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Measles is a common childhood disease that now can be prevented with a vaccine. Signs and symptoms of measles include cough, runny nose, inflamed eyes, sore throat, fever and a red, blotchy skin rash. Also called rubeola, measles can be serious and even fatal for small children. While death rates have been falling worldwide as more children receive the measles vaccine, the disease still kills several hundred thousand people a year, most under the age of 5. By 2000, the measles vaccine had practically eliminated measles in the United States. But there has been a recent resurgence of the disease, as more people have chosen not to vaccinate their children.

Complications of Measles

Most people recover from measles in 10 to 14 days. As many as 20 percent will develop complications, which may include:

  • Ear infection. One of the most common complications of measles is a bacterial ear infection.
  • Bronchitis, laryngitis or croup. Measles may lead to inflammation of your voice box (larynx) or inflammation of the inner walls that line the main air passageways of your lungs (bronchial tubes).
  • Pneumonia. Pneumonia is a common complication of measles. People with compromised immune systems can develop an especially dangerous variety of pneumonia that is sometimes fatal.
  • Encephalitis. About 1 in 1,000 people with measles develops encephalitis, an inflammation of the brain that may cause vomiting, convulsions and, rarely, coma or even death. Encephalitis can closely follow measles, or it can occur years later.
  • Pregnancy problems. Pregnant women need to take special care to avoid measles, because the disease can cause miscarriage, premature labor or babies with low birth weights. Rubella, or German measles, is a separate disease that can cause birth defects during pregnancy.
  • Low platelet count (thrombocytopenia). Measles may lead to a decrease in platelets — the type of blood cells that are essential for blood clotting.

Causes of Measles

  • The cause of measles is a very contagious virus, which lives in the mucus in the nose and throat of an infected child or adult. That child or adult is contagious from four days before the rash appears to four days after.
  • When someone with measles coughs, sneezes or talks, infected droplets spray into the air, where other people can inhale them. The infected droplets may also land on a surface, where they remain active and contagious for several hours. You can contract the virus by putting your fingers in your mouth or nose or rubbing your eyes after touching the infected surface.

Signs & Symptoms of Measles

Measles symptoms and signs appear 10 to 12 days after exposure to the virus. They typically include:

  • Fever
  • Dry cough
  • Runny nose
  • Inflamed eyes (conjunctivitis)
  • Sensitivity to light
  • Tiny white spots with bluish-white centers found inside the mouth on the inner lining of the cheek, called Koplik's spots
  • A skin rash made up of large, flat blotches that often flow into one another

The course of the measles virus

Measles typically begins with a mild to moderate fever, accompanied by other signs and symptoms, such as a persistent cough, runny nose, inflamed eyes (conjunctivitis) and sore throat. Two or three days later, Koplik's spots — a characteristic sign of measles — appear. Then a fever spikes, often as high as 104 or 105 F (40 or 40.6 C). At the same time, a red blotchy rash appears, usually on the face, along the hairline and behind the ears. This slightly itchy rash rapidly spreads downward to the chest and back and, finally, to the thighs and feet. After about a week, the rash fades in the same sequence that it appeared.

Diagnosis of Measles

Your doctor can usually diagnose measles based on the disease's characteristic rash as well as the small, bright red spots with bluish-white centers on the inside lining of the cheek, called Koplik's spots. If necessary, a blood test can confirm whether the rash is truly measles.

Treatments of Measles

No treatment can get rid of an established measles infection. However, some measures can be taken to protect vulnerable individuals who have been exposed to the virus.

  • Post-exposure vaccination. Nonimmunized people, including infants, may be given the measles vaccination within 72 hours of exposure to the measles virus, to provide protection against the disease. If measles still develops, the illness usually has milder symptoms and lasts for a shorter time.
  • Immune serum globulin. Pregnant women, infants and people with weakened immune systems who are exposed to the virus may receive an injection of proteins (antibodies) that can fight off infection, called immune serum globulin. When given within six days of exposure to the virus, these antibodies can prevent measles or make symptoms less severe.

Medications

  • Analgesics. You or your child may also take over-the-counter medications such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin, others) or naproxen (Aleve) to help relieve the fever that accompanies measles. Don't give aspirin to children because of the risk of Reye's syndrome — a rare but potentially fatal disease.
  • Antibiotics. If a bacterial infection, such as pneumonia or an ear infection, develops while you or your child has measles, your doctor may prescribe an antibiotic.

Isolation

Because measles is highly contagious from about four days before to four days after the rash breaks out, people with measles shouldn't return to activities in which they interact with other people during this period. It may also be necessary to keep nonimmunized people — siblings, for example — out of the infected person's house. Talk with your doctor about keeping someone with measles isolated.

When to seek Medical Advice

Call your doctor if you think you or your child may have been exposed to measles, or if you or your child exhibits symptoms that make you suspect measles. Review your family's immunization records with your doctor, especially before starting elementary school, before college and before international travel.


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