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.


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 . But, there have been outbreaks in recent years.

Causes

The measles virus is spread by:

  • Airborne transmission (less frequently)
  • Direct contact with nasal or throat secretions of infected people

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:

  • 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.
  • Immunosuppressed state (eg, untreated HIV ), even if vaccinated
  • Living in crowded and/or unsanitary conditions
  • Season: winter and spring
  • Traveling to less developed countries where measles is common
  • Unvaccinated or inadequately vaccinated

Tell your doctor is you have any of the risk factors.

Symptoms

Symptoms, which usually occur 8-12 days following exposure, include:

  • Raised, itchy rash:
    • Generally spreads to the arms, trunk, and legs over the next two days
    • Lasts about 4-6 days
    • Starts around the ears, face, and side of neck 3-5 days after initial symptoms appear
  • Exhaustion
  • Fever (often high)
  • Hacking cough
  • Red eyes
  • Runny nose
  • Sore throat
  • Very small spots inside the mouth (2-4 days after initial symptoms)

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
  • 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.
  • Drink plenty of liquids.
  • Eat a soft, bland diet.
  • Gargle with warm salt water to relieve sore throat. Using a humidifier may also help.
  • Get plenty of rest.
Complications

In most cases, complications are rare. You may need to be hospitalized if you have a severe case. Complications may include:

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.

If you or someone in your family gets measles, family members may need to be vaccinated or given immune globulin.

Ask your doctor if the vaccine is right for you. In general, avoid the vaccine if you:

  • Are pregnant—Avoid pregnancy for 1-3 months after receiving the vaccine.
  • Have a high fever or severe upper respiratory tract infection
  • Have a weakened immune system
  • Have had severe allergic reactions to vaccines or vaccine components

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.

Last reviewed: September 2011 by Lawrence Frisch, MD, MPH.

RESOURCES:
CANADIAN RESOURCES:
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 Nov 15;192(10):1686-93.
  • 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/healthLibrary/ . Updated February 2008. Accessed July 22, 2008.
  • Kassianos G. Vaccination for tomorrow: the need to improve immunization rates. J Fam Health Care . 2010;20(1):13-6.
  • 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.
  • 5/27/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Measles—United States, January—May 20, 2011. MMWR Morb Mortal Wkly Rep. 2011 May 20 early online.