From the Guidelines
Measles Symptoms
Measles symptoms typically include a prodrome of cough, coryza, and conjunctivitis with fever, followed by a characteristic maculopapular or morbilliform rash that begins on the face and spreads downward to the trunk and out to the extremities 1.
- The symptoms often present with Koplik spots, which are considered pathognomonic, and appear during the prodrome 1.
- Patients are contagious 4 days before the rash to 4 days after the rash appears 1.
- The incubation period of measles averages 10-12 days from exposure to prodrome and 14 days from exposure to rash (range: 7-18 days) 1.
- Measles can be severe and is most frequently complicated by diarrhea, middle ear infection, or bronchopneumonia 1.
- Encephalitis occurs in approximately one of every 1,000 reported cases, and survivors of this complication often have permanent brain damage and mental retardation 1.
- The risk for death from measles or its complications is greater for infants, young children, and adults than for older children and adolescents 1.
- The most common causes of death are pneumonia and acute encephalitis 1.
- In developing countries, measles is often more severe and the case-fatality rate can be as high as 25% 1.
From the Research
Symptoms of Measles (Rubeola)
The symptoms of measles (rubeola) include:
- A 2-3 day prodrome of fever, runny nose, cough, and conjunctivitis 2
- A characteristic maculopapular rash that spreads from the face and trunk to the extremities 2, 3
- The rash is a manifestation of the MeV-specific type 1 CD4⁺ and CD8⁺ T cell adaptive immune response with lymphocyte infiltration into tissue sites of MeV replication 2
- The symptoms occur after a clinically silent latent period of 10-14 days 2, 3
Disease Progression
The disease progression of measles (rubeola) involves:
- Extensive virus replication and spread during the latent period 2
- Clearance of infectious virus after the appearance of the rash 2, 3
- Persistence of viral RNA in lymphoid tissue for at least 6 months after infection 3
- Maturation of the immune response, resulting in lifelong protection from reinfection 2, 3