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What You Need to Know About Measles

What You Need to Know About Measles

Measles, also known as rubeola, is an infection caused by a virus. The measles was once very common all over North America, but since the introduction of the measles vaccine in 1968, the number of measles cases and deaths has reduced drastically. Measles occurs most often in the winter months, and is very contagious to others around you. Measles can cause a mild infection, or can be severe causing death.

What are the signs and symptoms of measles?

The following are some of the signs and symptoms that your child may show if infected with the measles:

  • Fever – this is the first sign of the measles and appears 10 to 12 days after being exposed to the virus, and generally lasts from 4 to 7 days.
  • Dry cough.
  • Runny nose.
  • Red, watery eyes.
  • Small white spots inside the mouth, on the inner side of the cheeks (called Koplik’s spots).
  • Rash – this rash begins about 5 days after the first symptom develops (for example, after the fever begins). The rash first appears on the face and neck, and eventually spreads to the trunk, arms, legs, and feet. The rash usually lasts for 5 to 6 days and then fades away on its own.

What is the progression of the measles?

There are a few different stages that the measles virus goes through.

Infection and Incubation: This stage is when you first become infected with measles virus. For about 10 to 14 days the virus invades your body. For most of this time you are not infectious to other people and you have no signs or symptoms of the virus.

Signs and Symptoms Appear: This is when the typical signs and symptoms of the measles virus begin to show up, like the fever, cough, runny nose, red eyes, and sore throat. This period lasts for about 2-3 days.

The Rash: Finally the rash appears. The rash looks like small red spots, that may be raised or flat, that develop into clusters. The first area to develop the rash is the face, and then spreads to the rest of the body including the trunk, legs, arms and feet. As the rash spreads, the fever increased and can be as high as 40⁰C to 41⁰C (104⁰F to 105.8⁰F). The rash fades about 5 to 6 days after it first develops.

When is my child infectious to others? How is it spread?

Measles is a very contagious virus. About 90% of people who come into contact with the virus will contract it. The period at which your child is infectious and can spread the infection to others begins about 4 days before rash appears, and ends about 4 days after the rash has been present. The measles virus lives in the mucus of the nose and throat and is easily spread from person to person by coughing or sneezing or close personal contact with someone infected with the virus. The virus can live on a surface or in the air for up to 2 hours, so if a person breathes in this contaminated air, or touches a surface that the virus is living on, they can become infected.

How is measles diagnosed?

When seeing your doctor or nurse practitioner they will examine your child looking for the above signs and symptoms. They will perform a physical exam and take a history including information about possible exposure to someone who is infected with the measles. A diagnosis can be determined often just by a clinical exam. The clinical diagnosis can be confirmed by taking a swab of the saliva or nasal mucus for testing to confirm the presence of the measles virus. This test will tell the doctor or nurse practitioner whether or not the signs and symptoms present are due to the measles virus or another bacteria or virus. This test usually takes a couple of days before results are confirmed.

Is there a treatment for measles?

Like most viral illness, the measles cannot be treated with antibiotics. The best defense against the measles is the MMR vaccine. As a parent you can help to manage your child’s symptoms and keep them comfortable. The following may be helpful for your child:

  • Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to reduce the fever. Do not give your child aspirin.
  • Keep your child well hydrated with water (juice may over stimulate the salivary glands causing more pain and discomfort).
  • Isolate your child by keeping them home from school or day care for the period in which they are contagious (about 4 days before the onset of the rash to 4 days after the rash develops).

Keep those who are non-immunized, and those who are at increased risk of developing the measles away from your infected child.

Who is at risk for contracting the measles virus?

The highest risk group are those children who have not been vaccinated against the measles virus. Unvaccinated pregnant women are also at high risk. Those who travel internationally, where the measles vaccine is not given routinely like it is in North America, can contract the virus. Measles is very common in underdeveloped and developing countries. Those with a weakened immune system from other medical conditions are also at a higher risk for contracting the measles virus.

How can measles be prevented?

The best protection from the measles is ensuring your vaccinations are up to date. The MMR vaccine is given twice during childhood. The first dose is given between 12-15 months, and the second dose is given between 4-6 years old. An additional dose of the MMR vaccine may be given later in life to adults, especially if they are traveling outside of North America. Not all countries routinely vaccinate against the measles like we do here in Canada. Health care professionals, university students and those who at risk during an outbreak may also receive an additional dose. (Click here for the immunization schedule).

Although the MMR vaccine is very effective in preventing the measles, there is still a chance your child, or you, could get the measles. Outbreaks of the measles sometimes do occur, especially in areas where people are in close direct contact with one another, such as schools, dormitories, or camps.

What are the complications of measles?

Measles can be serious at any age group, but is particularly dangerous in children under the age of 5 and over the age of 20. In mild cases of the measles, your child may also develop an ear infection, bronchitis, or diarrhea. In more severe cases they may develop pneumonia, thrombocytopenia, and encephalitis or may even die from the measles. About 1 in 1000 children who develop the measles will die from the virus. In women who are pregnant, the measles may cause premature labour and birth or a baby with a low birth weight.

– Dr. Christina Cesareo and Dr. G Paul Dempsey

[Featured image: CDC/Dr. Heinz F. Eichenwald]

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