Definition

Measles is viral infection that is highly contagious. It causes fever, cough, and a rash. Once a common childhood illness, it is now seen less often in the US, due to the use of the measles vaccine.

Measles Rash

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Causes

The measles virus is spread by:

• Direct contact with nasal or throat secretions of infected people
• Airborne transmission (less frequently)

Measles is communicable from:

• 1-2 days before onset of symptoms
• 3-5 days before the rash
• Four days after the appearance of the rash

Risk Factors

These factors increase your chance of developing measles:

• Unvaccinated or inadequately vaccinated
• Living in crowded and/or unsanitary conditions
• Traveling to less developed countries where measles is common
• Season: winter and spring
• Immunosuppressed state (eg, untreated HIV), even if vaccinated
• Born after 1956 and never been diagnosed with measles or received a vaccine before 1968

Tell your doctor is you have any of the risk factors.

Symptoms

Symptoms, which usually occur 8-12 days following exposure, include:

• Fever (often high)
• Runny nose
• Red eyes
• Hacking cough
• Sore throat
• Exhaustion
• Very small spots inside the mouth (2-4 days after initial symptoms)
• Raised, itchy rash:
  • Starts around the ears, face, and side of neck 3-5 days after initial symptoms appear
  • Generally spreads to the arms, trunk, and legs over the next two days
  • Lasts about 4-6 days

Full recovery, without scarring, generally takes 7-10 days from the onset of the rash.

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. Diagnosis is made from the symptoms and the rash. Lab tests are usually not needed.

Treatment

Because measles is caused by a virus, it cannot be treated with antibiotics. The focus is on relieving symptoms.

Prevention

Getting vaccinated is the best way to prevent measles. The vaccine contains live viruses that can no longer cause disease.

• The vaccine is usually given as part of a combined measles, mumps, and rubella (MMR) vaccination twice: at 12-15 months and again at 4-6 years (or at 11-12 years).
• In some cases, measles vaccine given within three days after exposure can prevent or reduce symptoms.
• Immune globulin is given to certain unvaccinated people (eg, infants, pregnant women) within six days of exposure.

Ask your doctor if the vaccine is right for you. In general, avoid the vaccine if you:

• Have had severe allergic reactions to vaccines or vaccine components
• Are pregnant—Avoid pregnancy for 1-3 months after receiving the vaccine.
• Have a weakened immune system
• Have a high fever or severe upper respiratory tract infection

If you are not vaccinated, avoid contact with someone who has measles.