Measles
(Rubeola)
Definition
Measles is viral infection. It is highly contagious. It causes fever, cough, and a rash. It was once a common childhood illness. Measles is now seen less often in the US. This is due to the use of the measles vaccine .
Measles Rash
Causes
The measles virus is spread by:
- Direct contact with nasal or throat secretions of infected people
- Airborne transmission (less frequently)
Measles is communicable from:
- 1-2 days before onset of symptoms
- 3-5 days before the rash
- Four days after the appearance of the rash
Risk Factors
These factors increase your chance of developing 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
- Immunosuppressed state (eg, untreated HIV ), even if vaccinated
- Born after 1956 and never been diagnosed with measles or received a vaccine before 1968, without additional vaccination
Tell your doctor is you have any of the risk factors.
Symptoms
Symptoms, which usually occur 8-12 days following exposure, include:
- Fever (often high)
- Runny nose
- Red eyes
- 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 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 are caused by a virus. Therefore, 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 non-aspirin medication. This includes
acetaminophen
. Cold sponge baths may also help.
- Note : Aspirin is not recommended for children or teens with a current or recent viral infection. This is because of the risk of Reye's syndrome . Ask your doctor which other medicines are safe for your child.
- 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:
- Encephalitis —inflammation of the brain
- Bacterial pneumonia —lung infection
If you are diagnosed with measles, follow your doctor's instructions .
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, and 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.
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.
RESOURCES:
Centers for Disease Control and Prevention
http://www.cdc.gov/
National Foundation for Infectious Disease
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:
Berkow R. The Merck Manual of Medical Information . 17th ed. New York, NY: Simon and Schuster, Inc; 2000.
Glickman-Simon R. Measles vaccine. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81 . Updated February 2008. Accessed July 22, 2008.
Peter G, Gardner P. Standards for immunization practice for vaccines in children and adults. Infect Dis Clin North Am . 2001;15:9-19.
Red Book: 2003 Report of the Committee on Infectious Diseases . 26th ed. Washington, DC: American Academy of Pediatrics; 2003.
Last reviewed September 2009 by David Horn, MD, FACP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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