MEASLES (Red Measles; Rubeola)

General Information

DEFINITION--A viral illness that infects the respiratory tract and skin. This is one of the most contagious diseases known. Measles was once very common, but it is now less common due to immunization. However, recent outbreaks have occurred due to low rates of immunization.

BODY PARTS INVOLVED--Skin; eyes; upper-respiratory tract.

SEX OR AGE MOST AFFECTED--All ages, but most common in children.

SIGNS & SYMPTOMS--

Measles symptoms usually occur in the following sequence:

• Fever, often high; fatigue; appetite loss.
• Sneezing and runny nose.
• Harsh, hacking cough.
• Red eyes and sensitivity to light.
• Koplik's spots (tiny white spots) in the mouth and throat; reddish rash on the forehead and around ears that spreads to the body.

CAUSES--Measles is caused by a rubeola virus infection that chiefly affects the skin and respiratory tract. The incubation period after exposure is 7 to 14 days.

RISK INCREASES WITH

• Crowded or unsanitary living conditions.
• Population groups that are not immunized.
• Measles epidemics. The disease becomes more virulent as it spreads.

HOW TO PREVENT

• Immunize children against measles. Prevention is important because measles can have rare, but serious, complications.
• If a person has not been immunized against measles and is exposed to it, a gamma globulin (antibodies) injection may prevent or reduce the severity of the disease.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• Diagnosis is usually determined by the appearance of the spots; however, laboratory studies may be required to rule out other disorders.

APPROPRIATE HEALTH CARE

• Home care after diagnosis.
• Doctor's treatment.

POSSIBLE COMPLICATIONS

• Ear and chest infections.
• Pneumonia.
• Encephalitis or meningitis.
• Strep throat.

PROBABLE OUTCOME--

• Symptoms usually subside after about 3 days.
• A child who has been immunized against measles will probably never develop it. A person who has been passively immunized with gamma globulin is protected against measles for about 3 months.

How To Treat

GENERAL MEASURES--

• Treatment involves rest, relief of symptoms and isolation during the communicable period.
• Use a cool-mist, ultrasonic humidifier to soothe the cough and to thin lung secretions so they can be coughed up more easily. Clean humidifier daily.
• Take morning and evening temperatures; keep a record. If the fever is 101F (38.3C) or higher, reduce it.

MEDICATION--

• Your doctor will not prescribe antibiotics for measles, which is a virus. However, if complications arise, such as pneumonia or a middle-ear infection, antibiotics may be necessary.
• Don't give aspirin to a person younger than 18. Use acetaminophen instead to relieve discomfort and reduce fever. Some research shows a link between the use of aspirin in children during a virus illness and the development of Reye's syndrome.

ACTIVITY--Rest until the fever and rash disappear. Encourage a child to rest, but don't force it. Light activities are acceptable once eyes are not painful. Children should not return to school until 7 to 10 days after the fever and rash disappear.

DIET--No special diet. Drink extra fluids, including water, tea, lemonade, cola and fruit juice. Maintaining an adequate fluid intake is very important in keeping lung secretions thin and preventing lung complications.

Call Your Doctor If

• You or your child have symptoms of measles.
• The following occurs during treatment: High fever, accompanied by a sore throat. Severe headache, even several weeks after infection. Earache. Convulsion. Excessive lethargy or drowsiness. Breathing rate above 35 breaths-per- minute or breathing difficulty.