What are the primary symptoms of measles. How is measles transmitted. Who is at highest risk for measles complications. What is the most effective way to prevent measles infection. How long does measles remain contagious. What are the potential complications of measles. When should you seek medical attention for suspected measles.

Understanding Measles: A Highly Contagious Viral Infection

Measles, also known as rubeola, is a highly infectious viral disease that primarily affects children. Once a common childhood illness, measles has become relatively rare in many developed countries due to widespread vaccination efforts. However, it remains a significant global health concern, particularly in areas with low vaccination rates.

Despite advances in prevention, measles continues to claim lives worldwide. According to recent estimates, over 200,000 people, mostly children, die from measles-related complications each year. This statistic underscores the importance of understanding the disease, its symptoms, and prevention methods.

What exactly is measles?

Measles is caused by a virus belonging to the paramyxovirus family. It is an airborne disease, meaning it spreads easily through respiratory droplets when an infected person coughs, sneezes, or talks. The virus can remain infectious in the air for up to two hours, making it one of the most contagious diseases known to medical science.

Recognizing the Symptoms of Measles

Measles infection progresses through distinct stages, each characterized by specific symptoms. Understanding these stages can help in early detection and prompt medical intervention.

What are the initial symptoms of measles?

The first signs of measles typically appear 10 to 14 days after exposure to the virus. These early symptoms often resemble those of a common cold and may include:

• Fever
• Dry cough
• Runny nose
• Sore throat
• Inflamed eyes (conjunctivitis)

As the infection progresses, more distinctive symptoms emerge. One unique sign of measles is the appearance of Koplik’s spots – tiny white spots with bluish-white centers on a red background found inside the mouth, typically on the inner lining of the cheek.

How does the measles rash develop?

The characteristic measles rash usually appears 3 to 5 days after the initial symptoms. This rash is a key diagnostic feature of the disease and follows a specific pattern:

1. It starts on the face, often behind the ears and along the hairline.
2. Over the next few days, it spreads downward to the neck, trunk, arms, and legs.
3. The rash consists of flat red spots, some of which may be slightly raised.
4. As the spots spread, they often merge, creating splotchy red areas on the skin.
5. The rash typically lasts for about a week before gradually fading.

During the rash phase, the fever often spikes, potentially reaching as high as 104 to 105.8°F (40 to 41°C). This combination of high fever and widespread rash marks the peak of the illness.

The Transmission and Spread of Measles

Understanding how measles spreads is crucial for preventing outbreaks and protecting vulnerable populations.

How contagious is measles?

Measles is exceptionally contagious. In fact, it’s estimated that 90% of unvaccinated people who come into close contact with an infected person will contract the virus. This high transmission rate is due to several factors:

• The virus can remain infectious in the air for up to two hours after an infected person has left the area.
• Infected individuals can spread the virus for about eight days – from four days before the rash appears to four days after its onset.
• The virus can survive on surfaces for several hours, allowing for indirect transmission through contaminated objects.

Who is most at risk for contracting measles?

While anyone who hasn’t been vaccinated or hasn’t had measles before is at risk, certain groups are particularly vulnerable:

• Unvaccinated young children
• Unvaccinated pregnant women
• People with compromised immune systems
• Individuals traveling to areas where measles is more common

It’s worth noting that even in countries with high vaccination rates, pockets of unvaccinated communities can lead to localized outbreaks.

Complications and Risks Associated with Measles

While many people recover from measles without significant issues, the disease can lead to serious complications, especially in certain high-risk groups.

What are the potential complications of measles?

Measles can lead to a range of complications, some of which can be life-threatening. These include:

• Severe diarrhea and dehydration
• Ear infections, which can result in permanent hearing loss
• Bronchitis, laryngitis, or croup
• Pneumonia, one of the most common causes of death from measles in young children
• Encephalitis (inflammation of the brain), which can cause seizures and brain damage
• Pregnancy problems, including premature birth and low birth weight

In rare cases, measles can lead to a fatal neurological complication known as subacute sclerosing panencephalitis (SSPE), which can develop years after the initial infection.

Who is at highest risk for measles complications?

While anyone can develop complications from measles, certain groups are at higher risk:

• Children under 5 years of age
• Adults over 20 years old
• Pregnant women
• People with compromised immune systems, such as those with HIV/AIDS or those undergoing chemotherapy
• Individuals with vitamin A deficiency

For these high-risk groups, prompt medical attention and careful monitoring during a measles infection are crucial to prevent and manage potential complications.

Diagnosis and Treatment of Measles

Accurate diagnosis and appropriate treatment are essential for managing measles and preventing its spread.

How is measles diagnosed?

Measles is typically diagnosed based on a combination of physical symptoms and laboratory tests. The distinctive rash and Koplik’s spots often provide strong clinical evidence. However, to confirm the diagnosis, doctors may order:

• Blood tests to check for measles antibodies
• Viral culture or polymerase chain reaction (PCR) test of a throat swab or urine sample

Early diagnosis is crucial not only for the patient’s treatment but also for implementing measures to prevent the spread of the virus to others.

What treatments are available for measles?

There is no specific antiviral treatment for measles. Care is primarily supportive and aimed at managing symptoms and preventing complications. Treatment may include:

• Rest and plenty of fluids to prevent dehydration
• Acetaminophen or ibuprofen to reduce fever and relieve discomfort
• Vitamin A supplements, which can help prevent eye damage and reduce the severity of the illness
• Antibiotics if secondary bacterial infections develop

In severe cases or for high-risk patients, hospitalization may be necessary to provide supportive care and monitor for complications.

Prevention: The Key to Controlling Measles

Prevention is the most effective strategy in controlling measles, with vaccination playing a central role.

How can measles be prevented?

The most effective way to prevent measles is through vaccination. The measles vaccine is typically given as part of the MMR (Measles, Mumps, Rubella) vaccine. The Centers for Disease Control and Prevention (CDC) recommends:

• Children should receive their first dose of MMR vaccine at 12-15 months of age
• A second dose should be given at 4-6 years of age
• Adults who haven’t been vaccinated or had measles should receive at least one dose of the MMR vaccine

In addition to vaccination, other preventive measures include:

• Practicing good hygiene, such as regular handwashing
• Avoiding close contact with infected individuals
• Isolating infected people to prevent spread

Is the measles vaccine safe and effective?

The MMR vaccine is both safe and highly effective. Studies have shown that:

• One dose of MMR vaccine is about 93% effective at preventing measles
• Two doses are about 97% effective
• The vaccine has been used for decades with an excellent safety record

While mild side effects like fever or rash can occur, serious adverse reactions are extremely rare. The benefits of vaccination far outweigh the risks, both for individuals and for public health.

Global Efforts to Eliminate Measles

Despite the availability of an effective vaccine, measles remains a global health challenge. Worldwide efforts are ongoing to increase vaccination rates and eliminate the disease.

What progress has been made in measles elimination?

Significant strides have been made in reducing measles cases and deaths globally:

• Between 2000 and 2018, measles vaccination prevented an estimated 23.2 million deaths
• Many countries have achieved measles elimination (defined as the absence of endemic measles transmission for at least 12 months)
• Global measles deaths have decreased by 73% from 2000 to 2018

However, recent years have seen concerning setbacks, with outbreaks occurring even in countries that had previously eliminated the disease.

What challenges remain in global measles elimination?

Several obstacles hinder the goal of global measles elimination:

• Insufficient vaccination coverage in some regions
• Misinformation and vaccine hesitancy
• Challenges in reaching remote or conflict-affected populations
• Gaps in health systems and disease surveillance

Addressing these challenges requires coordinated efforts from governments, health organizations, and communities worldwide.

Measles in the Context of Modern Public Health

The persistence of measles in the 21st century highlights important issues in public health and disease prevention.

Why do measles outbreaks still occur in developed countries?

Despite high overall vaccination rates, measles outbreaks can still occur in developed countries due to:

• Pockets of unvaccinated or under-vaccinated communities
• Importation of cases from countries where measles is more common
• Waning immunity in some vaccinated individuals
• Increased global travel and migration

These factors underscore the need for continued vigilance and maintenance of high vaccination rates.

How does measles relate to broader public health issues?

The fight against measles intersects with several key public health themes:

• Vaccine confidence and combating misinformation
• Health equity and access to preventive care
• Global health security and disease surveillance
• The importance of strong health systems and primary care

Lessons learned from measles control efforts can inform strategies for addressing other infectious diseases and public health challenges.

Measles – Symptoms & causes

Overview

Measles is a childhood infection caused by a virus. Once quite common, measles can now almost always be prevented with a vaccine.

Also called rubeola, measles spreads easily and can be serious and even fatal for small children. While death rates have been falling worldwide as more children receive the measles vaccine, the disease still kills more than 200,000 people a year, mostly children.

As a result of high vaccination rates in general, measles hasn’t been widespread in the United States in about two decades. Most recent measles cases in the U.S. originated outside the country and occurred in people who were unvaccinated or who didn’t know whether or not they had been vaccinated.

Measles

Measles causes a red, blotchy rash that usually appears first on the face and behind the ears, then spreads downward to the chest and back and finally to the feet.

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Symptoms

Measles signs and symptoms appear around 10 to 14 days after exposure to the virus. Signs and symptoms of measles typically include:

• Fever
• Dry cough
• Runny nose
• Sore throat
• Inflamed eyes (conjunctivitis)
• Tiny white spots with bluish-white centers on a red background found inside the mouth on the inner lining of the cheek — also called Koplik’s spots
• A skin rash made up of large, flat blotches that often flow into one another

The infection occurs in stages over 2 to 3 weeks.

• Infection and incubation. For the first 10 to 14 days after infection, the measles virus spreads in the body. There are no signs or symptoms of measles during this time.
• Nonspecific signs and symptoms. Measles typically begins with a mild to moderate fever, often with a persistent cough, a runny nose, inflamed eyes (conjunctivitis) and a sore throat. This relatively mild illness may last 2 to 3 days.

• Acute illness and rash. The rash is made up of small red spots, some of which are slightly raised. Spots and bumps in tight clusters give the skin a splotchy red appearance. The face breaks out first.

  Over the next few days, the rash spreads down the arms, chest and back, then over the thighs, lower legs and feet. At the same time, the fever rises sharply, often as high as 104 to 105.8 F (40 to 41 C).

• Recovery. The measles rash may last about seven days. The rash gradually fades first from the face and last from the thighs and feet. As other symptoms of the illness go away, the cough and darkening or peeling of the skin where the rash was may stay for about 10 days.

When can a person spread the measles virus?

A person with measles can spread the virus to others for about eight days, starting four days before the rash appears and ending when the rash has been present for four days.

When to see a doctor

Call your health care provider if you think you or your child may have been exposed to measles or if you or your child has a rash that looks like measles.

Review your family’s vaccination records with your provider, especially before your children start day care, school or college and before international travel outside of the U.S.

Causes

Measles is a highly contagious illness. This means it’s very easily spread to others. Measles is caused by a virus found in the nose and throat of an infected child or adult. When someone with measles coughs, sneezes or talks, infectious droplets spray into the air, where other people can breathe them in. The infectious droplets can hang in the air for about an hour.

The infectious droplets may also land on a surface, where they can live and spread for several hours. You can get the measles virus by putting your fingers in your mouth or nose or rubbing your eyes after touching the infected surface.

Measles is highly contagious from about four days before to four days after the rash appears. About 90% of people who haven’t had measles or been vaccinated against measles will become infected when exposed to someone with the measles virus.

Risk factors

Risk factors for measles include:

• Being unvaccinated. If you haven’t had the measles vaccine, you’re much more likely to get measles.
• Traveling internationally. If you travel to countries where measles is more common, you’re at higher risk of catching measles.
• Having a vitamin A deficiency. If you don’t have enough vitamin A in your diet, you’re more likely to have more-severe symptoms and complications of measles.

Complications

Complications of measles may include:

• Diarrhea and vomiting. Diarrhea and vomiting can result in losing too much water from the body (dehydration).
• Ear infection. One of the most common complications of measles is a bacterial ear infection.
• Bronchitis, laryngitis or croup. Measles may lead to irritation and swelling (inflammation) of the airways (croup). It can also lead to inflammation of the inner walls that line the main air passageways of the lungs (bronchitis). Measles can also cause inflammation of the voice box (laryngitis).
• Pneumonia. Measles can commonly cause an infection in the lungs (pneumonia). People with weakened immune systems can develop an especially dangerous type of pneumonia that sometimes can lead to death.
• Encephalitis. About 1 in 1,000 people with measles can develop a complication called encephalitis. Encephalitis is irritation and swelling (inflammation) of the brain. The condition can be especially dangerous for people with weakened immune systems. Encephalitis may occur right after measles, or it might not occur until months later. Encephalitis can cause permanent brain damage.
• Pregnancy problems. If you’re pregnant, you need to take special care to avoid measles because the disease can cause premature birth, low birth weight and fetal death.

Prevention

The U.S. Centers for Disease Control and Prevention (CDC) recommends that children and adults receive the measles vaccine to prevent measles.

Measles vaccine in children

The measles vaccine is usually given as a combined measles-mumps-rubella (MMR) vaccine. This vaccine may also include the chickenpox (varicella) vaccine — measles-mumps-rubella-varicella (MMRV) vaccine. Health care providers recommend that children receive the measles-mumps-rubella (MMR) vaccine between 12 and 15 months of age, and again between 4 and 6 years of age — before entering school.

The MMR vaccine’s two doses are 97% effective in preventing measles and protecting against it for life. In the small number of people who get measles after being vaccinated, the symptoms are generally mild.

Keep in mind:

• If you’ll be traveling internationally outside the U.S. when your child is 6 to 11 months old, talk with your child’s health care provider about getting the measles vaccine earlier.
• If your child or teenager didn’t get the two doses of the vaccine at the recommended times, your child may need two doses of the vaccine four weeks apart.

Babies born to women who have received the vaccine or who are already immune because they had measles are usually protected from measles for about 6 months after birth. If a child requires protection from measles before 12 months of age — for example, for foreign travel — the vaccine can be given as early as 6 months of age. But children who are vaccinated early still need to be vaccinated at the recommended ages later.

Providing a child with the MMR vaccine as a combination of recommended vaccines can prevent a child’s delay in protection against infection from measles, mumps and rubella — and with fewer shots. The combination vaccine is as safe and effective as the vaccines given separately. Side effects are generally mild and may include a sore arm where the shot was given and fever.

Measles vaccine in adults

You may need the measles vaccine if you’re an adult who does not have proof of immunity and:

• Has an increased risk of measles, such as attending college, traveling internationally outside the U. S. or working in a hospital environment.
• Was born in 1957 or later. If you’ve already had measles, your body has built up its immune system to fight the infection, and you can’t get measles again. Most people born or living in the U.S. before 1957 are immune to measles, simply because they’ve already had it.

Proof of immunity — protection from getting measles infection — includes:

• Written documentation of appropriate measles vaccinations
• Lab tests that show evidence of immunity
• Lab tests that show you’ve had measles in the past

If you’re not sure if you need the measles vaccine, talk to your health care provider.

Preventing measles during an outbreak or known infection

If someone in your household has measles, take these precautions to protect family and friends without immunity:

• Isolate. Because measles is highly contagious from about four days before to four days after the rash appears, people with measles should stay home and not return to activities where they interact with other people during this period.

  People who aren’t vaccinated — siblings, for example — should also stay away from the infected person.

• Vaccinate. Be sure that anyone who’s at risk of getting measles who hasn’t been fully vaccinated receives the measles vaccine as soon as possible. This includes infants older than 6 months and anyone born in 1957 or later who doesn’t have proof of immunity.

Preventing new infections

Getting vaccinated with the measles vaccine is important for:

• Promoting and preserving widespread immunity. Since the introduction of the measles vaccine, measles has virtually been eliminated in the U.S., even though not everyone has been vaccinated. This effect is called herd immunity.

  But herd immunity may now be weakening a bit, likely due to a drop in vaccination rates. The incidence of measles in the U.S. recently increased significantly.

• Preventing a resurgence of measles. Steady vaccination rates are important because soon after vaccination rates decline, measles begins to come back.

  Here’s one example. In 1998, a now-discredited study was published incorrectly linking autism to the measles-mumps-rubella (MMR) vaccine. In the United Kingdom, where the study originated, the rate of vaccination dropped to an all-time low of about 80% of all children in 2003 to 2004. In 2008, there were nearly 1,400 lab-confirmed cases of measles in England and Wales.

No proven link between the MMR vaccine and autism

After the MMR study in 1998, some drops in vaccine numbers were found in the UK and elsewhere, and some people believed there was a possible link. Since then, widespread concerns have been raised about a possible link between the MMR vaccine and autism. However, extensive reports from the American Academy of Pediatrics, the National Academy of Medicine, and the Centers for Disease Control and Prevention (CDC) conclude that there is no scientifically proven link between the MMR vaccine and autism.

These organizations note that autism is often identified in toddlers between the ages of 18 and 30 months, which is about the time children are given their first MMR vaccine. But this coincidence in timing shouldn’t be mistaken for a cause-and-effect relationship.

More Information

Measles – Symptoms & causes

Overview

Measles is a childhood infection caused by a virus. Once quite common, measles can now almost always be prevented with a vaccine.

Also called rubeola, measles spreads easily and can be serious and even fatal for small children. While death rates have been falling worldwide as more children receive the measles vaccine, the disease still kills more than 200,000 people a year, mostly children.

As a result of high vaccination rates in general, measles hasn’t been widespread in the United States in about two decades. Most recent measles cases in the U. S. originated outside the country and occurred in people who were unvaccinated or who didn’t know whether or not they had been vaccinated.

Measles

Measles causes a red, blotchy rash that usually appears first on the face and behind the ears, then spreads downward to the chest and back and finally to the feet.

Products & Services

Symptoms

Measles signs and symptoms appear around 10 to 14 days after exposure to the virus. Signs and symptoms of measles typically include:

• Fever
• Dry cough
• Runny nose
• Sore throat
• Inflamed eyes (conjunctivitis)
• Tiny white spots with bluish-white centers on a red background found inside the mouth on the inner lining of the cheek — also called Koplik’s spots
• A skin rash made up of large, flat blotches that often flow into one another

The infection occurs in stages over 2 to 3 weeks.

• Infection and incubation. For the first 10 to 14 days after infection, the measles virus spreads in the body. There are no signs or symptoms of measles during this time.
• Nonspecific signs and symptoms. Measles typically begins with a mild to moderate fever, often with a persistent cough, a runny nose, inflamed eyes (conjunctivitis) and a sore throat. This relatively mild illness may last 2 to 3 days.

• Acute illness and rash. The rash is made up of small red spots, some of which are slightly raised. Spots and bumps in tight clusters give the skin a splotchy red appearance. The face breaks out first.

  Over the next few days, the rash spreads down the arms, chest and back, then over the thighs, lower legs and feet. At the same time, the fever rises sharply, often as high as 104 to 105.8 F (40 to 41 C).

• Recovery. The measles rash may last about seven days. The rash gradually fades first from the face and last from the thighs and feet. As other symptoms of the illness go away, the cough and darkening or peeling of the skin where the rash was may stay for about 10 days.

When can a person spread the measles virus?

A person with measles can spread the virus to others for about eight days, starting four days before the rash appears and ending when the rash has been present for four days.

When to see a doctor

Call your health care provider if you think you or your child may have been exposed to measles or if you or your child has a rash that looks like measles.

Review your family’s vaccination records with your provider, especially before your children start day care, school or college and before international travel outside of the U.S.

Causes

Measles is a highly contagious illness. This means it’s very easily spread to others. Measles is caused by a virus found in the nose and throat of an infected child or adult. When someone with measles coughs, sneezes or talks, infectious droplets spray into the air, where other people can breathe them in. The infectious droplets can hang in the air for about an hour.

The infectious droplets may also land on a surface, where they can live and spread for several hours. You can get the measles virus by putting your fingers in your mouth or nose or rubbing your eyes after touching the infected surface.

Measles is highly contagious from about four days before to four days after the rash appears. About 90% of people who haven’t had measles or been vaccinated against measles will become infected when exposed to someone with the measles virus.

Risk factors

Risk factors for measles include:

• Being unvaccinated. If you haven’t had the measles vaccine, you’re much more likely to get measles.
• Traveling internationally. If you travel to countries where measles is more common, you’re at higher risk of catching measles.
• Having a vitamin A deficiency. If you don’t have enough vitamin A in your diet, you’re more likely to have more-severe symptoms and complications of measles.

Complications

Complications of measles may include:

• Diarrhea and vomiting. Diarrhea and vomiting can result in losing too much water from the body (dehydration).
• Ear infection. One of the most common complications of measles is a bacterial ear infection.
• Bronchitis, laryngitis or croup. Measles may lead to irritation and swelling (inflammation) of the airways (croup). It can also lead to inflammation of the inner walls that line the main air passageways of the lungs (bronchitis). Measles can also cause inflammation of the voice box (laryngitis).
• Pneumonia. Measles can commonly cause an infection in the lungs (pneumonia). People with weakened immune systems can develop an especially dangerous type of pneumonia that sometimes can lead to death.
• Encephalitis. About 1 in 1,000 people with measles can develop a complication called encephalitis. Encephalitis is irritation and swelling (inflammation) of the brain. The condition can be especially dangerous for people with weakened immune systems. Encephalitis may occur right after measles, or it might not occur until months later. Encephalitis can cause permanent brain damage.
• Pregnancy problems. If you’re pregnant, you need to take special care to avoid measles because the disease can cause premature birth, low birth weight and fetal death.

Prevention

The U.S. Centers for Disease Control and Prevention (CDC) recommends that children and adults receive the measles vaccine to prevent measles.

Measles vaccine in children

The measles vaccine is usually given as a combined measles-mumps-rubella (MMR) vaccine. This vaccine may also include the chickenpox (varicella) vaccine — measles-mumps-rubella-varicella (MMRV) vaccine. Health care providers recommend that children receive the measles-mumps-rubella (MMR) vaccine between 12 and 15 months of age, and again between 4 and 6 years of age — before entering school.

The MMR vaccine’s two doses are 97% effective in preventing measles and protecting against it for life. In the small number of people who get measles after being vaccinated, the symptoms are generally mild.

Keep in mind:

• If you’ll be traveling internationally outside the U.S. when your child is 6 to 11 months old, talk with your child’s health care provider about getting the measles vaccine earlier.
• If your child or teenager didn’t get the two doses of the vaccine at the recommended times, your child may need two doses of the vaccine four weeks apart.

Babies born to women who have received the vaccine or who are already immune because they had measles are usually protected from measles for about 6 months after birth. If a child requires protection from measles before 12 months of age — for example, for foreign travel — the vaccine can be given as early as 6 months of age. But children who are vaccinated early still need to be vaccinated at the recommended ages later.

Providing a child with the MMR vaccine as a combination of recommended vaccines can prevent a child’s delay in protection against infection from measles, mumps and rubella — and with fewer shots. The combination vaccine is as safe and effective as the vaccines given separately. Side effects are generally mild and may include a sore arm where the shot was given and fever.

Measles vaccine in adults

You may need the measles vaccine if you’re an adult who does not have proof of immunity and:

• Has an increased risk of measles, such as attending college, traveling internationally outside the U.S. or working in a hospital environment.
• Was born in 1957 or later. If you’ve already had measles, your body has built up its immune system to fight the infection, and you can’t get measles again. Most people born or living in the U.S. before 1957 are immune to measles, simply because they’ve already had it.

Proof of immunity — protection from getting measles infection — includes:

• Written documentation of appropriate measles vaccinations
• Lab tests that show evidence of immunity
• Lab tests that show you’ve had measles in the past

If you’re not sure if you need the measles vaccine, talk to your health care provider.

Preventing measles during an outbreak or known infection

If someone in your household has measles, take these precautions to protect family and friends without immunity:

• Isolate. Because measles is highly contagious from about four days before to four days after the rash appears, people with measles should stay home and not return to activities where they interact with other people during this period.

  People who aren’t vaccinated — siblings, for example — should also stay away from the infected person.

• Vaccinate. Be sure that anyone who’s at risk of getting measles who hasn’t been fully vaccinated receives the measles vaccine as soon as possible. This includes infants older than 6 months and anyone born in 1957 or later who doesn’t have proof of immunity.

Preventing new infections

Getting vaccinated with the measles vaccine is important for:

• Promoting and preserving widespread immunity. Since the introduction of the measles vaccine, measles has virtually been eliminated in the U.S., even though not everyone has been vaccinated. This effect is called herd immunity.

  But herd immunity may now be weakening a bit, likely due to a drop in vaccination rates. The incidence of measles in the U.S. recently increased significantly.

• Preventing a resurgence of measles. Steady vaccination rates are important because soon after vaccination rates decline, measles begins to come back.

  Here’s one example. In 1998, a now-discredited study was published incorrectly linking autism to the measles-mumps-rubella (MMR) vaccine. In the United Kingdom, where the study originated, the rate of vaccination dropped to an all-time low of about 80% of all children in 2003 to 2004. In 2008, there were nearly 1,400 lab-confirmed cases of measles in England and Wales.

No proven link between the MMR vaccine and autism

After the MMR study in 1998, some drops in vaccine numbers were found in the UK and elsewhere, and some people believed there was a possible link. Since then, widespread concerns have been raised about a possible link between the MMR vaccine and autism. However, extensive reports from the American Academy of Pediatrics, the National Academy of Medicine, and the Centers for Disease Control and Prevention (CDC) conclude that there is no scientifically proven link between the MMR vaccine and autism.

These organizations note that autism is often identified in toddlers between the ages of 18 and 30 months, which is about the time children are given their first MMR vaccine. But this coincidence in timing shouldn’t be mistaken for a cause-and-effect relationship.

More Information

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Measles: causes, symptoms, diagnosis and treatment.

Measles is a highly contagious disease caused by an RNA virus.

Ways of transmission of measles

1. Direct contact of a healthy person with an infected person.
2. Airborne, when the virus enters the body through mucous membranes.

The measles virus is unstable in the external environment, quickly dies under chemical (disinfectants) and physical (heating, UV irradiation) exposure, at negative temperatures it can persist for up to several weeks. The causative agent of measles is introduced into the body through the mucous membranes of the upper respiratory tract, where the initial reproduction of the virus occurs. Starting from the third day of the incubation period, viral particles circulate in the blood. Once in the central nervous system, the virus infects nerve cells, which can cause the development of complications such as encephalitis, meningoencephalitis (damage to the brain and spinal cord and its membranes).

Newborns retain passive immunity for three months, obtained from a mother who has had measles.

Those who have had measles develop strong immunity, which makes the possibility of reinfection unlikely.

Causes of measles

1. Refusal to vaccinate (dangerous for young children and pregnant women).
2. Reduced immunity.
3. Exhaustion, the presence of long-term chronic diseases.
4. Hypovitaminosis.

Classification of the disease

According to the type of clinical presentation:

1. Measles with typical symptoms.
2. Atypical measles.

By severity:

1. Mild severity.
2. Moderate severity.
3. Severe.

Downstream:

1. Smooth flow.
2. With the presence of complications, the addition of a secondary infection, exacerbation of chronic diseases.

By disease period:

1. Incubation period.
2. Catarrhal (prodromal) period.
3. Eruption period.
4. Pigmentation period.

Measles symptoms

In the clinical picture of the disease, a number of features are noted: an acute onset, high fever, the appearance of a rash on the body and oral mucosa on the 4-5th day of illness, severe catarrhal phenomena (runny nose, sore throat, etc.) in the first days.

The incubation period (from the moment the virus enters the body until the first symptoms appear) lasts about 9-17 days. At this time, the virus actively multiplies and fixes in different tissues, but there are no symptoms of the disease.

At this time, it is possible to introduce measles immunoglobulin in order to neutralize the virus. However, the use of this method is relevant no later than 5 days after contact with a measles patient.

Then comes the catarrhal period with fever (high body temperature, accompanied by chills, usually persists for 4-7 days), runny nose, cough (caused by irritation of the back of the throat with flowing mucus from the nose), redness of the eyes with signs of conjunctivitis and lacrimation. Perhaps the appearance of small white spots on the inner surface of the cheeks (Belsky-Filatov-Koplik spots) is a sign that is unique to measles. During the prodromal period, the virus leaves the interstitial location in the blood and spreads throughout the body. Dark small spots appear on the palate by the 2-3rd day of the disease, which persist until the disappearance of skin rashes. The disease is characterized by symptoms of general intoxication: malaise, weakness, lack of appetite, short-term diarrhea is possible.

Around the third day of fever, a maculopapular (slightly elevated) rash occurs on the neck, then behind the ears, then along the scalp. During the day, the rash spreads to the cheeks and torso. This is a feature of measles: the initial appearance of a rash on the head with the transition to the trunk. By the second day, the rash appears on the skin of the hands and feet, on the third day the rash can be found on the feet.

Features of the rash (on which day it appeared, the place of occurrence of the first rashes, whether it was accompanied by fever, the appearance of the rash elements, the rate of spread) is an important diagnostic sign of measles, which distinguishes it from other infectious diseases.

The rash persists on the skin for about 6 days, from the moment of infection to the appearance of spots, 14 days pass. Three days after the appearance on the face, the rash turns pale, then peels off; rashes at the same time do not have clear boundaries, uneven, merging with each other. This is a pigmentation period that lasts about a week and a half. Its characteristic features are a weakening of the symptoms of intoxication, a tendency to normalize body temperature, a decrease or disappearance of a runny nose, cough. At this time, the development of complications is possible, which is associated with a pronounced suppression of the functions of the immune system by the measles virus and leads to an exacerbation of chronic diseases or the addition of a secondary infection.

A distinctive feature of measles is the descending nature of skin manifestations, severe fever, the appearance of spots on the inner surface of the cheeks, lips, gums, and on the hard palate. In adults, skin manifestations are usually more abundant than in children.

A patient with measles is considered non-infectious from the 5th day after the onset of rashes. The patient is dangerous for healthy people from the last two days of the incubation period (8-10 days after contact with the measles virus) until the 4th day of skin rashes.

Diagnosis of measles

Diagnosis of measles is based on the determination of the level of class M immunoglobulins in the blood, starting from the 5-7th day of illness.
The detection of IgM to the measles virus indicates an acute infection, the detection of IgG indicates a past one (due to illness or vaccination).

IgG antibodies to measles virus, quantitative test (anti-Measles virus IgG, Rubeola Antibody IgG, quantitative)

Synonyms: Blood test for antibodies to measles; IgG antibodies to the measles virus; Class G antibodies to the measles virus; Immunoglobulins class G to Measles Virus; Am to measles virus, IgG.
Measles Virus Sp…

Up to 2 business days

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1 050 RUB

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The definition of IgM is irrelevant if vaccination was carried out on the eve of the disease.

PCR is used to detect viral RNA in the blood.

Rubella virus, determination of RNA in blood serum (Rubella Virus, RNA, Serum)

Synonyms: Blood test for rubella; Determination of rubella virus RNA.

Rubella virus, RNA, PCR; Rubella RNA; Rubella virus RNA by Real-Time PCR.

Brief description of the study

Up to 1 working day

Available with house call

RUB 915

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A general blood test and a leukocyte formula are required.

Clinical blood test: general analysis, leukoformula, ESR (with microscopy of a blood smear in the presence of pathological changes)

Synonyms: Complete blood count, UAC. Full blood count, FBC, Complete blood count (CBC) with differential white blood cell count (CBC with diff), Hemogram.
Brief description of the study CBC: general a…

Up to 1 working day

Available with house call

RUB 810

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Leukocyte count (Differential White Blood Cell Count) with blood smear microscopy in the presence of pathological changes

Synonyms: Differential leukocyte count; Leukocytogram; The ratio of various forms of leukocytes in the blood; Differentiated leukocyte count; Leucog…

Up to 1 working day

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410 RUB

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For the timely diagnosis of kidney damage, a general urine test should be taken.

General urinalysis (Urine analysis with sediment microscopy)

Method of determination

Determination of physical and chemical parameters is carried out on an automatic analyzer using the “dry chemistry” method.

Hardware microscope…

Up to 1 working day

Available with house call

410 RUB

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To detect lung lesions with the development of pneumonia, x-rays or computed tomography of the chest organs are performed.

Plain chest x-ray

X-ray examination of the structure of the lungs to diagnose various pathologies.

RUB 2,440

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CT scan of the chest and mediastinum

Examination that provides data on the condition of the chest and mediastinum.

RUB 5,490

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In the diagnosis of myocardial lesions, ECG and EchoCG are used.

ECG in 5 minutes

Examination of the functionality of the heart – quickly, painlessly and informatively.

RUB 1,790

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Echocardiography

Examination to assess functional and organic changes in the heart, its contractility, as well as the condition of the valvular apparatus.

RUB 4,190

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Which doctors to contact

When the first symptoms of the disease appear (runny nose, fever, watery eyes), you should contact
general practitioner or infectious disease specialist. The doctor will be able to diagnose and prescribe treatment. In case of an atypical course of the disease, when the appearance of a rash is the prevailing symptom, it is possible to contact a dermatologist, who, according to its characteristics, can suggest a diagnosis and refer you to the necessary consultations. pregnant or
women planning pregnancy are recommended to be observed at
an obstetrician-gynecologist to prescribe appropriate examinations and tests, maintain
pregnancy and addressing the issue of the advisability of carrying out preventive measures.

Ultrasound diagnosis of pregnancy

Examination to confirm pregnancy and determine the site of attachment of the ovum (to exclude ectopic pregnancy).

RUB 2,390

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At the first signs of damage to the ENT organs, a change in the nature of nasal discharge (the appearance of pathological impurities – blood, pus), it is necessary to seek help from an otorhinolaryngologist. To confirm the diagnosis, an examination by a doctor is carried out, radiography R09or computed tomography of the paranasal sinuses, to select the optimal therapy, a smear is taken from the mucous membrane of the upper respiratory tract.

CT scan of the paranasal sinuses

An examination that allows the detection of various pathologies of the ENT organs.

RUB 4,890

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Upper Respiratory Culture, Routine. Aerobic Bacteria Identification and Antibiotic Susceptibility testing

Synonyms: Upper Respiratory Culture, Routine. Aerobic Bacteria Identification and Antibiotic Susceptibility testing.

Brief description of the study “Inoculation of the discharge of the upper respiratory tract on a microf…

Up to 6 business days

Available with house call

RUB 1,260

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With swelling of the larynx, shortness of breath, the diagnosis of false croup is likely – a life-threatening condition in which a visit to a doctor is mandatory.

In cases of bacterial damage to the organs of vision, it is necessary to contact an ophthalmologist for examination, determining the tactics of treatment and conducting the necessary tests – taking a scraping from the conjunctiva and sowing the discharge from the eye for the sensitivity of the flora to antibiotics.

Culture of wound discharge and tissues for microflora and determination of sensitivity to antimicrobial drugs

Synonyms:
Wound/tissue Culture. Aerobic Bacteria Identification and Antibiotic Susceptibility testing.
Brief description of the study “Sowing of wound discharge and tissues for microflora and determination of sensi…

Up to 7 business days

Available with house call

RUB 1,460

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If convulsions, focal neurological symptoms, persistent headache, visual disturbances, hallucinations, loss of consciousness appear, you should immediately contact
a neurologist to provide specialized care and exclude or confirm damage to the nervous system.

In the diagnosis of such conditions, CT or MRI of the brain, analysis of cerebrospinal fluid is used.

CT scan of the brain and skull

Scanning of the brain, skull and surrounding tissues, which allows diagnosing various pathologies.

RUB 4,890

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MRI of the brain

Safe and informative scanning of brain structures for the diagnosis of its pathologies.

RUB 5,640

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Free light chains of immunoglobulins kappa and lambda in CSF (Cerebrospinal Fluid Concentration of Immunoglobulin Free Light Chains)

The study is used in the diagnosis of multiple sclerosis and inflammatory diseases of the central nervous system.

The main immunological marker of multiple sclerosis is …

Up to 9 working days

Available with house call

2 195 RUB

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If cough with sputum discharge persists, fever should be addressed to

therapist

or

pulmonologist

for the diagnosis of inflammatory lung diseases. In addition to radiation diagnostic methods, it is possible to conduct sputum tests (general and culture for sensitivity to antibiotics) to select the most effective therapy.

Sputum examination

The success of cytological diagnosis depends on the correct collection of sputum and its processing. For analysis, you should take a morning portion of sputum, coughed up pain …

Up to 2 business days

Available with house call

RUB 1,030

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Culture of sputum and tracheobronchial washings for microflora with determination of sensitivity to antimicrobial drugs and smear microscopy

Synonyms: Lower respiratory tract culture, routine. Bacteria identification, antibiotic susceptibility testing. Sputum culture routine. Bacteria identification, antibiotic susceptibility testing.

Brief description of the study “Sowing wet …

Up to 6 business days

Available with house call

RUB 1,535

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Measles treatment

In the absence of complications, treatment can be carried out at home, subject to periodic medical examination.

The patient is prescribed restorative drugs (vitamins), it is recommended to drink plenty of water, in case of fever – antipyretics and other symptomatic treatment. With the development of complications, the patient is hospitalized for massive therapy to reduce or completely regress the complications of the course of measles. For emergency prophylaxis, measles immunoglobulin or normal human immunoglobulin is administered; those who have been in contact with the sick person are isolated for the entire incubation period. With the addition of a secondary infection, the development of pneumonia, bronchitis, antibiotics are prescribed.

Complications of measles

1. Development of inflammatory diseases of the ENT organs: otitis media, sinusitis, frontal sinusitis (inflammatory diseases of the ears, paranasal sinuses). The development of these pathologies is associated with swelling of the mucous membrane of the upper respiratory tract in response to the penetration of the virus, which interferes with the normal passage of mucus produced in the nasal cavity.
2. Complication of the course of conjunctivitis (inflammation of the mucous membrane lining the eyelids from the inside) due to the addition of a bacterial infection with the development of blepharitis, iridocyclitis (inflammation of the eyelids, iris, etc.).
3. The affinity of the virus to the cells of the central nervous system can lead to the development of encephalitis and meningoencephalitis (inflammation of the meninges and brain). These conditions are a direct threat to the life of the patient and require specialized care in a hospital setting. Measles encephalitis, according to medical statistics, is a very rare complication.
4. The development of pneumonia or bronchitis is a fairly common complication of measles. It is associated with the entry of mucus abundantly produced by the upper respiratory tract into the bronchi and lungs.

5. False croup is a disease of an infectious-allergic nature, in which, due to edema of the upper respiratory tract, a critical narrowing of the larynx occurs, threatening suffocation. It develops more often in children. Requires immediate medical attention.

Prevention

1. Isolation of a patient with measles for a period of 5 days.
2. Separation of unvaccinated persons who have been in contact with a patient with measles for up to 17 days.
3. Timely and complete measles vaccination in individuals at risk or living in endemic areas.
4. Administration of normal human immunoglobulin to pregnant women exposed to measles virus during the first 5 days after exposure (emergency prophylaxis). Non-pregnant women are given anti-measles immunoglobulin at the same time.

Sources:

1. Decree of the Chief State Doctor of the Russian Federation “On approval of the Program “Prevention of measles and rubella during the period of verification of their elimination in the Russian Federation (2013–2015)” and the plan for its implementation.” Registered with the Ministry of Justice of the Russian Federation on August 30, 2013 No. 29831.
2. Clinical recommendations (treatment protocol) for the provision of medical care to children with measles. Federal State Budgetary Institution NIIDI FMBA of Russia, Public Organization “Eurasian Society for Infectious Diseases”, Public Organization “Association of Infectious Disease Doctors of St. Petersburg and the Leningrad Region” (AVISPO). – 2015. – 33s.
3. WHO website.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

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symptoms, causes, diagnosis, treatment and prevention

Pediatrician of the highest category

Morozova

Ekaterina Vyacheslavovna

Experience 19 years

Candidate of Medical Sciences. Member of the Union of Pediatricians of Russia. Annually takes part in international congresses of pediatricians. She was awarded a certificate of gratitude and an honorary diploma from the Moscow Department of Health for conscientious and many years of work in the metropolitan healthcare system.

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Measles is a highly contagious viral infectious disease, after which a person develops strong immunity. The infection is most common in children aged 2-5 years. Measles is rare in adults. Most often it occurs in people who have not received vaccinations.

The causative agent of the disease is a specific measles virus. Re-infection with them does not occur due to the development of persistent immunity. In this regard, a person may encounter the symptoms and treatment of measles only once. Most often, the disease resolves within 1-2 weeks without any immunological disorders.

Symptoms and signs of measles

The measles virus develops in the human body in several stages. First comes the incubation period, which on average lasts about 7-14 days, in rare cases – 21 days. During this period, the symptoms of measles do not yet occur. They appear already at the next stage – catarrhal. At this stage, measles in adults causes the following clinical signs:

• general weakness and body aches;
• coryza with profuse discharge;
• temperature 38-40°C;
• severe headache;
• agonizing dry cough;
• sore throat when swallowing;
• inflammation of the mucous membrane of the eyes;
• sore throat when swallowing.

The catarrhal stage takes an average of 5 days. After it, the symptoms of measles begin to decrease somewhat, and the patient feels relieved. But after about a day, the symptoms increase again and the state of health worsens. The next stage is coming – the period of rashes. They represent a maculopapular rash – individual elements merge into single foci.

Spots first appear on the neck, head, upper chest, and then spread throughout the body. 3 days after the onset, the rash begins to turn pale – a recovery period begins, when the temperature and general well-being return to normal.

Causes and routes of infection

Measles is caused by an RNA virus. It is transmitted from a sick person by airborne droplets – after contact with the mucous membranes of the respiratory tract, the pathogen enters the bloodstream and spreads throughout the body. The patient is especially dangerous in the first days of infection.

Measles can be caught not only through direct contact with a sick person. Infection can occur even if you just go into the room where the patient has recently been. It is considered harmless only from the 5th day after the appearance of rashes.

Complications

In especially severe cases or if treatment is not started in time, measles can be complicated by a secondary bacterial infection – pneumonia. In adulthood, it can also contribute to the development of the following pathologies:

• meningitis;
• meningoencephalitis;
• polyneuritis;
• corneal ulcers, keratitis;
• hearing loss;
• lesions of intra-abdominal lymph nodes.

The most rare and dangerous complication is measles encephalitis, which causes inflammation of the brain. That is why timely measles vaccination for adults is very important. In childhood, the disease is more easily tolerated, and in adulthood it can cause severe complications.

When to see a doctor

Going to the clinic for measles is essential because there is a serious risk of complications in adulthood. The doctor should be visited as early as possible, immediately after the first signs of the disease appear. By recognizing the symptoms of measles, a specialist can prescribe the appropriate treatment.

In JSC “Medicina” (clinic of academician Roitberg) in the center of Moscow, if you suspect measles, you can contact a general practitioner or an infectious disease specialist. They also decide whether measles vaccination is necessary.

Diagnosis of measles

Test for measles early in the course of the disease to detect immunoglobulins M (IgM). These are early antibodies that indicate the initial stage of the disease and indicate that the body has already begun to fight the virus.

Analysis for measles shows an increase in IgM titer of at least 4 times. The first time it is prescribed when characteristic signs of the disease appear, and the second time after 2-3 weeks to confirm infection with a similar infection. Other procedures for the diagnosis of measles, carried out at JSC “Medicine” (clinic of academician Roitberg), include:

• serological blood test;
• urinalysis;
• chest x-ray for complications.

Treatment

Measles can be treated on an outpatient basis if the patient does not have serious complications of the disease. Hospitalization is necessary in case of a general serious condition of the patient or the impossibility of isolation, for example, when living in a hostel, military unit, etc. Measles treatment is exclusively symptomatic, i.e. the patient is prescribed drugs that facilitate the course of the disease:

• antipyretics;
• antiviral;
• vasoconstrictor from the common cold.

In the event of a bacterial infection (otitis or pneumonia), the patient is prescribed antibacterial drugs. Sufficient efficiency in this case have pills taken orally. Antibiotics are prescribed on the basis of an analysis to identify the causative agent of the infection in order to determine its sensitivity to specific drugs.

Measles vaccination

Measles vaccination for adults is prescribed for children under 35 years of age. Vaccination is mandatory regardless of age for people working with children. In general, vaccination is necessary because in adulthood there is a risk of serious complications, and also because of the severe course of the infection.

The measles vaccine is believed to provide immunity for an average of 20 years. Vaccination is done twice with an interval of 3 months. The modern measles vaccine has a one-, two- or three-component composition, i.e. it is made for one or more diseases: measles, measles-mumps, measles-mumps-rubella.

Home remedies

Home treatment for measles is to keep the patient in bed for the entire febrile period. Doctors advise avoiding bright light, adhere to the rules of oral and eye hygiene. The room where the patient is located should be regularly ventilated and wet cleaned twice a day. The patient needs a light diet that does not irritate the intestines. Vitamins A and C must be included in the diet.

Myths and dangerous misconceptions in the treatment of measles

There are many myths and misconceptions around measles, which in some cases lead to serious consequences. Among the most common myths are the following.

• Nobody has had measles for a long time. According to statistics, quite the opposite. Outbreaks of the disease still occur in areas with a low level of medical development. Developed countries are not immune from this either.
• Only children get measles. Yes, 95% of patients are children under the age of 16, but there is no guarantee that an adult will not get measles.
• It’s better to get sick. Many parents believe that it is better for a child to have measles and become immune to it than to be vaccinated, considering the infection to be a harmless childhood disease like chickenpox. In reality, it’s not like that at all. According to WHO, measles is one of the leading causes of death among young children.
• Vaccination does not work. This is also a misconception, as confirmed by WHO data. In 2000-2015 mass vaccination was able to reduce the number of cases worldwide by 75%.

Prophylaxis

There is no specific prophylaxis against measles. Even the most careful hygiene does not guarantee protection against infection. The measles virus is highly contagious, spreads easily from person to person, and persists in the air for up to 2 hours. The most effective method of prevention is only timely vaccination.

How to make an appointment with a general practitioner or infectious disease specialist

To make an appointment with a specialist, you can fill out an online form on the website, where you will be asked to choose a doctor and an appointment time.