Measles, also called rubeola, is a highly contagious disease caused by the measles virus. The measles virus grows in the cells that line the back of the throat and lungs. Before a vaccine was available, almost everyone was infected with the measles virus during childhood. Vaccination for measles in the United States began in 1963, which dramatically reduced measles disease in the United States. However, measles remains a common disease in many parts of the world, including Europe, Asia, Africa, and the Pacific. Each year around the world, measles infects about 20 million people and kills about 164,000 people; 100,000 of these deaths are children.
Signs and Symptoms
The symptoms of measles generally begin about 7 to 14 days after a person is infected. A typical case of measles begins with mild to moderate fever, cough, runny nose, red eyes, and sore throat. Two or three days after symptoms begin, tiny white spots (Koplik’s spots) may appear inside the mouth.
Three to 5 days after the start of symptoms, a red or reddish-brown rash appears. The rash usually begins on a person’s face at the hairline and spreads downward to the neck, trunk, arms, legs, and feet. When the rash appears, a person’s fever may spike to more than 104 degrees Fahrenheit.
After a few days, the fever subsides and the rash fades.
About 1 out of 10 children with measles also gets an ear infection, and up to 1 out of 20 gets pneumonia. About 1 out of 1,000 gets meningitis (inflammation of the brain), and 1 or 2 out of 1,000 die. Other rash-causing diseases often confused with measles include roseola (roseola infantum) and rubella (German measles). Measles can also make a pregnant woman have a miscarriage or give birth prematurely.
Subacute sclerosing panencephalitis (SSPE) is a very rare, but fatal disease of the central nervous system that results from a measles virus infection acquired earlier in life. SSPE generally develops 7 to 10 years after a person has measles, even though the person seems to have fully recovered from the illness. The risk of developing SSPE may be higher for a person who gets measles before they are two years of age.
Transmission (How it Spreads)
Measles is highly contagious and can be spread to others from 4 days before to 4 days after the rash appears. Measles is so contagious that if one person has it, 90% of the people close to that person who are not immune will also become infected with the measles virus.
The virus lives in the mucus in the nose and throat of the infected person. When that person sneezes or coughs, droplets spray into the air. The droplets can get into other people’s noses or throats when they breathe or put their fingers in their mouth or nose after touching an infected surface. The virus can live on infected surfaces for up to 2 hours and spreads so easily that people who are not immune will probably get it when they come close to someone who is infected.
Measles is a disease that affects humans; it is not spread by other animal species.
Testing and Treatment
Measles is diagnosed based on symptoms and laboratory testing. Your medical provider will ask you questions about any vaccinations you may have received against measles, if you have traveled in the last 3 weeks, and about any ill individuals you may have had contact with during the last 3 weeks. Your medical provider may swab your nose as well as collect urine and blood for laboratory testing.
There is no specific treatment for measles. Measles is caused by a virus, so antibiotics are not effective against it. Treatment is usually supportive, including fever-reducing medications like Tylenol, rest, and drinking plenty of fluids. Aspirin should not be given to children under 16 years of age.
The measles, mumps, and rubella vaccine (MMR) is the best way to protect against getting measles. Children should be given the first dose of MMR vaccine soon after the first birthday (12 to 15 months of age). The second dose is recommended before the start of the kindergarten. Adults at increased risk of getting measles — college students, international travelers and healthcare workers — should make sure they have been vaccinated against measles.
If you are planning a trip to Europe, Asia, Africa, or the Pacific, please make sure you are vaccinated against measles before you travel. It takes a few weeks to build up immunity against measles after being vaccinated. Don’t wait until the last minute to get vaccinated!
For more information on measles, visit the Centers for Disease Control and Prevention’s (CDC’s) website on measles.
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