Measles

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at February 3, 2016
StartDiseasesMeasles

Measles is an extremely contagious infection that is caused by a virus. Its signature symptom is the red rash that appears throughout the body. While measles used to be incredibly common, better vaccination standards have made it rare in the United States. Nevertheless, it is estimated by the WHO that it killed 145,700 people globally in 2013 and is a leading cause of death for children worldwide.

Contents

Definition & Facts

Measles is caused by the measles virus, which is spread through the air. There are 21 different strains of the virus, which are all so similar that one vaccination will protect against all strains. Among young children, older people, or malnourished people, it can have a death rate of up to 10%. Measles weakens the immune system and can cause fatalities from complications that arise such as diarrhea and pneumonia.

Symptoms & Complaints

Most of the signs and symptoms follow a particular pattern, and they occur 10 to 14 days after a patient is exposed. First, the patient will typically develop a low grade fever. Along with the fever, a measles patient will normally have a runny nose, swollen eyes and itchy eyes, a sore throat, and a constant cough.

After a few days of feeling mildly ill, the measles will become more severe. A rash, made up of small red spots, which are occasionally slightly raised, will begin to spread. They first appear along the face, near the ears and the hairline, and then the measles rash spreads over the arms, torso, thighs, calves, and feet. The fever normally begins to rapidly increase during this time, and it may be as high as 105.8 degrees Fahrenheit. If a patient’s immune system fights off the measles, the spots will turn dark brown and gradually disappear, starting at the feet and going up towards the face.

However, measles can be deadly; in 0.1% of cases, the virus may travel to the brain. This causes encephalitis, which is an inflammation of the brain that results in swelling, convulsions, coma, and brain damage. The high grade fever may also be deadly if it is left untreated, and the cough can turn into pneumonia or bronchitis, causing further complications and increasing the fatality of measles.

Causes

Measles is caused by the measles virus, which is part of the Paramyxoviridae virus family. The measles virus is a mutated form of the rinderpest virus, a disease that infects cattle instead of humans. The virus is airborne, and it has a contagion rate of roughly 90% among unvaccinated people. Since it is airborne and causes a cough, measles typically spreads through the coughs and sneezes of infected people. When a droplet of the measles virus is expelled into the air or lands on a nearby surface, it can still be active and contagious several hours later.

The measles can be spread by a person breathing in an airborne particle of the measles virus, or it can be spread by a person touching an infected surface and then touching their nose, mouth, or eyes. A measles patient can cause the disease for roughly an eight day period, which begins four days before the rash shows up and ends four days after the rash has appeared.

Diagnosis & Tests

Measles can first be diagnosed if a person has a fever for at least three days and has a cough, inflamed eyes, or a runny nose. During the time between the fever and the distinctive measles rash, measles can still be diagnosed due to Koplik’s spots. Koplik’s spots are small, bluish-white lesions that cluster along the inside mucus linings of the mouth, situated near the molars. Not everyone with measles has Koplik’s spots, but they can be a useful diagnostic tool that allows measles to be treated as soon as possible.

If a person does not have Koplik’s spots, then the measles may not be diagnosed until the rash appears. Though the measles rash is distinctive enough to diagnose measles normally, a doctor can take a blood test in order to confirm the presence of the virus.

Treatment & Therapy

There is not any form of treatment that destroys the measles infection. However, being vaccinated during the 72 hours after initial exposure leads to a shorter illness with milder symptoms. Large doses of vitamin A have also been shown to lessen the severity of measles, and it decreases the risk of blindness. In general, a person with measles needs rest in order to let their immune system fight the virus.

A person with measles should also drink plenty of fluids and take fever reducing medications. However, aspirin is not recommended, since it may be linked to children developing Reye's syndrome, a potentially deadly condition. If the measles causes a brain inflammation, there is no treatment. When the measles results in medical complications such as pneumonia or bronchitis, medical supervision and antibiotic prescriptions can normally clear up any issues.

Prevention & Prophylaxis

Measles is an entirely preventable disease. Most children in developed countries are vaccinated against the measles at twelve months in age, but the vaccination is less common in developing countries. Though most people do not die after catching measles, there is still some risk, so it is absolutely crucial to be vaccinated for the measles.

Unfortunately, there has been a decrease in vaccinations against measles due to anti-vaccination propaganda. However, the measles vaccination is extremely safe, since an adverse reaction only happens in less than one million cases. Therefore, the best form of prevention is to ensure that a person is vaccinated against the disease.

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