From the Guidelines
Measles (rubeola) is a highly contagious viral disease characterized by fever, cough, runny nose, red eyes, and a distinctive rash that spreads from the face to the rest of the body, with a high risk of complications such as diarrhea, middle ear infection, bronchopneumonia, and encephalitis, especially in infants, young children, and adults. The disease has an incubation period of 10-12 days from exposure to prodrome and 14 days from exposure to rash, with a range of 7-18 days 1.
Key Characteristics of Measles
- 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.
- Measles can be severe, with encephalitis occurring in approximately one of every 1,000 reported cases, and survivors often having permanent brain damage and mental retardation 1.
- In developing countries, measles is often more severe, with a case-fatality rate as high as 25% 1.
Prevention and Treatment
- Vaccination is the most effective prevention method, with the MMR (measles, mumps, rubella) vaccine recommended for all children with first dose at 12-15 months and second dose at 4-6 years of age 1.
- For those exposed to measles without immunity, the MMR vaccine can prevent disease if given within 72 hours of exposure, while immune globulin can be administered within 6 days to high-risk individuals.
- Treatment is primarily supportive, including rest, fluids, fever reducers like acetaminophen or ibuprofen, and vitamin A supplementation (especially in malnourished children) 1.
Transmission and Contagiousness
- Measles is extremely contagious, spreading through airborne droplets when infected people cough or sneeze, with the virus remaining active in the air for up to two hours.
- Infected individuals are contagious from four days before the rash appears until four days after, necessitating isolation during this period to prevent transmission 1.
From the Research
Definition and Overview of Measles
- Measles, also known as rubeola, is a highly contagious illness that classically presents with a rash, fever, cough, coryza, and conjunctivitis 2.
- It is a major cause of childhood morbidity and mortality, with complications that can be associated with significant morbidity and mortality 3, 4.
- Measles affects multiple systems, including the respiratory system, with pneumonia being one of the most lethal complications 5.
Symptoms and Diagnosis
- Symptoms of measles include fever, maculopapular rash, and at least one of cough, coryza, or conjunctivitis, although vaccinated individuals can have milder or even no symptoms 6.
- Laboratory diagnosis relies largely on the detection of specific IgM antibodies in serum, dried blood spots, or oral fluid, or the detection of viral RNA in throat or nasopharyngeal swabs, urine, or oral fluid 6.
- Clinical suspicion should be confirmed with laboratory testing, which is most commonly a serum immunoglobulin M 2.
Complications and Management
- Complications from measles are relatively common and can include otitis media, laryngotracheobronchitis, pneumonia, stomatitis, and diarrhoea 6.
- Neurological complications are uncommon but serious, and can occur during or soon after the acute disease or months or even years later 6.
- Patient management mainly involves supportive therapy, such as vitamin A supplementation, monitoring for and treatment of secondary bacterial infections with antibiotics, and rehydration in the case of severe diarrhoea 3, 4, 6.
- There is no specific antiviral therapy for the treatment of measles, and disease control largely depends on prevention through vaccination 6.