What are the symptoms and complications of measles (Rubeola)?

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From the Guidelines

Measles (Rubeola) is a severe disease that can lead to complications such as diarrhea, middle ear infection, bronchopneumonia, and encephalitis, with a mortality rate of 1-2 per 1,000 reported cases in the United States, and up to 25% in developing countries. The symptoms of measles include high fever, cough, runny nose, red watery eyes, and small white spots inside the mouth called Koplik spots, followed by a characteristic red rash appearing after 3-5 days 1. The disease can be severe, especially in infants, young children, and adults, with the most common causes of death being pneumonia and acute encephalitis 1.

Common Complications

  • Diarrhea
  • Middle ear infection
  • Bronchopneumonia
  • Encephalitis (brain inflammation)
  • Death

The risk of death from measles or its complications is greater for certain populations, including infants, young children, and adults, than for older children and adolescents 1. In developing countries, measles is often more severe, with a higher case-fatality rate 1.

Treatment and Prevention

Treatment for measles focuses on supportive care, including rest, fluids, and fever reducers, as well as vitamin A supplementation to reduce severity and mortality 1. Antibiotics may be prescribed if bacterial complications develop 1. Prevention through vaccination is crucial, as measles is highly contagious, with the MMR vaccine providing effective protection when given at 12-15 months with a booster at 4-6 years of age.

From the Research

Symptoms of Measles

  • Fever, cough, coryza, and conjunctivitis followed by a characteristic rash 2, 3, 4, 5
  • Maculopapular rash 5
  • Symptoms can be milder or even absent in vaccinated individuals 5

Complications of Measles

  • Diarrhea 2, 3, 6, 5
  • Otitis media 2, 3, 6, 5
  • Pneumonia 2, 3, 5
  • Encephalitis 2
  • Laryngotracheobronchitis 5
  • Stomatitis 5
  • Neurological complications, such as acute disseminated encephalomyelitis, measles inclusion body encephalitis, and subacute sclerosing panencephalitis 5

Management and Prevention

  • Supportive therapy, such as vitamin A supplementation, monitoring for and treatment of secondary bacterial infections with antibiotics, and rehydration in the case of severe diarrhea 3, 4, 5
  • No specific antiviral therapy for the treatment of measles 5
  • Prevention through vaccination, with a live attenuated vaccine developed in 1958 2
  • Importance of increasing global coverage with two doses of measles vaccine to prevent outbreaks and achieve regional elimination and global eradication 3

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

History of measles.

Presse medicale (Paris, France : 1983), 2022

Research

Measles.

Lancet (London, England), 2017

Research

An Update and Review of Measles for Emergency Physicians.

The Journal of emergency medicine, 2020

Research

Measles.

Lancet (London, England), 2022

Research

Measles: pathology, management and public health issues.

Nursing standard (Royal College of Nursing (Great Britain) : 1987), 2014

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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