Measles

Measles is spread by direct contact with a person who has measles. It is spread by contaminated droplets that are breathed or coughed into the air from the contagious person.

The symptoms of measles include:

• fever
• fatigue
• loss of appetite
• sneezing and runny nose
• hacking cough
• red eyes and sensitivity to light
• tiny white spots in the mouth and throat, called Koplik's spots
• reddish rash on the forehead and ears that spreads to the body

Measles is caused by the rubeola virus. People who live in crowded or unsanitary conditions are more likely to get measles.

Children should be immunized against measles with an MMR vaccine. This vaccination is a combined one for measles, mumps, and rubella. It is usually given at 1 year of age, and again at 4 to 6 years.

If a person who has not had the vaccine is exposed to measles, a shot of gamma globulin may be given. This may prevent the disease, or at least make it less severe. Gamma globulin will protect a person from measles for 3 months.

Measles is diagnosed when Koplik's spots are seen. A blood test, known as an antibody titer, can also detect the measles virus. Antibodies appear within 3 days after the rash begins.

Possible complications of measles are:

• ear infections such as acute otitis media
• chest infections, such as pleuritis
• lung infections, such as pneumonia
• meningitis, which is inflammation of the linings of the spinal cord
• encephalitis, which is inflammation of the linings of the brain
• strep throat

Measles is very contagious. If a person has not had measles, and has not had the MMR vaccine, contact with the infected person should be avoided during the contagious period. A person is contagious from day 11 to day 15 after exposure. Measles becomes apparent 8 to 14 days after exposure.

Treatment of measles involves relieving symptoms by such measures as:

• vaporizers and a warm room to help reduce the cough
• acetaminophen for fever or discomfort
• plenty of oral fluids to help keep lung secretions thin
• a dark room or sunglasses if the person is sensitive to light

The person should be isolated during the contagious period.

Acetaminophen, as well as other medications, may cause stomach upset. Aspirin should not be given to anyone younger than 16. There is a link between the use of aspirin in children with a viral illness and Reye's syndrome. Reye's syndrome is a rare disease that involves the brain, and it has a high mortality rate.

A person with measles should rest until the fever and the rash disappear. The individual should not go back to school or work for 7 to 10 days, or until after the fever and rash are gone.

It's very important to carefully isolate the person during the contagious period, so that others are not infected. It is also very important to watch for signs of secondary infection, including:

• pneumonia, including shortness of breath
• ear infection, or otitis, which can cause ear pain
• encephalitis, or infection of the linings of the brain, and meningitis, or infection of the linings of the spinal cord.

These infections can cause a high fever, headache that progress to a stiff neck and back, and extreme drowsiness. Any new or worsening symptoms should be reported to the healthcare provider.