Measles is highly infectious disease caused by Measles Virus. Measles virus can be transmitted through droplets when the infected person coughs or sneezes. The virus enters the body of a healthy person who comes in contact with an infected person.
Measles virus belongs to the family paramyxoviridae. Measles is also called as rubeola.
Measles is not the same as German measles or rubella.
Measles most commonly occurs in children under 5 years of age; however it can affect anyone who is not vaccinated with Measles or MMR vaccine. Once a person is infected with measles, he/ she develops life-long immunity; therefore repeat infection of measles is rare.
Measles infection is characterized by peculiar red-brownish spotty skin rash, usually starts from back of ears and later spread to head and neck to the entire body.
Symptoms start to appear after around 10 days the person is exposed to someone who have measles infection.
Measles infection can be serious and life-threatening especially in young children. About 30% of measles infection develops other complications like, pneumonia, ear infection, meningitis and diarrhea.
Measles infections used to be very common, almost everyone used to have it. However due to increase use of MMR vaccine, cases of measles have become very low in developed countries. MMR vaccine is very effective in preventing measles infection.
In developing world measles infection is still very common. According to WHO, Measles is one of the leading cause of death in children. Based on WHO estimates, measles is causing about 314 deaths per day – approx. 13 deaths per hour, globally.
The symptoms start to appear after approximately 10 – 14 days of first exposure to the measles virus.
The general symptoms include:
- Runny nose or congested nose
- High fever
- Red inflamed eyes (watery eyes)
- Sore throat
- Muscle pain and Tiredness
- Loss of appetite
- Small grey-white spots inside the mouth and throat (referred as Koplik’s spots)
After the above symptoms, red-brown rash appears, usually starts from the back of the ear extending to the head & neck to the entire body. The rash appears 3-4 days after the initial general symptoms and lasts for around a week. At first, the spots are smaller, which later becomes bigger and often overlap each other.
Measles infection can be life-threatening especially in young children. About 30% of measles infections develop other complications like, pneumonia, bronchitis, ear infection, encephalitis and diarrhea.
As a rare serious complication (i.e. 1 in 1000 cases) measles is associated to cause encephalitis, which is inflammation of the brain – As a result of encephalitis, patient may suffer with vomiting, seizures, coma and death. Encephalitis can also lead to hearing loss, mental retardation and log-term disability. Due to the above complications, death in children and adults may occur
Measles infection is caused by Measles virus.
The virus spreads through the droplets in the air when the infected person coughs, sneezes or talks which is then inhaled by a healthy person. The virus can also be spread from sharing drinking glasses of the infected person or by touching hands or surfaces having infected droplets or secretions from nose or throat on them and then bringing them close to mouth and nose.
The virus multiplies in the nose and throat of the infected person. Later it moves to the lungs and the entire body.
Measles patients remain infectious from the day when the initial symptoms appear until approximately four days after the rash appeared.
The following are the risk factors that can result in Measles infection:
- Persons who have not received MMR vaccine
- Travelling to countries where measles infection is common
- People who have Vitamin A deficiency
Measles is mostly diagnosed based on the clinical signs and symptoms.
The distinctive rash and grey-white spots (Koplick’s spots) inside the mouth and throat are characteristics symptoms of measles.
If required, the doctor may request blood test for confirmation.
Most cases of measles infection get better themselves. Measles virus takes its own course and most patients starts to feel better in 7 -10 days. There is no specific antiviral treatment or medication available to treat measles infection.
As for many other viral infections, measles infection also require supportive symptomatic treatment, for example regular fever controlling medication (paracetamol) along with some pain medications (analgesics) to control the pain. Since measles is a viral infection, antibiotics are generally not prescribed as antibiotics do not work on viruses. In some patients, bacterial infection may develop at the same time, which requires antibiotics to treat.
Patient may experience sore eyes, regular cleaning with soft cotton cloth soaked in water helps reducing the sore eyes symptoms.
It is recommended that severe measles patient or hospitalized patients should receive Vitamin A. Patient should consume plenty of fluids (water and juices) to prevent dehydration. Consuming water or fluid also helps in controlling fever.
Measles, Mumps and Rubella (MMR) vaccine is the best possible option to prevent measles infection. MMR is usually given to children at 12 months of age. Adults and older children if not vaccinated can receive the MMR vaccine shot if they have a risk of getting measles.
Isolation of infected patient is important to prevent the spread of infection. Patient should also stay home, take plenty of rest and do not go to school or work, avoid social gatherings to prevent transmission of measles infection to healthy persons. Limit exposure to people who are taking care of the patient. It is important that home caregiver should be vaccinated with measles vaccine.
Especially, measles patient should not be brought in contact with persons who may have immuno-compromised disease, cancer patients taking chemotherapy drugs and infants less than 1 years.
Pregnant women should also avoid exposure to measles patients.
Patients experiencing complications such as shortness of breath and severe chest pain should rush to the hospital.