Measles

Introduction
History of Measles
In the 9th century, a Persian doctor published one
of the first written accounts of measles disease. In the
decade before 1963 when a vaccine became available,
nearly all children got measles by the time they were
15 years of age. It is estimated 3 to 4 million people in
the Philippines were infected each year.
When was the Measles first
discovered?
History of the causes of measles. A Scottish physician,
Francis Home, demonstrated in 1757 that measles was
caused by an infectious agent present in the blood of
patients. In 1954 the virus that causes measles was isolated
in Boston, Massachusetts, by John F. Enders and Thomas
C. Peebles.
What animal did measles come
from?
Modern scientists would later suggest
that measles evolved after the rise of early
civilization in the Middle East and may have
come from animals; the virus was highly
similar to rinderpest, which infected cattle.
 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 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 100,000
people a year, most under the age of 5.
As a result of high vaccination rates in general, measles hasn't been
widespread in the United States for more than a decade. The United States
averaged about 60 cases of measles a year from 2000 to 2010, but the
average number of cases jumped to 205 a year in recent years. Most of
these cases originate outside the country and occurred in people who were
unvaccinated or who didn't know whether or not they had been vaccinated.
 Signs and 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
The infection occurs in sequential stages over a period of two to three
weeks.
 Infection and incubation. For the first 10 to 14 days after you're infected, the measles virus
incubates. You have no signs or symptoms of measles during this time.
 Nonspecific signs and symptoms. Measles typically begins with a mild to moderate fever, often
accompanied by a persistent cough, runny nose, inflamed eyes (conjunctivitis) and sore throat.
This relatively mild illness may last two or three days.
 Acute illness and rash. The rash consists 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 and trunk, 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). The
measles rash gradually recedes, fading first from the face and last from the thighs and feet.
 Communicable period. 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.
Risk factors for measles include:

Being unvaccinated. If you haven't received

the vaccine for measles, you're much more
likely to develop the disease.
Traveling internationally. ...
Having a vitamin A deficiency.
 Diagnostic Tests for Measles
Your doctor can usually diagnose measles based on the
disease's characteristic rash as well as a small, bluish-white
spot on a bright red background — Koplik's spot — on the
inside lining of the cheek. However, many doctors have
never seen measles, and the rash can be confused with a
number of other illnesses. If necessary, a blood test can
confirm whether the rash is truly measles.
 Management/Treatment
There's no specific treatment for an established measles infection. However, some
measures can be taken to protect vulnerable individuals who have been exposed to the virus.
 Post-exposure vaccination. Nonimmunized people, including infants, may be given the
measles vaccination within 72 hours of exposure to the measles virus to provide
protection against the disease. If measles still develops, the illness usually has milder
symptoms and lasts for a shorter time.
 Immune serum globulin. Pregnant women, infants and people with weakened immune
systems who are exposed to the virus may receive an injection of proteins (antibodies)
called immune serum globulin. When given within six days of exposure to the virus, these
antibodies can prevent measles or make symptoms less severe
 Medications
 Fever reducers. You or your child may also take over-the-counter medications such as acetaminophen
(Tylenol, others), ibuprofen (Advil, Children's Motrin, others) or naproxen (Aleve) to help relieve the fever
that accompanies measles.
 Don't give aspirin to children or teenagers who have measles symptoms. Though aspirin is approved for use
in children older than age 3, children and teenagers recovering from chickenpox or flu-like symptoms
should never take aspirin. This is because aspirin has been linked to Reye's syndrome, a rare but potentially
life-threatening condition, in such children.
 Antibiotics. If a bacterial infection, such as pneumonia or an ear infection, develops while you or your child
has measles, your doctor may prescribe an antibiotic.
 Vitamin A. Children with low levels of vitamin A are more likely to have a more severe case of measles.
Giving vitamin A may lessen the severity of the measles. It's generally given as a large dose of 200,000
international units (IU) for children older than a year.
 Caregiver Responsibilities
Caregiving Interventions
 Interventions for a child with measles are:
 Isolation. Patients will need to be on isolation precautions to decrease transmission within the community;
emphasize the need for immediate isolation when early catarrhal symptoms appear.
 Skin care. Measles causes extreme pruritus; nursing interventions include keeping the patient’s nails short,
encourage long pants and sleeves to prevent scratching, keeping skin moist with health care provider
recommended lotions, and avoiding sunlight and heat.
 Eye care. Treat conjunctivitis with warm saline when removing eye secretions and encourage patient not to
rub eyes; protect the eyes from the glare of strong light.
 Hydration. Encourage oral hydration; medical literature encourages the use of oral rehydration solution.
 Temperature control. Antipyretics should be administered to the patient as ordered for a temperature
greater than 100.4 Fahrenheit unless directed elsewise by a healthcare provider; be sure to remind parents
not to administer aspirin due to the risk of Reye’s syndrome.