Stephanie Ray, RN, BSN
Understanding Measles: Causes, Symptoms, Prevention, and Treatment
Measles is a highly contagious viral infection that primarily affects children but can also occur in adults. It is caused by the measles virus, which belongs to the family Paramyxoviridae. Despite being preventable through vaccination, measles continues to be a global health concern, particularly in regions with low vaccination rates.
Causes of Measles
Measles is caused by the measles virus, which is spread through respiratory droplets when an infected person coughs or sneezes. The virus can also live on surfaces for a few hours, making it possible for individuals to contract the virus by touching contaminated surfaces and their face.
The virus is highly contagious—an infected person can spread it to others even before they show symptoms. Those who are unvaccinated or not immune to the virus are most at risk. Measles can spread to 90% of susceptible people who come in contact with an infected individual.
Symptoms of Measles
The incubation period for measles is typically about 10-12 days after exposure to the virus. The symptoms usually begin with the following:
Fever: This is often the first sign and can be high.
Cough: A persistent dry cough typically accompanies the fever.
Runny nose and sore throat: These common cold-like symptoms also often develop early on.
Conjunctivitis: Red, watery eyes are common, often accompanied by sensitivity to light.
Koplik Spots: These are small, white spots with bluish-white centers that appear inside the mouth, usually a few days before the characteristic rash appears.
Rash: A red, blotchy rash usually appears 3-5 days after the onset of symptoms. It typically begins at the hairline, spreads to the face and neck, and then to the rest of the body, including the arms and legs. The rash can last for several days and is often accompanied by a fever.
As the rash progresses, it may be accompanied by more severe symptoms, including ear infections, pneumonia, and in rare cases, encephalitis (inflammation of the brain), which can be life-threatening.
Transmission and Contagion
Measles is one of the most contagious viruses, one person infected with measles can potentially infect 12 to 18 others in a susceptible population.
The virus is airborne and can spread by coughing, sneezing, or talking. It can survive in the air for up to two hours after an infected person leaves a room. People with measles are contagious from about four days before to four days after the appearance of the rash.
Diagnosis and Testing
Measles can typically be diagnosed based on its characteristic symptoms, particularly the appearance of the rash and Koplik spots. In some cases, laboratory testing is used to confirm the diagnosis, such as:
Blood testing: Detecting antibodies in the blood.
Polymerase chain reaction (PCR): A test that detects the virus’s genetic material.
In areas with low vaccination rates, clinicians should consider measles in the differential diagnosis if a patient presents with a fever and rash, particularly in a child who may have been exposed to an infected person.
Prevention of Measles
The most effective way to prevent measles is through vaccination. The measles, mumps, rubella (MMR) vaccine is a combination vaccine that protects against all three diseases. The vaccine is typically administered in two doses:
The first dose at 12-15 months of age.
The second dose at 4-6 years of age.
In addition to the MMR vaccine, the measles, mumps, rubella, and varicella (MMRV) vaccine is also available in some regions. The MMR vaccine is over 95% effective at preventing measles after two doses.
It is crucial to maintain high vaccination coverage to achieve herd immunity, which reduces the spread of the virus in the community, even among those who are not vaccinated.
For those who have not been vaccinated or are unsure of their immunity status, a blood test can determine whether they have immunity to measles, and vaccination may be recommended.
Complications of Measles
While measles is often considered a mild illness, especially for children, it can lead to serious complications, particularly in young children, pregnant women, and individuals with weakened immune systems. Some potential complications include:
Pneumonia: This is one of the most common and severe complications of measles.
Otitis Media: Middle ear infections, which can lead to permanent hearing loss.
Encephalitis: Inflammation of the brain that can cause permanent brain damage or death.
Diarrhea and Dehydration: These are common in children with measles, leading to malnutrition and other issues.
Pregnancy Complications: Pregnant women who get measles are at higher risk of miscarriage, premature birth, or low birth weight babies.
Rarely, a severe complication known as subacute sclerosing panencephalitis (SSPE) can occur years after infection. SSPE is a fatal, progressive neurological disorder that leads to severe brain damage.
Treatment for Measles
There is no specific antiviral treatment for measles, but supportive care is essential. Management typically includes:
Fever control: Using antipyretics like acetaminophen (Tylenol) to manage fever.
Fluids and nutrition: To prevent dehydration and maintain proper nutrition.
Vitamin A supplementation: The World Health Organization recommends Vitamin A for children with measles, as it can reduce the risk of complications like blindness and death.
Antibiotics: For secondary bacterial infections, like pneumonia or ear infections.
In severe cases, hospitalization may be required, especially for complications like pneumonia or encephalitis.
Global Impact and Recent Trends
While measles was declared eliminated in many high-income countries, there have been recent outbreaks in areas with lower vaccination rates. Factors contributing to these outbreaks include vaccine misinformation, access to healthcare, and vaccine hesitancy.
The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) have both made efforts to increase vaccination rates globally, especially in regions with limited access to healthcare services. Despite these efforts, measles remains a leading cause of preventable death worldwide, particularly in low-income countries.
Conclusion
Measles is a dangerous and highly contagious disease that can be prevented with a simple vaccination. While it is often mild in children, it can lead to serious complications, especially in vulnerable populations. Ensuring widespread vaccination coverage is key to preventing outbreaks and ultimately eliminating measles. By staying informed about the disease and its prevention, we can protect ourselves and others from the threat of measles.
Sources:
https://www.cdc.gov/measles/about/index.html
https://www.nhs.uk/conditions/measles/
https://www.who.int/news-room/fact-sheets/detail/measles