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Measles

(Rubeola)

Definition

Measles is an infection that spreads easily. It causes fever, cough, fatigue, runny nose, conjunctivitis, 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    TOP

Measles is caused by a virus. The virus is spread by:

  • Direct contact with nasal or throat secretions of infected people, such as through kissing
  • Airborne transmission, which is less common, such as through coughing and sneezing

Measles can be spread:

  • 1-2 days before symptoms appear
  • 3-5 days before the rash
  • Up to 4 days after the appearance of the rash

Risk Factors    TOP

Factors that may increase your risk of measles include:

  • 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    TOP

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 whitish 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 2 days
    • Lasts about 4-6 days

Full recovery, without scarring, generally takes 7-10 days from the onset of the rash.

Diagnosis    TOP

You will be asked 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    TOP

Measles is caused by a virus. It cannot be treated with antibiotics. The focus is on relieving symptoms with rest and comfort measures such as:

  • Gargling with warm salt water
  • Using a humidifier
  • Over-the-counter pain relievers
  • Cold sponge baths
  • Drinking plenty of liquids and eating 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    TOP

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 3 days after exposure. This can prevent or reduce symptoms. Immune globulin is given to certain unvaccinated people within 6 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.

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—Canadian Paediatric Society
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 are prevented 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:
...(Click grey area to select URL)
Updated April 15, 2016. Accessed June 7, 2016.
Measles. World Health Organization website. Available at:
...(Click grey area to select URL)
Updated March 2016. Accessed June 7, 2016.
Measles (rubeola). Centers for Disease Control and Prevention website. Available at:
...(Click grey area to select URL)
Updated September 10, 2015. Accessed June 7, 2016.
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
...(Click grey area to select URL)
Measles—United States, January—May 20, 2011. MMWR Morb Mortal Wkly Rep. 2011;60(20)666-668.
Last reviewed June 2016 by Marcie Sidman, MD
Last Updated: 5/11/2013

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