Measles

Measles, also called rubella, is a highly

contagious respiratory infection that's caused by a
virus. It causes a total-body skin rash and flu-like
symptoms, including a fever, cough, and runny nose.
Though rare in the United States, 20 million cases
occur worldwide every year.

Since measles is caused by a virus, there is no

specific medical treatment and the virus has to run its
course. But a child who is sick should be sure to
receive plenty of fluids and rest, and be kept from
spreading the infection to others.
Signs and Symptoms
Measles is probably best known for the full-body rash it
causes, the symptoms of the infection are usually a hacking cough,
runny nose, high fever, light sensitivity (photophobia), muscle pain,
sore throat and red eyes. A characteristic marker of measles is
Koplik's spots, small red spots with blue-white centers that appear
inside the mouth.

The measles rash typically has a red or reddish brown

blotchy appearance, and first usually shows up on the forehead, then
spreads downward over the face, neck, and body, then down to the
arms and feet.
Rash

Usually appears 3 - 5 days after the first signs of being sick

May last 4 - 7 days

Usually starts on the head and spreads to other areas, moving

down the body

Rash may appear as flat, discolored areas (macules) and

solid, red, raised areas (papules) that later join together

Itchy
Infectious agent

Measles virus is a member of the genus Morbillivirus (causative agents

of measles).

Period of communicability

Cases are infectious from slightly before the beginning of the prodromal
period, usually five days prior to rash onset. They continue to be
infectious until four days after the onset of the rash.

Reservoir
Humans.
Mode of transmission

The infection is spread by contact with droplets from the nose, mouth,
or throat of an infected person. Sneezing and coughing can put
contaminated droplets into the air.
Measles transmission is airborne by respiratory droplet nuclei
spread or it can be transmitted by direct contact with infected nasal
or throat secretions. The virus can persist in the environment for up
to two hours. Transmission has been reported to people whose only
apparent source of infection was a room presumably contaminated
with measles virus when it had been occupied by a patient with
measles up to two hours earlier.
Susceptibility & resistance

Natural infection provides lifelong immunity. A history of prior

measles infection should be confirmed serologically before vaccination is
deferred as reports of clinical measles infection are not always accurate.

Vaccination at 12 months of age produces a protective antibody

in approximately 95% of recipients. The second dose of vaccine,
recommended at 4 years, increases protection to approximately 99% of
recipients.
Method of diagnosis
The diagnosis should be confirmed by demonstration of anti-
measles IgM antibody, detection of measles RNA by polymerase chain
reaction (PCR) techniques (if available) or by viral culture. The latter is
particularly useful for epidemiological purposes.

Suspected cases should be bled at the time of clinical

diagnosis. The detection of anti-measles IgM increases to 100% for
samples taken 4–14 days after rash onset. If testing is negative for anti-
measles IgM on a sample collected three days or less after rash onset, it
should be repeated between 4–14 days after rash onset.

The diagnosis can also be confirmed by demonstration of a

fourfold or greater change in measles antibody titre between acute and
convalescent-phase sera. These should be obtained at least two weeks
apart, with the tests preferably conducted in parallel at the same
laboratory.
Preventive measures
Live attenuated measles vaccine is recommended for all
persons born after 1966 unless specific contra-indications to live
vaccines exist.
It is recommended that this vaccine be given as measles-mumps-
rubella (MMR) vaccine at 12 months of age and a second dose at four
years of age (prior to school entry). The second dose is not a booster
but is designed to vaccinate the approximately five per cent of
children who do not seroconvert to measles after the first dose of
vaccine.

Older children and adults born after 1966 who are

unimmunized and those with serological evidence of non-immunity
should be given at least one dose of MMR and ideally a second dose
of MMR one month later.
Treatment

There is no specific treatment for the measles. To help manage

symptoms, which usually last for about 2 weeks, give your child plenty of fluids
and encourage extra rest. If fever is making your child uncomfortable, you may
want to give a non-aspirin fever medication such as acetaminophen or ibuprofen.
Remember, you should never give aspirin to a child who has a viral illness since
the use of aspirin in such cases has been associated with the development of Reye
syndrome.

Kids with measles should be closely monitored. In some cases, measles

can lead to other complications, such as otitis media, croup, diarrhea, pneumonia,
and encephalitis (a serious brain infection), which may require antibiotics or
hospitalization.

In developing countries, vitamin A has been found to decrease

complications and death associated with measles infections. In the U.S., vitamin
A supplementation should be considered for children between 6 months and 2
years who are hospitalized with measles and its complications.
The following may relieve symptoms:

•Acetaminophen (Tylenol)
•Bed rest
•Humidified air

Some children may need vitamin A supplements. Vitamin A

reduces the risk of death and complications in children in less
developed countries, where children may not be getting enough
vitamin A. People who don't get enough vitamin A are more likely to
get infections, including measles. It is not clear whether children in
more developed countries would benefit from supplements.
Possible Complications

Complications of measles infection may include:

•Bronchitis
•Encephalitis (about 1 out of 1,000 measles cases)
•Ear infection (otitis media)
•Pneumonia

As with all immunization schedules, there are important exceptions

and special circumstances. Your child's doctor should have the most current
information regarding recommendations about the measles immunization.
Measles vaccine should not be given to pregnant women or to kids with
untreated tuberculosis, leukemia or other cancers, or people whose immune
systems are suppressed for any reason.

Also, the vaccine shouldn't be given to kids who have a history of

severe allergic reaction to gelatin or to the antibiotic neomycin, as they are at
risk for serious reactions to the vaccine.
Duration
The rubella rash usually lasts 3 days. Lymph nodes may remain
swollen for a week or more, and joint pain can last for more than 2 weeks.
Children who have rubella usually recover within 1 week, but adults may take
longer.

When to Call the Doctor

Call the doctor immediately if you suspect that your child has measles.
Also, it's important to get medical care following measles exposure, especially if
your child:

•is an infant
•is taking medicines that suppress the immune system
•has tuberculosis, cancer, or a disease that affects the immune system

Remember that measles, a once common childhood disease, is

preventable through routine childhood immunization.
by: Raisa Robelle T. Quicho