From the Guidelines
Measles (rubeola) is a severe and potentially life-threatening viral disease characterized by a high fever, cough, runny nose, red eyes, and a characteristic rash, with an incubation period averaging 10-12 days from exposure to prodrome and 14 days from exposure to rash. The disease can be complicated by diarrhea, middle ear infection, or bronchopneumonia, and encephalitis occurs in approximately one of every 1,000 reported cases, often resulting in permanent brain damage and mental retardation 1. Key characteristics of measles include:
- Incubation period: 10-12 days from exposure to prodrome and 14 days from exposure to rash
- Complications: diarrhea, middle ear infection, bronchopneumonia, and encephalitis
- Case-fatality rate: 1-2 per 1,000 reported cases in the United States, and up to 25% in developing countries
- High-risk groups: infants, young children, and adults
The severity of measles and its potential for serious complications, including death, emphasize the importance of prevention through vaccination and prompt medical attention if symptoms occur. According to the study by 1, the risk for death from measles or its complications is greater for certain age groups, highlighting the need for vigilant prevention and treatment strategies. Vaccination with the MMR vaccine is the most effective prevention method, and individuals should receive two doses: first at 12-15 months and second at 4-6 years of age. If exposed to measles, unvaccinated individuals should receive the vaccine within 72 hours or immune globulin within 6 days to prevent or reduce symptoms. Treatment is primarily supportive, including rest, fluids, and vitamin A supplementation in severe cases.
From the Research
Definition and Overview of Measles
- Measles, also known as rubeola, is a highly communicable viral infection with serious complications 2.
- It is characterized by a serious febrile illness that may lead to pneumonia, blindness, deafness, neurological disorders, and even death 3.
- Measles infection leads to immune suppression for weeks to months, and complications of measles are of high frequency and severity 2.
Transmission and Diagnosis
- Transmission of measles is dependent on person-to-person spread through respiratory droplets or direct contact 2.
- Diagnosis is based on recognizing the clinical picture and can be confirmed with results of laboratory testing, such as serologic tests or polymerase chain reaction 2.
- A detailed history and physical examination facilitate the diagnosis, and investigations include blood tests for measles-specific antibodies, CT, MRI, and analysis of the CSF 4.
Treatment and Prevention
- There is no specific antiviral treatment for measles; treatment with vitamin A is recommended for younger children to decrease mortality from measles 2.
- The measles vaccine is highly effective, cost-effective, and safe, and two doses are required to achieve sufficient immunity against measles 2, 5.
- The administration of the measles vaccine is the major means of preventing this disease in childhood, with the first dose at the age of 12-15 months and the second at 4-6 years of age 4.
- Supportive care includes administering acetaminophen for fever, oral rehydrating salt (ORS) for diarrhea and vomiting, antibiotics for otitis media and pneumonia, and using anti-epileptics such as sodium valproate for seizures 4.
Vaccination Recommendations
- The Advisory Committee on Immunization Practices (ACIP) recommends 2 doses of MMR vaccine routinely for children with the first dose administered at age 12 through 15 months and the second dose administered at age 4 through 6 years before school entry 6.
- Two doses are recommended for adults at high risk for exposure and transmission, and 1 dose for other adults aged ≥18 years 6.
- ACIP also recommends vaccination for persons with human immunodeficiency virus (HIV) infection, and revaccination of persons with perinatal HIV infection who were vaccinated before establishment of effective antiretroviral therapy (ART) 6.