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

© 2009 Nucleus Medical Media, Inc.

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 either:
  • You have never been diagnosed with measles.
  • You received a vaccine before 1968, and you have never been fully vaccinated since.

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.

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:

• Mumps and rubella vaccine (MMR)
• Mumps, rubella, and varicella (chicken pox) vaccine (MMRV)

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 givven 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 US. They may have been caused by increasing numbers of children who are not vaccinated. Discuss the benefits of vaccination with your doctor.