Measles

Measles is a highly contagious viral infection. It causes fever, cough, and a characteristic rash. Once a common childhood illness, it is rarely seen in the United States. This is due to the widespread use of the Measles vaccine, which provides lifelong immunity.

Causes

Measles is caused by the Measles virus, a paramyxovirus. It is spread by direct contact with nasal or throat secretions of infected people. Less frequently, it can be spread by airborne transmission. Measles is communicable from 2-4 days prior to the appearance of symptoms. It remains so until the rash has disappeared.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.
  • Unvaccinated people living in crowded and/or unsanitary conditions
  • People traveling to lesser developed countries where measles is common
  • Season: winter and spring
  • Age: less than 1 year of age (too young to be vaccinated)
  • People who are immunosupressed, even if previously vaccinated
  • People born after 1956 that have never been diagnosed with measles or only received an inactived vaccine prior to 1967
It is very unlikely to contract measles if properly immunized as a child.

Symptoms

Symptoms usually occur 1-2 weeks following exposure to the Measles virus.
Symptoms include:
  • Fever (often high)
  • Runny nose
  • Red eyes
  • Bad, hacking cough
  • Sore throat
  • Exhaustion
  • Very small spots inside the mouth (2-4 days after initial symptoms)
  • Raised, itchy rash:
    • Starts around the ears, face and side of neck 3-5 days after initial symptoms appear
    • Generally spreads to the arms, trunk and legs over the next 2 days
    • Lasts about 4 to 6 days
Full recovery, without scarring, generally takes 7-10 days from the onset of the rash.

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. Diagnosis of Measles is almost always made from the symptoms and the rash. Lab tests are rarely necessary.

Treatment

There is no treatment to cure the Measles. Because measles is caused by a virus, it cannot be treated with antibiotics. Treatment is focused on relieving the symptoms.
Comfort Measures
  • Gargle with warm salt water to relieve sore throat. Cool, moist humidification can also help a sore throat and cough.
  • Treat high fever with non-aspirin pain medication, such as acetaminophen, and cold sponge baths. Note: Aspirin is not recommended for children with a current or recent viral infection. Check with your doctor before giving a child aspirin.
  • Get plenty of rest.
  • Drink plenty of liquids.
  • Eat a soft, bland diet.
Complications In otherwise healthy, well-nourished children, complications from measles are extremely rare. In the event of complications such as encephalitis (brain infection) or bacterial pneumonia, or in severe cases, patients are admitted to the hospital for more aggressive treatment.

Prevention

Vaccination is the best way to prevent measles. The vaccine contains live viruses that can no longer cause disease.
  • Measles vaccine is usually given as part of a combined measles, mumps and rubella (MMR) vaccination twice: at 12 months and 4 to 6 years (or 11 to 12 years).
  • In some cases, measles vaccine given within 3 days after exposure to the measles virus can prevent or alleviate the symptoms.
  • Immune globulin is often given to non-vaccinated people within a week of exposure to the measles. This is especially appropriate for infants or immunocompromised people who live in a house with a measles-contagious person.
Check with your doctor to find out about the exceptions and special circumstances regarding the MMR vaccine. In general, people who should not receive Measles vaccination include:
  • Those who have had severe allergic reactions to vaccines or vaccine components (such as gelatin or the antibiotic neomycin)
  • Women who are pregnant (Women receiving the mumps vaccination should avoid pregnancy for 3 months after receiving the vaccination.)
  • People with a weakened immune system (with the exception of HIV-positive individuals where the benefits of immunization usually far outweigh the risks)
  • People with a high fever or severe upper respiratory tract infection (They should delay immunization until these symptoms have resolved.)
Any unvaccinated person who has not contracted measles should avoid contact with an infected person until all symptoms have subsided.