Measles

Measles is a viral infection of the respiratory tract and the skin. It is one of the most contagious diseases known. Measles was once very common, but a vaccine has made it much more rare.

What is going on in the body?

Measles is spread by direct contact with a person who has measles. It is spread by contaminated droplets that are breathed or coughed into the air from the contagious person.

What are the causes and risks of the disease?

Measles is caused by the rubeola virus. People who live in crowded or unsanitary conditions are more likely to get measles.

Measles is a viral infection characterized by a red, bumpy rash.

What is going on in the body?

Measles is acquired by coming into contact with infected respiratory secretions and droplets. Infected people can spread it when they cough, sneeze or wipe their noses.

The measles vaccine has greatly reduced the number of measles cases in the United States. Usually, measles is imported into this country by travelers.

What are the causes and risks of the infection?

Measles is caused by the measles virus, which belongs to the Paramyxovirus family of viruses.

About 0.1% of patients can contract encephalitis, an infection of the brain after becoming infected with measles. Encephalitis can result in brain damage and, sometimes, death.

Rarely, many years after the first measles infection, a person may develop subacute sclerosing panencephalitis. This is a condition characterized by behavioral changes, mental decline and seizures.

What are the signs and symptoms of the infection?

Symptoms usually begin about 1 to 1-1/2 weeks after acquiring the virus. The symptoms can include:

What are the signs and symptoms of the disease?

The symptoms of measles include:

How is the disease diagnosed?

Measles is diagnosed when Koplik's spots are seen. A blood test, known as an antibody titer, can also detect the measles virus. Antibodies appear within 3 days after the rash begins.

How is the infection diagnosed?

Healthcare providers test for measles antibodies in the blood. Antibodies are molecules that protect the body from a certain disease or condition. The measles virus also can be cultured from infected respiratory secretions. It can also be cultured from the eye, the blood and the urine during the fever phase of the illness.

What can be done to prevent the infection?

The measles vaccine is very effective at preventing measles in immunized people. In children, the vaccine is usually combined with the rubella and mumps vaccine and given as one shot, called the MMR vaccine, but it can be given alone. Side effects of the MMR vaccine include:

Other side effects are rare. The vaccine should not be given to pregnant women or to women who are planning on getting pregnant in the 3 months following immunization.

Another way to prevent the spread of infection is to isolate the infected person. An infected person with a normal immune system should stay home from school or work for 4 days after the rash appears. An infected person with autoimmune problems, where the body attacks its own tissues, may be contagious for even longer.

Some people with autoimmune problems should not have the measles vaccine. If these unprotected people are exposed to an infected person, they should receive immune globulin prophylaxis, an injection of disease-fighting proteins.

What are the long-term effects of the infection?

Although it is rare, measles encephalitis can leave a person with brain damage and can sometimes result in death. Subacute sclerosing panencephalitis is a chronic degenerative brain disease.

What are the risks to others?

Measles is contagious and can be spread to other individuals.

What can be done to prevent the disease?

Children should be immunized against measles with an MMR vaccine. This vaccination is a combined one for measles, mumps, and rubella. It is usually given at 1 year of age, and again at 4 to 6 years.

If a person who has not had the vaccine is exposed to measles, a shot of gamma globulin may be given. This may prevent the disease, or at least make it less severe. Gamma globulin will protect a person from measles for 3 months.

What are the long-term effects of the disease?

Possible complications of measles are:

What are the risks to others?

Measles is very contagious. If a person has not had measles, and has not had the MMR vaccine, contact with the infected person should be avoided during the contagious period. A person is contagious from day 11 to day 15 after exposure. Measles becomes apparent 8 to 14 days after exposure.

What are the treatments for the disease?

Treatment of measles involves relieving symptoms by such measures as:

The person should be isolated during the contagious period.

What are the side effects of the treatments?

Acetaminophen, as well as other medications, may cause stomach upset. Aspirin should not be given to anyone younger than 16. There is a link between the use of aspirin in children with a viral illness and Reye's syndrome. Reye's syndrome is a rare disease that involves the brain, and it has a high mortality rate.

What happens after treatment for the disease?

A person with measles should rest until the fever and the rash disappear. The individual should not go back to school or work for 7 to 10 days, or until after the fever and rash are gone.

How is the disease monitored?

It's very important to carefully isolate the person during the contagious period, so that others are not infected. It is also very important to watch for signs of secondary infection, including:

These infections can cause a high fever, headache that progress to a stiff neck and back, and extreme drowsiness. Any new or worsening symptoms should be reported to the healthcare provider.

What are the treatments for the infection?

There is no approved treatment for measles. Acetaminophen may be recommended for discomfort. Cough medicine may be prescribed for a cough. A person should check with a healthcare provider for recommendations. Antibiotics may be prescribed for secondary infections such as pneumonia or encephalitis.

What are the side effects of the treatments?

The side effects of treatment depend on what medicines are used. Antibiotics may cause allergic reactions or stomach upset. Persons should contact a healthcare provider for any side effects that develop.

What happens after treatment for the infection?

Normally, the measles infection lasts 10 days to 2 weeks and a person recovers completely. If pneumonia or encephalitis develop, further treatment and evaluation may be necessary.

How is the infection monitored?

Unless a person develops complications from measles, no further monitoring is necessary. Once a person has measles, he or she is permanently immune and should not develop measles again.

Author:Danielle Zerr, MD
Date Written:
Editor:Keefe, Sandy, RN, MSN
Edit Date:05/14/00
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:05/12/00

Author:Gail Hendrickson, RN, BS
Date Written:
Editor:Duff, Ellen, BA
Edit Date:04/27/00
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:07/13/01

Sources