From the Guidelines
Measles symptoms typically appear 10-14 days after exposure to the virus, with an incubation period averaging 10-12 days from exposure to prodrome and 14 days from exposure to rash. The disease can manifest with various symptoms, including:
- High fever
- Cough
- Runny nose
- Red, watery eyes
- A distinctive rash that begins as flat red spots on the face at the hairline and spreads downward to the neck, trunk, arms, legs, and feet
- Small white spots called Koplik spots may appear inside the mouth before the rash develops, which are a hallmark sign of measles
- Sore throat
- Muscle pain
- Sensitivity to light Measles is highly contagious and can lead to serious complications, including pneumonia, encephalitis, and even death, particularly in young children, pregnant women, and immunocompromised individuals, with a case-fatality rate as high as 25% in developing countries 1. The virus spreads through respiratory droplets when an infected person coughs or sneezes. Vaccination with the MMR (measles, mumps, rubella) vaccine is the most effective way to prevent measles infection. It is essential to note that the risk for death from measles or its complications is greater for infants, young children, and adults than for older children and adolescents, with the most common causes of death being pneumonia and acute encephalitis 1.
From the Research
Measles Symptoms
- Measles is an acute febrile illness characterized by fever, cough, coryza, and conjunctivitis 2
- Koplik's spots may appear on the buccal mucosa, providing an opportunity for early diagnosis 2
- A rash typically appears 3-4 days after the onset of fever, initially on the face and behind the ears 2
- Measles can affect multiple systems, including the respiratory system, with pneumonia being one of the most lethal complications 2
Neurological Complications
- Measles can cause neurological complications, including primary measles encephalitis, acute post-measles encephalitis, subacute sclerosing panencephalitis (SSPE), and measles inclusion body encephalitis (MIBE) 3, 4, 5
- Encephalitis presents with symptoms such as fever, headache, altered level of consciousness, and focal neurological deficits 4, 5
- Diagnosis is based on clinical symptoms, blood tests for measles-specific antibodies, CT, MRI, and analysis of the CSF 4
Management and Prevention
- Management of measles involves supportive care, correction of dehydration and nutritional deficiencies, treatment of secondary bacterial infections, and provision of vitamin A 2
- Prevention through measles vaccination is crucial, with two doses required to achieve sufficient immunity against measles 4
- Measles vaccination has been shown to be effective in preventing measles, with a decrease in global measles deaths from 2000 to 2015 2
- Post-exposure prophylaxis (PEP) with measles, mumps, and rubella vaccine (MMR) or immune globulin (IG) can be effective in preventing measles in nonimmune contacts 6