Measles (thing)

Measles, also known as rubeola used to be a very common childhood infection until immunization against it got going. Even though it is known for its characteristic rash, it is actually a respiratory infection caused by the measles virus, a paramyxovirus.

Symptoms:

• Respiratory symptoms appear first -- cough, running nose, fever. This is when the patient is most infectious and should be quarantined.
• Conjunctivitis may appear at this point
• a day or two later, rashes appear on the skin and Koplik's spots (a diagnostic feature) appear on the oral mucosa. The rash is characteristic and is described as being reddish to brown, maculopapular (blotches with raised papules here and there which merge together) and is seen first on the head and face and then spreads downwards. On recovery, the rash disappears in the same order.

Other symptoms:

• ear infections (otitis media)
  

Complications:

• secondary bacterial infections, especially otitis media and pneumonia
• encephalitis, in about 1 in 1000 cases
• very rarely sub-acute sclerosing panencephalitis (SSPE)
• in the malnourished child or child with poor medical care:
  • secondary bacterial infections!!
  • corneal lesions and a secondary bacterial infection of the eye, possibly leading to blindness
  • haemorrhagic rashes ('black measles')
  • diarrhoea - exacerbates malnutrition, halts growth and impairs recovery
  • measles is a major cause of death in childhood for children in this category

Diagnosis, treament, prevention
The diagnosis should be obvious clinically. Laboratory tests are usually unnecessary.

No antivirals are recommended and supportive therapy is all that is needed in most cases.

A live, attenuated vaccine is available which is effective. It is combined with vaccines for mumps and rubella in the MMR vaccine. Gamma globulin can be given for protection from infection in special circumstances (pregnant mothers, immunosuppressed individuals) where immunization is not possible.