Measles

(Rubeola)

Definition

Measles is an infection that spreads easily. It causes fever, cough, and a rash. It was once a common childhood illness, but it is now less common in the United States due to the use of the measles vaccine .
Measles Rash
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Causes

Measles is caused by a virus. The virus is spread by:
  • Direct contact with nasal or throat secretions of infected people
  • Airborne transmission, which is less common
Measles can be spread:
  • 1-2 days before symptoms appear
  • 3-5 days before the rash
  • 4 days after the appearance of the rash

Risk Factors

Factors that may increase your chance of measles:
  • Unvaccinated or inadequately vaccinated
  • Living in crowded and/or unsanitary conditions
  • Traveling to less developed countries where measles is common
  • Season: winter and spring
  • Weakened immune system even if vaccinated
  • Born after 1956 and either:
    • You have never been diagnosed with measles
    • You received a vaccine before 1968 and you have never been fully vaccinated since

Symptoms

Measles symptoms generally appear 8-12 days following exposure. They include:
  • Conjunctivitis
  • Fever, often high
  • Runny nose
  • Sneezing
  • Discomfort
  • Red eyes
  • Hacking cough
  • Sore throat
  • Exhaustion
  • Very small spots inside the mouth—2-4 days after initial symptoms
  • Raised, itchy red to brownish rash:
    • Starts around the ears, face, and side of the neck 3-5 days after the first symptoms appear
    • Generally spreads to the arms, trunk, and legs over the next two days
    • Lasts about 4-6 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. A physical exam will be done. Diagnosis is made from the symptoms and the rash. Lab tests are usually not needed.

Treatment

Measles is caused by a virus. It cannot be treated with antibiotics. The focus is on relieving symptoms.

Comfort Measures

  • Gargle with warm salt water to relieve sore throat. Using a humidifier may also help.
  • Treat high fever with an over-the-counter pain reliever such as acetaminophen. Cold sponge baths may also help.
    • Note : Aspirin is not recommended for children with a current or recent viral infection. Check with your doctor before giving your child aspirin.
  • Get plenty of rest.
  • Drink plenty of liquids.
  • Eat a soft, bland diet.

Complications

In most cases, complications are rare. You may need to be hospitalized if you have a severe case. Complications may include:

Prevention

Getting vaccinated is the best way to prevent measles. The vaccine contains live viruses that can no longer cause disease. There is a single vaccine to prevent measles. It is also available in combination with:The regular schedule for giving the vaccine is at age 12-15 months and again at age 4-6 years. If you or your child has never been vaccinated against the measles, talk to the doctor.In some cases, the MMR vaccine is given within three days after exposure. This can prevent or reduce symptoms. Immune globulin is given to certain unvaccinated people within six days of exposure. This is usually for infants and pregnant women.If you or someone in your family gets measles, family members may need to be vaccinated or given immune globulin.Ask your doctor if the vaccine is right for you. In general, avoid the vaccine if you:
  • Have had severe allergic reactions to vaccines or vaccine components
  • Are pregnant—Avoid pregnancy for 1-3 months after receiving the vaccine.
  • Have a weakened immune system
  • Have a high fever or severe upper respiratory tract infection
If you are not vaccinated, avoid contact with someone who has measles. Recent outbreaks of measles have occurred in Europe and the United States. They may have been caused by increasing numbers of children who are not vaccinated. Discuss the benefits of vaccination with your doctor.

RESOURCES

Centers for Disease Control and Prevention
http://www.cdc.gov

National Foundation for Infectious Diseases
http://www.nfid.org

CANADIAN RESOURCES

Caring for Kids
http://www.caringforkids.cps.ca

Public Health Agency of Canada
http://www.phac-aspc.gc.ca

References

Bellini WJ, Rota JS, Lowe LE, et al.Subacute sclerosing panencephalitis: more cases of this fatal disease areprevented by measles immunization than was previously recognized. J Infect Dis. 2005;192(10):1686-1693.

Kassianos G. Vaccination for tomorrow: the need to improve immunization rates. J Fam Health Care. 2010;20(1):13-6.

Measles. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 25, 2014. Accessed August 27, 2014.

Measles (rubeola). Centers for Disease Control and Prevention website. Available at: http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3-infectious-diseases-related-to-travel/measles-rubeola.htm. Updated December 13, 2013. Accessed August 27, 2014.

Peter G, Gardner P. Standards for immunization practice for vaccines in children and adults. Infect Dis Clin North Am. 2001;15:9-19.

5/27/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Measles—United States, January—May 20, 2011. MMWR Morb Mortal Wkly Rep. 2011;60(20)666-668.

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