What is measles?
Measles is a highly contagious infectious disease caused by the measles virus. Symptoms usually develop 10–12 days after exposure to an infected person and last 7–10 days. Initial symptoms typically include fever, often greater than 40 °C (104 °F), cough, runny nose, and inflamed eyes. Small white spots known as Koplik’s spots may form inside the mouth two or three days after the start of symptoms.
A red, flat rash that usually starts on the face and then spreads to the rest of the body typically begins three to five days after the start of symptoms. Common complications include diarrhea (in 8% of cases), middle ear infection (7%), and pneumonia (6%). These occur in part due to measles-induced immunosuppression. Less commonly seizures, blindness, or inflammation of the brain may occur. Other names include morbilli, rubeola, red measles, and English measles. Both rubella, also known as “German measles”, and roseola are different diseases caused by unrelated viruses.
Measles is an airborne disease that spreads easily through the coughs and sneezes of infected people. It may also be spread through direct contact with the mouth or nasal secretions. Nine out of ten people who are not immune and share living space with an infected person will be infected. People are infectious to others from four days before to four days after the start of the rash. Most people do not get the disease more than once. Testing for the measles virus in suspected cases is important for public health efforts.
The measles vaccine is effective at preventing the disease and is often delivered in combination with other vaccines. Vaccination resulted in an 80% decrease in deaths from measles between 2000 and 2017, with about 85% of children worldwide have received their first dose as of 2017. Once a person has become infected, no specific treatment is available, although supportive care may improve outcomes. Such care may include oral rehydration solution (slightly sweet and salty fluids), healthy food, and medications to control the fever. Antibiotics should be prescribed if secondary bacterial infections such as ear infections or pneumonia occur. Vitamin A supplementation is also recommended for children.
Measles affects about 20 million people a year, primarily in the developing areas of Africa and Asia. While often regarded as a childhood illness, it can affect people of any age. It is one of the leading vaccine-preventable disease causes of death. In 1980, 2.6 million people died of it, and in 1990, 545,000 died; by 2014, global vaccination programs had reduced the number of deaths from measles to 73,000. Despite these trends, rates of disease and deaths increased from 2017 to 2019 due to a decrease in immunization. The risk of death among those infected is about 0.2%, but maybe up to 10% in people with malnutrition. Most of those who die from the infection are less than five years old. Measles is not known to occur in other animals.
Types Of Measles
There are two types of measles:
- Measles: This is the standard form caused by the rubeola virus.
- Rubella, or German measles: This is caused by the rubella virus.
Rubella generally presents as mild but presents more of a risk trusted Source to unborn infants than young children if a woman contracts the virus while she is pregnant.
It is neither as infectious nor as severe as standard measles.
The measles, mumps, and rubella (MMR) vaccine contain immunizations for both types.
Symptoms of Measles
Measles signs and symptoms appear around 10 to 14 days after exposure to the virus. Signs and symptoms of measles typically include:
- Dry cough
- Runny nose
- Sore throat
- Inflamed eyes (conjunctivitis)
- Tiny white spots with bluish-white centers on a red background found inside the mouth on the inner lining of the cheek — also called Koplik’s spots
- A skin rash made up of large, flat blotches that often flow into one another
The infection occurs in sequential stages over a period of two to three weeks.
- Infection and incubation. For the first 10 to 14 days after you’re infected, the measles virus incubates. You have no signs or symptoms of measles during this time.
- Nonspecific signs and symptoms. Measles typically begin with a mild to moderate fever, often accompanied by a persistent cough, runny nose, inflamed eyes (conjunctivitis) and sore throat. This relatively mild illness may last two or three days.
- Acute illness and rash. The rash consists of small red spots, some of which are slightly raised. Spots and bumps in tight clusters give the skin a splotchy red appearance. The face breaks out first.Over the next few days, the rash spreads down the arms and trunk, then over the thighs, lower legs and feet. At the same time, the fever rises sharply, often as high as 104 to 105.8 F (40 to 41 C). The measles rash gradually recedes, fading first from the face and last from the thighs and feet.
- Communicable period. A person with measles can spread the virus to others for about eight days, starting four days before the rash appears and ending when the rash has been present for four days.
Complications from measles are fairly common. Some can be serious.
People most at riskTrusted Source are patients with a weak immune system, such as those with HIV, AIDS, leukemia, or a vitamin deficiency, very young children, and adults over the age of 20 years.
Older people are more likely to have complications than healthy children over the age of 5 years.
Complications can include trusted Source:
- eye infection
- respiratory tract infections, such as laryngitis and bronchitis
- difficulty breathing
- ear infections, which can lead to permanent hearing loss
- febrile seizures
Patients with a weakened immune system who have measles are more susceptible to bacterial pneumonia. This can be fatal if not treated.
The following less common complications are also possible:
- Hepatitis: Liver complications can occur in adults and in children who are taking some medications.
- Encephalitis: This affects around 1 in every 1,000Trusted Source patients with measles. It is an inflammation of the brain that can sometimes be fatal. It may occur soon after measles, or several years later.
- Thrombocytopenia, or low platelet count, affects the blood’s ability to clot. The patient may bruise easily.
- Squint: Eye nerves and eye muscles may be affected.
Complications that are very rare but possible include:
- Neuritis, an infection of the optic nerve that can lead to vision loss
- Heart complications
- Subacute sclerosing panencephalitis (SSPE): A brain disease that can affect 2 in every 100,000Trusted Source people, months or years after measles infection. Convulsions, motor abnormalities, cognitive issues, and death can occur.
- Other nervous system complications include toxic encephalopathy, retrobulbar neuritis, transverse myelitis, and ascending myelitis.
Causes of Measles
Measles is caused by infection with the rubeola virus. The virus lives in the mucus of the nose and throat of an infected child or adult.
The disease is contagious for 4 days before the rash appears, and it continues to be contagious for about 4 to 5 days after.
The infection spreads through:
- physical contact with an infected person
- being near infected people if they cough or sneeze
- touching a surface that has infected droplets of mucus and then putting fingers into the mouth, or rubbing the nose or eyes
The virus remains active on an object for 2 hours.
How does a measles infection develop?
As soon as the virus enters the body, it multiplies in the back of the throat, lungs, and the lymphatic system. It later infects and replicates in the urinary tract, eyes, blood vessels, and central nervous system.
The virus takes 1 to 3 weeks to establish itself, but symptoms appear between 9 and 11 days after the initial infection.
Anyone who has never been infected or vaccinated is likely to become ill if they breathe in infected droplets or are in close physical contact with an infected person.
Approximately 90 percent of trusted sources of people who are not immune will develop measles if they share a house with an infected person.
Measles during pregnancy
Pregnant women who don’t have immunity to measles should take care to avoid exposure during their pregnancy. Coming down with measles during your pregnancy can have significant negative health effects on both the mother and fetus.
Pregnant women are at an increased risk for complications from measles such as pneumonia. Additionally, having measles while pregnant can lead to the following pregnancy complications:
- preterm labor
- low birth weight
Measles can also be transmitted from mother to child if the mother has measles close to her delivery date. This is called congenital measles. Babies with congenital measles have a rash after birth or develop one shortly afterward. They’re at an increased risk of complications, which can be life-threatening.
If you’re pregnant, don’t have immunity to measles, and believe that you’ve been exposed, you should contact your doctor immediately. Receiving an injection of immunoglobulin may help to prevent an infection.
Measles has a low death rate in healthy children and adults, and most people who contract the measles virus recover fully. The risk of complications is higher in the following groups:
- children under 5 years old
- adults over 20 years old
- pregnant women
- people with a weakened immune system
- individuals who are malnourished
- people with a vitamin A deficiency
Approximately 30 percent trusted Source of people with measles experience one or more complications. Measles can lead to life-threatening complications, such as pneumonia and inflammation of the brain (encephalitis).
Other complications associated with measles may include:
- ear infection
- severe diarrhea
- pregnancy complications, such as miscarriage or preterm labor
- subacute sclerosing panencephalitis (SSPE), a rare degenerative condition of the nervous system that develops years after infection
You can’t get measles more than once. After you’ve had the virus, you’re immune for life.
However, measles and its potential complications are preventable through vaccination. Vaccination not only protects you and your family but also prevents the measles virus from circulating in your community and affecting those who can’t be vaccinated.
Treatment of Measles
There is no specific treatment. If there are no complications, the doctor will recommend rest and plenty of fluids to prevent dehydration.
Symptoms usually go away within 7 to 10 days.
The following measures may help:
- If the child’s temperature is high, they should be kept cool, but not too cold. Tylenol or ibuprofen can help control fever, aches, and pains. Children under 16 years should not take aspirin. A doctor will advise about acetaminophen dosage, as too much can harm the child, especially the liver. There is an excellent selection online if you want to buy Tylenol or ibuprofen.
- People should avoid smoking near the child.
- Sunglasses, keeping the lights dim or the room darkened may enhance comfort levels, as measles increases sensitivity to light.
- If there is crustiness around the eyes, gently clean with a warm, damp cloth.
- Cough medicines will not relieve a measles cough. Humidifiers or placing a bowl of water in the room may help. If the child is over 12 months, a glass of warm water with a teaspoon of lemon juice and two teaspoons of honey may help. Do not give honey to infants.
- A fever can lead to dehydration, so the child should drink plenty of fluids.
- A child who is in the contagious stage should stay away from school and avoid close contact with others, especially those who are not immunized or have never had measles.
- Those with a vitamin A deficiency and children under 2 years who have measles may benefit from vitamin A supplements. These can help prevent complications, but they should only be taken with a doctor’s agreement. If you want to buy vitamin A supplements, then there is an excellent selection online with thousands of customer reviews.
Antibiotics will not help against the measles virus, but they may sometimes be prescribed if an additional bacterial infection develops.
Diagnosis for Measles
A doctor can normally diagnose measles by looking at the signs and symptoms. A blood test will confirm the presence of the rubeola virus.
In most countries, measles is a notifiable disease. The doctor has to notify the authorities of any suspected cases. If the patient is a child, the doctor will also notify the school.
A child with measles should not return to school until at least 5 days after the rash appears.
Prevention of Measles
People who have already had measles are normally immune and they are unlikely to get it again.
People who are not immune should consider the measles vaccine.
In the United States, the measles, mumps, and rubella (MMR) vaccine are routinely given at 12 to 15 months of age, followed by a booster shot before entering school at the age of 4 to 6 years.
Newborns carry their mother’s immunity for a few months after birth if their mothers are immune, but sometimes the vaccine is recommended before the age of 12 months, and as early as 6 months.
This may happen if they are, or are likely to be, in an area where there is a serious outbreak.
The WHO estimates that measles vaccination programs led to a 79 percent trusted Source drop in measles deaths globally, from 2000 to 2015, preventing around 20.3 million deaths.
Adults do not require a vaccine in the U.S. if they:
- were born or lived in the U.S. before 1957Trusted Source in the U.S.
- received two MMR shots after they were 12 months old
- had one MMR vaccine plus a second dose of measles vaccine
- are found to be immune to measles, mumps, and rubella after a blood test
The vaccine should not be taken by:
- women who are pregnant or plan to become pregnant soon
- people with a serious allergy to gelatin or neomycin, an antibiotic
Anybody whose immune system may be compromised by a condition or treatment for a condition should ask their doctor whether they should receive the vaccine.
There has been concern about an alleged link between the MMR vaccine a risk of autism, but scientists have found no evidence trusted Source of a link.
The CDC points out that during an outbreak of measles in the U.S. between 1989 and 1991, 90 percent trusted Source of fatal cases were among those with no history of vaccination.
Other prevention methods
Not everyone can receive measles vaccination. But there are other ways that you can help to prevent the spread of measles.
If you’re susceptible to infection:
- Practice good hand hygiene. Wash your hands before eating, after using the bathroom, and before touching your face, mouth, or nose.
- Don’t share personal items with people who may be ill. This can include things like eating utensils, drinking glasses, and toothbrushes.
- Avoid coming into contact with people who are sick
If you’re sick with measles:
- Stay home from work or school and other public places until you aren’t contagious. This is four days after you first develop the measles rash.
- Avoid contact with people who may be vulnerable to infection, such as infants too young to be vaccinated and immunocompromised people.
- Cover your nose and mouth if you need to cough or sneeze. Dispose of all used tissues promptly. If you don’t have a tissue available, sneeze into the crook of your elbow, not into your hand.
- Be sure to wash your hands frequently and to disinfect any surfaces or objects that you touch frequently.
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