Measles

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Alternative names
Rubeola

Definition
Measles is a highly contagious viral illness characterized by a fever, cough, conjunctivitis (redness and irritation in membranes of the eyes), and spreading rash.

Causes, incidence, and risk factors

Measles is caused by a virus. The infection is spread by contact with droplets from the nose, mouth, or throat of an infected person. The incubation period is 8 to 12 days before symptoms generally appear.

Immunity to the disease occurs after vaccination or active infection.

Before widespread immunization, measles was so common during childhood that the majority of the population had been infected by age 20. Measles cases dropped over the last several decades to virtually none in the U.S. and Canada because of widespread immunization, but rates have crept up again recently.

Some parents are refusing to have their children vaccinated because of fears that the MMR vaccine, which protects against Measles, Mumps, and Rubella, can cause Autism.

Large studies of thousands of children have found no connection between this vaccine and the development of Autism, however, lower vaccination rates can cause outbreaks of measles, Mumps, and Rubella—which can be serious.

Symptoms

• sore throat
  
• runny nose
  
• cough
  
• muscle pain
  
• fever
  
• bloodshot eyes
  
• tiny white spots inside the mouth (called Koplik’s spots)
  
• photophobia (light sensitivity)
  
• rash
  o appears around the fifth day of the disease
  o may last 4 to 7 days
  o usually starts on the head and spreads to other areas, progressing downward
  o maculopapular rash—appears as both macules (flat, discolored areas) and papules (solid, red, elevated areas) that later merge together (confluent)
  
• itching of the rash

Note: The period between the appearance of the earliest symptoms and the appearance of a rash or fever is usually 3 to 5 days.

Signs and tests

• viral culture (rarely done)
  
• a measles serology

Treatment
There is no specific treatment of measles, though some children may require supplementation with Vitamin A. Symptoms may be relieved with bed rest, acetaminophen, and humidified air.

Expectations (prognosis)
The probable outcome is excellent in uncomplicated cases. However, pneumonia or encephalitis are possible complications.

Complications
Associated bacterial infection may cause otitis media, bronchitis, or pneumonia. Encephalitis occurs in approximately 1 out of 1,000 measles cases.

Calling your health care provider
Call your health care provider if you or your child has symptoms of measles.

Prevention
Routine immunization is highly effective in the prevention of measles. Unimmunized or under-immunized people are at high risk.

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