases reported in the U.S. between 1985 and 1992, death occurred in only 0.2% of cases, but may be up to 10% in people with malnutrition. Most of those who die from the infection are less than five years old.
The measles vaccine is effective at preventing the disease, is exceptionally safe, and is often delivered in combination with other vaccines. Vaccination resulted in an 80% decrease in deaths from measles between 2000 and 2017, with about 85% of children worldwide having received their first dose as of 2017. Measles affects about 20 million people a year, primarily in the developing areas of Africa and Asia. It is one of the leading vaccine-preventable disease causes of death. In 1980, 2.6 million people died from measles, and in 1990, 545,000 died due to the disease; by 2014, global vaccination programs had reduced the number of deaths from measles to 73,000. Despite these trends, rates of disease and deaths increased from 2017 to 2019 due to a decrease in immunization.
