Overview
Measles, also known as rubeola, is a quite contagious viral disease that may cause truly serious complications, particularly in very young children as well as adults who are not vaccinated. Although measles outbreaks are preventable through certain strict vaccination efforts, they persistently occur on a broader worldwide scale, further underscoring the utmost importance of general common immunity. In this article, we will discuss everything you need to know about measles symptoms, how the disease is caused by it, its treatment, as well as why vaccination against measles is important for you.
What is Measles (Rubeola)?
Measles is an infectious disease caused by the rubeola virus, a member of the paramyxovirus family. It primarily affects children but can also occur in adults, especially if they are unvaccinated. The measles virus is extremely contagious, spreading through droplets when an infected person coughs or sneezes. Measles is caused by exposure to the rubeola virus, which attacks the respiratory system before spreading to other parts of the body, including the skin and mucous membranes.
Measles disease manifests in multiple stages, typically beginning with flu-like symptoms such as fever, cough, and a runny nose. As the infection progresses, a distinctive measles rash appears, often starting at the hairline and spreading downward across the body. The disease can be severe and lead to complications like pneumonia, encephalitis, and even death in some cases.
What are the Different Stages of Measles?
Measles progresses through several distinct stages, each with its own set of symptoms. These stages typically unfold over the course of 7 to 10 days after exposure to the measles virus. Here’s an overview of the different stages of measles:
Incubation Period (10-14 Days After Exposure)
The incubation period is the time between exposure to the measles virus and the onset of symptoms. During this stage, the virus is multiplying in the body, but no symptoms are visible. It usually lasts from 10 to 14 days.
Prodromal Stage (Early Symptoms)
This is the initial stage when measles symptoms begin to appear, and it typically lasts about 2-4 days. This stage is crucial for identifying measles, as the fever typically worsens before the rash appears. Early symptoms are similar to a common cold or flu and include:
Koplik Spots Stage (2-3 Days Before the Rash)
One of the prominent signs of measles is the appearance of Koplik spots, which are small, white spots with blue centers that appear inside the mouth, typically on the inside of the cheeks. These spots are an early sign of measles and usually appear 1-2 days before the rash..
Around 3 to 5 days after the onset of the first symptoms, the classic measles rash appears. It starts as flat, red spots at the hairline, behind the ears, or on the face. Over the next several days, the rash spreads downward to the neck, trunk, arms, legs, and feet. The rash may be blotchy and can merge into larger areas of redness.
At the same time as the rash appears, the fever often spikes to its highest point. The rash generally lasts for about 5-7 days.
After the rash fades, the fever subsides, and other symptoms improve. This stage marks the body’s recovery from measles. The rash typically begins to fade from the top of the body (head) and gradually disappears from the face and trunk. In some cases, the skin may peel in the areas where the rash was most intense.
This stage can last about 7-10 days after the rash appears. Although the symptoms improve, people who have had measles can remain contagious for several days after the rash appears.
Potential Complications Stage (Varies)
Some individuals, particularly children under the age of 5, adults over the age of 20, and those with weakened immune systems, can experience serious complications during or after the measles stages. These complications can include:
What are the Symptoms of Measles?
The signs and symptoms of measles typically appear 10 to 14 days after exposure to the measles virus. Early symptoms include:
High fever
Cough
Runny nose
Red, watery eyes
Sore throat
For measles in adults, the symptoms may be more intense and last longer, especially if the person has an underlying health condition. In babies, measles symptoms can be particularly severe, leading to a higher risk for complications. As the infection progresses, measles symptoms in babies and adults may include:
A measles rash (red, blotchy spots) beginning on the face and spreading to the rest of the body
Koplik spots (small white spots inside the mouth, a hallmark of the disease)
How are Measles Caused?
Measles is caused by the rubeola virus, which spreads through direct contact with respiratory secretions from an infected person. It can also spread through the air in places like schools, hospitals, and crowded areas. The virus is contagious from four days before the rash appears to four days after it appears.
Risk Factors for Measles Virus
Certain individuals are at higher risk for contracting the measles virus, including:
The most significant risk factor for contracting measles is not receiving the measles vaccine.
Traveling internationally
Measles is still common in many parts of the world, so international travel can increase the risk of exposure.
Having a vitamin A deficiency
People with low levels of vitamin A are more susceptible to severe forms of measles and complications.
Diagnosis and Tests for Measles Virus
Diagnosing measles typically involves a physical examination, including observing the characteristic measles rash. To confirm the diagnosis, the internal medicine doctor may take a blood or urine sample to detect the presence of the measles virus or antibodies. The measles test can help distinguish between measles and other similar viral infections.
Management and Treatment of Measles
There is no specific antiviral treatment for measles. Treatment primarily focuses on managing symptoms and preventing the condition from progressing further. Moreover, over-the-counter medications can help alleviate fever, pain, and discomfort. In some cases, hospitalized patients may need supplemental oxygen or intravenous fluids.
Supportive Care for Measles Symptoms
Since measles is caused by a virus, antibiotics are not effective in treating the infection itself. Instead, treatment focuses on managing the symptoms and supporting the immune system during recovery. Common supportive measures include:
Fever Management
A high fever is one of the most common symptoms of measles. To help manage the fever:
Medicinescan be prescribed to reduce fever and alleviate discomfort. Avoid giving aspirin to children, as it is associated with Reye’s syndrome, a rare but serious condition.
Cool compresses or lukewarm baths can help lower body temperature and provide comfort.
Hydration
Measles can cause dehydration due to fever, diarrhea, and a reduced appetite. It is essential to drink plenty of fluids, such as water, oral rehydration solutions (ORS), and clear soups, to maintain hydration. In severe cases, where dehydration is significant, intravenous fluids may be required.
Encouraging plenty of rest is crucial for recovery. Patients should stay in a quiet, comfortable environment to reduce the impact of light sensitivity, especially because measles often causes conjunctivitis (red, watery eyes).
Managing Respiratory Symptoms
For the cough and runny nose associated with measles, consider using:
Vitamin A Supplementation
Studies have shown that vitamin A supplementation can reduce the severity of measles and the risk of complications, particularly in children. For children diagnosed with measles, internal medicine doctors may recommend vitamin A supplements, especially in regions where vitamin A deficiency is prevalent. It has been shown to help strengthen the immune system and reduce the duration and severity of the illness.
Dosage of vitamin A typically depends on the child’s age and nutritional status, and it is often given in two doses, 24 hours apart.
Measles Treatment in Adults
Adults can experience more severe symptoms of measles compared to children, especially if they are not vaccinated or have underlying health conditions. Measles treatment in adults generally involves the same supportive care as in children, including fever management, hydration, and rest.
However, adults are more likely to develop complications such as pneumonia or encephalitis. In severe cases, adults may require hospitalization for close monitoring, oxygen support, or intravenous fluids.
Measles Treatment for Babies
Measles symptoms in babies can be particularly severe, and infants under the age of 12 months may not yet have received the measles vaccine. Babies are at higher risk for complications like pneumonia and encephalitis. Measles treatment for babies includes:
Vitamin A supplementation to reduce the severity of the disease.
Hydration and fever management to maintain comfort and prevent complications.
Close monitoring for signs of complications such as difficulty breathing or unusual lethargy.
Complications of Untreated Measles
Measle disease can lead to serious complications, including:
Diarrhea and vomiting: Common in children with measles, leading to dehydration.
Ear infections: The condition may result in hearing loss.
Bronchitis, laryngitis, or croup: Respiratory complications are common.
Pneumonia: A severe lung infection that can be life-threatening.
Encephalitis: Inflammation of the brain, which can lead to permanent neurological damage or death.
Pregnancy problems: Pregnant women with measles are at increased risk of miscarriage, premature birth, or low birth weight.
Measles Prevention: Tips to Manage and Preserve Immunity
The most effective way to prevent measles is through vaccination, which promotes immunity and prevents outbreaks. The measles vaccine, typically administered as part of the MMR vaccine (measles, mumps, and rubella), is safe and highly effective in reducing the incidence of the disease worldwide.
Measles Vaccine in Children
The measles vaccine in children is usually given at ages 12-15 months, with a second dose administered between ages 4-6. Vaccination provides long-lasting immunity and is crucial in preventing the spread of measles.
Measles Vaccine in Adults
Adults who have not been vaccinated or lack evidence of immunity should receive the measles vaccine to protect themselves and others. This is particularly important for individuals who travel internationally or work in healthcare settings.
Isolation and Infection Control
To prevent the spread of measles, individuals diagnosed with the disease should be isolated, especially in healthcare settings, schools, or households with vulnerable individuals (such as newborns or immunocompromised people). Measles is highly contagious, and infected individuals should avoid contact with others, particularly for four days after the rash appears.
Measles patients should stay home and avoid public places to reduce the risk of transmission.
If the patient is hospitalized, healthcare settings should take appropriate isolation precautions.
Management of Complications
Although the majority of people with measles recover without major problems, complications can arise, particularly in high-risk groups such as young children, adults over 20, and individuals with weakened immune systems. Measles complications may include pneumonia, encephalitis, and secondary bacterial infections like ear infections.
Pneumonia is a leading cause of death in children with measles. If pneumonia develops, treatment may involve:
Antibiotics to treat secondary bacterial infections.
Oxygen therapy or mechanical ventilation if breathing difficulties are severe.
Hospitalization may be necessary if the pneumonia is severe.
Encephalitis (brain inflammation) is a rare but serious complication of measles. Symptoms include a sudden change in behavior, confusion, seizures, or loss of consciousness. Treatment involves:
Hospitalization for intensive care.
Anticonvulsants to manage seizures.
Steroids or other medications to reduce brain inflammation.
Ear infections are common in children with measles and can cause pain, fluid drainage, and hearing loss. Treatment may include:
Other Complications
Diarrhea and vomiting: Oral rehydration solutions (ORS) may be used to prevent dehydration.
Pregnancy complications: Pregnant women with measles may require monitoring and additional care to reduce the risk of miscarriage or premature birth.
Preventing Measles During an Outbreak or Known Infection
To stop the spread of measles and prevent new infections, the following measures are essential:
Promoting and Preserving Widespread Immunity
Widespread vaccination is critical to maintaining immunity in the population and preventing outbreaks. The measles vaccine has been proven to be highly effective in reducing the incidence of the disease worldwide.
Preventing a Resurgence of Measles
A resurgence of measles can occur when vaccination rates decline. Governments, doctors, and communities need to work together to ensure that the measles vaccination remains a priority. During a measles outbreak, or if someone is known to be infected, the following measures can help prevent further spread:
Isolation and Infection Control
To prevent the spread of measles, individuals diagnosed with the disease should be isolated, especially in healthcare settings, schools, or households with vulnerable individuals (such as newborns or immunocompromised people). Measles is highly contagious, and infected individuals should avoid contact with others, particularly for four days after the rash appears.
Measles patients should stay home and avoid public places to reduce the risk of transmission.
If the patient is hospitalized, hospitals should take appropriate isolation precautions.
Artemis Hospitals Offers Comprehensive Measles Treatment by Top Medical Experts in Gurgaon
To book an appointment with the best pediatricians at Artemis Hospitals, call our customer care at +91-124-451-1111 or WhatsApp us at +91 9599285476. You can also schedule an appointment through our online patient portal or download and register on the Artemis Personal Health Record mobile app, available for both iOS and Android devices.
Article By Dr. Rajiv Chhabra
Chief - Paediatric
Artemis Hospitals
Frequently Asked Questions
What can I expect if I have measles?
If you have measles, expect symptoms like a high fever, cough, runny nose, and a characteristic measles rash.
Do you have to isolate with measles?
Yes, measles is contagious, and it’s important to isolate yourself from others, especially vulnerable populations.
How Long Does Measles Last?
Measles typically lasts 7-10 days, with the rash appearing about 3-5 days after the first symptoms.
Can Measles Be Prevented?
Yes, measles can be prevented with the measles vaccine.
Why Is Vaccination Important?
Vaccination is crucial to protect individuals from measles, prevent its spread, and avoid severe complications.
Is Measles Contagious?
Yes, measles is highly contagious, spreading easily through respiratory droplets.
How Do People Get Measles?
People get measles through contact with infected respiratory secretions or exposure to contaminated surfaces.
When Should I Call the Doctor?
Call your doctor if you suspect measles, especially if you develop a fever and rash or if complications arise.
What does measles look like?
A measles rash appears as red, blotchy spots that start at the hairline and spread downward across the body.
