What are the other Names for this Condition? (Also known as/Synonyms)

• 10-Day Measles
• Red Measles
• Rubeola Infection

What is Measles? (Definition/Background Information)

• Measles is a highly-contagious viral infection of the respiratory system, caused by Rubeola virus belonging to the genus Morbillivirus. Any individual who is not vaccinated against the virus or has not had Measles infection (previously) is susceptible to it
• The virus spreads through contact with infected individuals by inhaling respiratory droplets, when the individual sneezes, coughs, talks, etc. It can also spread through contaminated surfaces and shared items
• The risk factors for Measles include not being vaccinated, having reduced immunity, traveling to places where the disease is rampant, and having severe vitamin A deficiency
• The typical symptoms of Measles include fever, skin rash, sore throat, dry cough, runny nose, and redness of the eyes. To aid in Measles diagnosis, physicians may check for certain symptoms, such as rashes or spots in the mouth known as Koplik’s spots
• Measles could potentially lead to complications such as diarrhea, ear infections, encephalitis, and pneumonia. Additionally, pregnant women infected with Measles might miscarry or go into pre-term labor. Babies born after a maternal  Measles infection may have low birth weight
• Pregnant women or immunocompromised individuals may be prescribed immune serum globulin when they contract Measles, to reduce the severity of the disease. For others, symptomatic treatment for fever and antibiotics for secondary bacterial infections may be prescribed
• Vaccinations are an excellent method to avoid being infected by Measles. Once an individual gets infected, isolating the individual so that others are not infected is  advisable
• Most individuals recover from a Measles infection without any lasting after-effects,  unless certain complications, such as pneumonia or encephalitis, develops

Who gets Measles? (Age and Sex Distribution)

• Measles is generally a childhood disease; however any individual can contract the condition at any age, if they have not had the disease before, and/or if they have not been vaccinated
• Both males and females have equal risk for the condition
• Measles occurs worldwide and there are no specific racial or ethnic group preferences

What are the Risk Factors for Measles? (Predisposing Factors)

The following are the risk factors associated with Measles:

• Vaccination: Those who have not received the Measles-Mumps-Rubella (MMR) vaccination for prevention of Measles are at a high risk of contracting the disease
• Travel: Those who travel to places where Measles is prevalent at a higher incidence are more likely to contract it
• Vitamin A deficiency: Individuals who lack vitamin A in their diet are more likely to be affected by Measles
• Certain conditions such as HIV infection, AIDS, leukemia, etc.
• Immunocompromised individuals
• Children with a natural decrease in protective maternal  antibodies (which cross the placenta in utero to give early infection protection to newborns), before they reach the normal age for immunization
• Malnutrition
• Pregnancy

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Measles? (Etiology)

• Measles is a highly-contagious viral infection of the respiratory system caused by the Rubeola virus. The virus belongs to the genus Morbillivirus and family Paramyxoviridae
• The virus resides in the mucus of the nose and throat of an infected individual. It can spread from one individual to another by inhalation of the tiny infected droplets that gets mixed with the air, when an infected individual coughs, sneezes, or even talks
• The infection can also spread through contaminated surfaces and objects, when an individual touches his/her nose or mouth after touching the infected object or surface

What are the Signs and Symptoms of Measles?

The signs and symptoms of Measles appear after 14 days of exposure to the virus and they may include:

• Fever
• Dry cough
• Runny nose
• Sore throat
• Conjunctivitis or redness of the eyes
• Sensitivity to light
• Koplik’s spots: Small white spots with bluish-white centers appearing inside the mouth on the inner side of the cheek (buccal mucosa)
• Skin rashes
• Swelling of the lymph nodes

How is Measles Diagnosed?

A physician might make a diagnosis of Measles based on:

• Complete physical examination with medical history review
• The physical examination may involve a study of the signs and symptoms such as:
  • Skin rashes
  • Koplik’s spots inside the mouth
• Blood test to confirm that the rashes are indeed caused by Measles

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Measles?

Measles may lead to following complications:

• Diarrhea
• Bacterial ear infection
• Bronchitis or inflammation of the larynx (voice box) and lungs causing respiratory difficulties
• Pneumonia: When the blockage in the lungs becomes severe, it may lead to pneumonia. This is more common in those with weak immune systems
• Encephalitis - inflammation of the brain that can cause:
  • Vomiting
  • Convulsions
  • Coma, and even death
• Pregnancy-related adverse health conditions such as:
  • Pregnancy loss
  • Preterm labor
  • Low birth weight baby
• Measles may cause thrombocytopenia, a low count of platelets (that are essential for blood clotting)

How is Measles Treated?

The treatment and management of Measles may include:

• Post-exposure vaccination: When immunized individuals are infected with Rubeola virus, they may be vaccinated within 72 hours of exposure to the virus in order to prevent Measles infection
• Immune serum globulin: It is an injection of proteins and antibodies that are given to pregnant women, infants, and immune compromised individuals to reduce the effect of Measles
• Other medications used may include:
  • For reducing fever: Acetaminophen, ibuprofen, and naproxen
  • Antibiotics: Antibiotics are usually prescribed if there are secondary bacterial infections such as pneumonia or ear infection
  • Vitamin A: Vitamin A deficiency could make one susceptible to Measles; hence, increasing vitamin A in the diet is advisable, in case of poor vitamin A intake

How can Measles be Prevented?

Large-scale Measles outbreaks have been observed in various regions of the world. To prevent such outbreaks, certain measures may be adopted which include:

• Vaccination: Any individual born after 1957 and not vaccinated, as well as infants over 6 months old, are advised vaccination against Measles
• Isolation: Measles is a highly-contagious condition, and hence, any infected individual should be kept isolated in a separate room and treated accordingly

What is the Prognosis of Measles? (Outcomes/Resolutions)

• The prognosis of individuals with Measles infection is usually excellent. Most individuals are able to recover within 2 weeks
• However, complications, such as pneumonia, encephalitis, seizures, and meningitis, may occur that can be serious
• In rare cases, acute encephalitis due to Measles is a complication that may cause coma or even lead to brain injury and death

The known prevalence of serious outcomes from Measles infections during the pre-vaccine era, and current outcomes among the unvaccinated, makes vaccination for Measles strongly advisable in the absence of significant contraindications.

Additional and Relevant Useful Information for Measles:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/diseases-conditions/infection-center/