Measles (patient information)

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 * Assistant Editor-In-Chief: Meagan E. Doherty

Overview
Measles (also called Rubeola) is an infectious respiratory disease caused by a virus. It spreads easily from person to person. The main symptom of measles is an itchy skin rash. The rash often starts on the head and moves down the body.

The virus normally grows in the cells that line the back of the throat and in the cells that line the lungs.

What are the symptoms of Measles?
Common Symptoms
 * Fever
 * Rash
 * Cough
 * Runny Nose
 * Conjunctivitis (pink eye)

Serious Symptoms/Complications
 * Diarrhea
 * Ear infections
 * Pneumonia
 * Encephalitis
 * Seizures
 * Death

Approximately 20% of reported measles cases experience one or more complications. These complications are more common among children under 5 years of age and adults over 20 years old. Measles causes ear infections in nearly one out of every 10 children who get it. As many as one out of 20 children with measles gets pneumonia, and about one child in every 1,000 who get measles will develop encephalitis. (This is an inflammation of the brain that can lead to convulsions, and can leave your child deaf or mentally retarded.) For every 1,000 children who get measles, one or two will die from it. Measles can also make a pregnant woman have a miscarriage, give birth prematurely, or have a low-birth-weight baby. In developing countries, where malnutrition and vitamin A deficiency are prevalent, measles has been known to kill as many as one out of four people. It is the leading cause of blindness among African children. Measles kills almost 1 million children in the world each year.

What causes Measles?
Measles is an infectious respiratory disease caused by a virus. It spreads easily from person to person. The main symptom of measles is an itchy skin rash. The rash often starts on the head and moves down the body. The virus normally grows in the cells that line the back of the throat and in the cells that line the lungs.

Who is at highest risk?
Measles is spread by contact with an infected person, through coughing and sneezing (highly contagious) The disease is highly contagious, and can be transmitted from 4 days prior to the onset of the rash to 4 days after the onset. If one person has it, 90% of their susceptible close contacts will also become infected with the measles virus. The virus resides in the mucus in the nose and throat of the infected person. When that person sneezes or coughs, droplets spray into the air. The infected mucus can land in other people’s noses or throats when they breathe or put their fingers in their mouth or nose after handling an infected surface. The virus remains active and contagious on infected surfaces for up to 2 hours. Measles spreads so easily that anyone who is not immunized will probably get it, eventually.

When to seek urgent medical care?
You should seek immediate medical attention at the first sign of symptoms that resemble Measles or if you have been exposed to the someone who has the Measles virus and may be contagious. This is especially important for young children or anyone who may have a compromised immune system due to medication or illness.

Diagnosis
Measles can be diagnosed through:
 * Measles serology
 * Viral culture (rarely done)

Treatment options
There is no drug treatment for measles.

Diseases with similar symptoms

 * Roseola infantum
 * German measles (rubella)
 * Scarlet fever
 * Serum reactions
 * Other Drugs including: phenobarbital, diphenylhydantoin, the sulfonamides, phenolphthalein, and penicillin.

Where to find medical care for Measles?
Directions to Hospitals Treating Measles

What to expect (Outlook/Prognosis)?
Measles itself is unpleasant, but the complications are dangerous. Six to 20 percent of the people who get the disease will get an ear infection, diarrhea, or even pneumonia. One out of 1000 people with measles will develop inflammation of the brain, and about one out of 1000 will die.

Possible complications
Measles itself is unpleasant, but the complications are dangerous. Six to 20 percent of the people who get the disease will get an ear infection, diarrhea, or even pneumonia.

Prevention
Measles vaccine (contained in MMR, MR and measles vaccines) can prevent this disease. The MMR vaccine is a live, attenuated (weakened), combination vaccine that protects against the measles, mumps, and rubella viruses. It was first licensed in the combined form in 1971 and contains the safest and most effective forms of each vaccine. It is made by taking the measles virus from the throat of an infected person and adapting it to grow in chick embryo cells in a laboratory. As the virus becomes better able to grow in the chick embryo cells, it becomes less able to grow in a child’s skin or lungs. When this vaccine virus is given to a child it replicates only a little before it is eliminated from the body. This replication causes the body to develop an immunity that, in 95% of children, lasts for a lifetime. A second dose of the vaccine is recommended to protect those 5% who did not develop immunity in the first dose and to give "booster" effect to those who did develop an immune response.

Do Children Need this Vaccine?
Children should get 2 doses of MMR vaccine: These are the recommended ages. But children can get the second dose at any age, as long as it is at least 28 days after the first dose.
 * The first dose at 12-15 months of age
 * The second dose at 4-6 years of age

Do Adults Need this Vaccine?
 You do NOT need the measles, mumps, rubella vaccine (MMR) if: You SHOULD get the measles vaccine if you are not among the categories listed above, and:
 * You had blood tests that show you are immune to measles, mumps, and rubella.
 * You are a man born before 1957.
 * You are a woman born before 1957 who is sure she is not having more children, has already had rubella vaccine, or has had a positive rubella test.
 * You already had two doses of MMR or one dose of MMR plus a second dose of measles vaccine.
 * You already had one dose of MMR and are not at high risk of measles exposure.
 * You are a college student, trade school student, or other student beyond high school.
 * You work in a hospital or other medical facility*.
 * You travel internationally, or are a passenger on a cruise ship.
 * You are a woman of childbearing age.