Measles:Symptoms, Causes, Types, Risk factors, Complications, Diagnosis, Treatment and Prevention


Measles is a highly infectious illness affecting the respiratory system caused by the rubeola virus.

May 7, 2018

Measles is a highly infectious illness affecting the respiratory system caused by the rubeola virus. Measles can be serious and even fatal for small children. Cough, runny nose, inflamed eyes, sore throat, fever and a red, blotchy skin rash are some of the common sign and symptoms of measles.
Measles is a very contagious disease that can spread through contact with infected mucus and saliva. The infection can be spread into the air when an infected person cough or sneeze. As the infected particles enter the air and virus can live on surfaces for several hours, anyone within close proximity can become infected.
Drinking from an infected person's glass, or sharing eating utensils with an infected person, increases your risk of infection.
Visit your doctor to receive a measles vaccine within 72 hours of contact to prevent infection if you come into contact with an infected person and have not received a measles vaccine before. You can also prevent an infection with a dose of immunoglobulin. This should be taken within 6 days of contact with an infected person.

Symptoms of Measles:

Symptoms of measles generally appear within 10 to 14 days of exposure to the virus. Symptoms include:

  • dry cough
  • fever
  • red eyes
  • light sensitivity
  • muscle aches
  • runny nose
  • sore throat
  • white spots inside the mouth
  • A skin rash which appears as red, itchy bumps, made up of large, flat blotches that often flow into one another

The rash can last up to seven days and generally appears within the first 3 to 5 days of exposure to the virus. A measles rash commonly develops on the head and slowly spreads to other parts of the body.
The infection occurs in sequential stages over a period of 2 to 3 weeks. The measles virus incubates for the first 10 to 14 days after you get an infection. You have no signs or symptoms of measles during this time. It will then start with a mild to moderate fever, often accompanied by a persistent cough, runny nose, inflamed eyes and sore throat. This relatively mild illness may last 2 or 3 days. The rash will appear as small red spots, some of which are slightly raised. Spots and bumps in tight clusters give the skin a splotchy red appearance. The face breaks out first, particularly behind the ears and along the hairline.
The rash spreads down the arms and trunk after some days. It then starts spreading over the thighs, lower legs and feet. At the same time, fever rises sharply, often as high as 104 to 105.8 F. The recovery will also happen in the same manner.The measles rash gradually recedes, fading first from the face and last from the thighs and feet.
A person with measles is contagious for about eight days. He/she can spread the virus to others starting 4 days before the rash appears till 4 days the rash has been present.

Causes of Measles:

The cause of measles is rubeola virus that replicates in the nose and throat of an infected child or adult. The disease is contagious for 4 days before the rash appears, and it continues to be contagious for about 4 to 5 days after it is developed.
It can spread through air when someone with measles coughs, sneezes or talks as the infected droplets may land on a surface, where they remain active and contagious for several hours. Infection can spreads through:

  • physical contact with an infected person
  • being near infected people if they cough or sneeze
  • touching a surface that has infected droplets of mucus and then putting fingers into the mouth, or rubbing the nose or eyes

Types of Measles:

There are two types of measles which include:

  • Measles that is the standard form caused by the rubeola virus
  • Rubella, or German measles that is caused by the rubella virus

Rubella has a greater risk to unborn infants than young children if a woman contracts the virus while she is pregnant. It is neither as infectious nor as severe as standard measles.

Risk factors:

Risk factors for measles include:

Being unvaccinated:

If you have not received the vaccine for measles at any period of your life time, you are much more likely to develop the disease.

Traveling to measles prone area:

You are at higher risk of getting the disease if you travel to developing countries, where measles is more common.

Having a vitamin A deficiency:

You are more likely to contract measles and to have more severe symptoms if you don't have enough vitamin A in your diet.

Complications of Measles:

As soon as the virus enters the body, it multiplies in the back of the throat, lungs, and the lymphatic system. It later infects and replicates in the urinary tract, eyes, blood vessels, and central nervous system.
Complications are more likely in older people. This can include:

  • diarrhea
  • vomiting
  • eye infection
  • respiratory tract infections, such as laryngitis and bronchitis leading to inflammation of your voice box (larynx) or inflammation of the inner walls
  • difficulty breathing
  • ear infections, which can lead to permanent hearing loss
  • febrile seizures

People with a weakened immune system who have measles can easily develop bacterial pneumonia which can be fatal if not treated.
Some of the less common complications are also possible which could be:

Hepatitis:

Complications in liver can occur in adults and in children who are taking some medications.

Encephalitis:

It is an inflammation of the brain that can cause vomiting, convulsions, and, rarely, coma or even death. It may occur soon after measles, or several years later. About 1 in 1,000 people with measles develops encephalitis.

Thrombocytopenia, or low platelet count:

Measles may lead to a decrease in platelets, the type of blood cells that are essential for blood clotting. Therefore affecting the blood's ability to clot. The patient may bruise easily.

Squint:

Eye nerves and eye muscles may be affected.

Pregnancy Problem:

Measles during pregnancy can lead to miscarriage, early delivery, or low birth weight. A woman who is planning to become pregnant and has not been vaccinated should ask her doctor for advice.
Some of the possible complications that are very rare include:

  • Neuritis which is an infection of the optic nerve that can lead to vision loss
  • Heart complications
  • Subacute sclerosing panencephalitis (SSPE)which is a brain disease that can affect 2 in every 100,000 people, months or years after measles infection. The infection can lead to convulsions, motor abnormalities, cognitive issues, and even death.
  • Other nervous system complications include toxic encephalopathy, retrobulbar neuritis, transverse myelitis, and ascending myelitis.

Anyone who has never been infected or vaccinated is likely to get the disease if they breathe in infected droplets or are in close physical contact with an infected person.

Diagnosis of Measles:

Measles can be diagnosed by looking at the signs and symptoms. A blood test will be done to confirm the presence of the rubeola virus.This is a is a notifiable disease and utmost precaution is taken once it is diagnosed to prevent the spread. The doctor has to notify the authorities of any suspected cases. If the patient is a child, the doctor will also notify the school. A child with measles should not return to school until at least 5 days after the rash appears as he/she will be contagious at that period of time.

Treatment of Measles:

There is no specific treatment for measles. If there are no complications, symptoms usually go away within 7 to 10 days on its own without any treatment.
In this case the doctor will recommend rest and plenty of fluids to prevent dehydration.
Following the below things may help relieve the symptoms:

  • Children should be kept cool if they have high fever. But ensure not to keep them too cold. Tylenol or ibuprofen can help control fever, aches, and pains.
  • Aspirin is not recommended for children under 16 years. As too much of acetaminophen can harm the child, especially the liver, the dose will always be recommended by a doctor. Do not take this medication without doctor's recommendation.
  • Avoid smoking near the child.
  • As measles increases sensitivity to light, sunglasses, keeping the lights dim or the room darkened may increase comfort levels.
  • Gently clean with a warm, damp cloth if there is crustiness around the eyes.
  • Cough medicines will not relieve a measles cough. However, humidifiers or placing a bowl of water in the room may help. A glass of warm water with a teaspoon of lemon juice and two teaspoons of honey may help if the child is over 12 months. Do not give honey to infants.
  • The child should drink plenty of fluids as fever can lead to dehydration.
  • A child who is in the contagious stage should stay away from school and avoid close contact with others, especially those who are not immunized or have never had measles.
  • People with a vitamin A deficiency and children under 2 years who have measles may benefit from vitamin A supplements. These can help prevent complications. But they should only be taken with a doctor's advise.

Antibiotics will not help cure the measles. However, sometimes they may be prescribed if an additional bacterial infection develops.

Prevention of Measles:

People who have already had measles are normally immune and most likely they do not get it again. But people who are not immune should consider the measles vaccine.
Anyone born after 1957 who hasn't been vaccinated, as well as infants older than 6 months should get the vaccine. Newborns will get immunity from their mother for a few months after birth if their mothers are immune. But sometimes the vaccine is recommended before the age of 12 months, and as early as 6 months.
This is required if they are, or are likely to be, in an area where there is a serious outbreak.
The vaccine should not be taken by women who are pregnant or plan to become pregnant soon or people with a serious allergy to gelatin or neomycin, an antibiotic.
Anybody whose immune system may be compromised by a condition or treatment for a condition should ask their doctor whether they should receive the vaccine.
Because measles is highly contagious from about four days before to four days after the rash breaks out, people with measles should stay isolated. It may also be necessary to keep  people who are not immunized away from the infected person.