What are the symptoms of measles (Rubeola)?

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From the Guidelines

Measles (Rubeola) is characterized by a distinct set of symptoms, including cough, coryza, conjunctivitis, fever, and a maculopapular or morbilliform rash that typically starts on the face and spreads to the trunk and extremities.

Common Symptoms

  • Prodrome: cough, coryza, and conjunctivitis with fever
  • Rash: maculopapular or morbilliform, begins on the face and spreads downward to the trunk and out to the extremities
  • Koplik spots: pathognomonic, appear during the prodrome

Complications

  • Diarrhea
  • Middle ear infection
  • Bronchopneumonia
  • Encephalitis: occurs in approximately one of every 1,000 reported cases, with permanent brain damage and mental retardation in survivors 1
  • Pneumonia and acute encephalitis are the most common causes of death

Transmission and Contagious Period

  • Contagious period: 4 days before the rash to 4 days after the rash appears 1
  • Transmission: respiratory droplets and airborne spread 1

From the Research

Symptoms of Measles (Rubeola)

The symptoms of measles include:

  • Fever
  • Maculopapular rash
  • At least one of the following:
    • Cough
    • Coryza
    • Conjunctivitis As noted in the study 2, vaccinated individuals can have milder or even no symptoms.

Complications of Measles

Measles can lead to various complications, including:

  • Otitis media
  • Laryngotracheobronchitis
  • Pneumonia
  • Stomatitis
  • Diarrhea
  • Neurological complications, such as:
    • Acute disseminated encephalomyelitis
    • Measles inclusion body encephalitis
    • Subacute sclerosing panencephalitis These complications are discussed in studies 2, 3, 4, 5.

Clinical Presentation

Measles is a highly contagious acute febrile viral illness, classically presenting with a rash, fever, cough, coryza, and conjunctivitis, as described in studies 6, 4. The disease mainly affects young children, with a mortality peak in the first three years of life 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Measles.

Lancet (London, England), 2022

Research

History of measles.

Presse medicale (Paris, France : 1983), 2022

Research

An Update and Review of Measles for Emergency Physicians.

The Journal of emergency medicine, 2020

Research

Measles (Rubeola): An Update.

Journal of special operations medicine : a peer reviewed journal for SOF medical professionals, 2020

Research

Measles: Contemporary considerations for the emergency physician.

Journal of the American College of Emergency Physicians open, 2023

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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