What is Measles (Rubeola)

Measles is a highly contagious viral illness characterized by a fever, cough, conjunctivitis (redness and irritation in membranes of the eyes), and a spreading rash. It is one of the five classic exanthems along with rubella, roseola, fifth disease, and chicken pox. Measles affects the skin and respiratory tract.

Statistics on Measles (Rubeola)

Measles is highly communicable and occurs world-wide. Since the introduction of immunisation, the incidence of measles has fallen dramatically in the west. However, measles is still one of the most common childhood infections in resource-deprived countries.

Risk Factors for Measles (Rubeola)

Measles is highly contagious, and spread by respiratory droplets. Measles is preventable with vaccination. Hence the main risk factors for infection are:

  • Unvaccinated children coming into contact with a (adult or another child) carrier or an infected case;
  • Immunosuppressed individuals not developing immunity after vaccination.

Progression of Measles (Rubeola)

Measles is spread by droplet infection and is infective for 4 days before the rash and 2 days after the onset of the rash. It has an incubation period of 8-14 days with 2 distinct phases:

  1. The pre-erruptive and catarrhal stage: Signs of a general viral illness.
  2. The erruptive or exanthematous stage: The classic measle rash then occurs.

Complications include:

  • Early complications: otitis media, croup, bronchopneumonia, and encephalitis.
  • Late complications: Subacute Sclerosing Panencephalitis: a central nervous system disorder developing many months or years after clinical measles with the patient developing abnormalities in personality, behaviour, and memory, as well as blindness, muscle jerks, and spasticity.

How is Measles (Rubeola) Diagnosed?

  • Diagnosis is usually clinical because of the characteristic signs.
  • A per-nasal aspirate and CXR may be needed – the latter if pneumonia complicates the illness.
  • Encephalitis requires a CT scan of the head for diagnosis.

Prognosis of Measles (Rubeola)

The probable outcome is excellent in uncomplicated cases. Complications such as pneumonia and encephalitis can be severe, however. Pneumonia accounts for 60% of deaths due to measles, because it is more common than encephalitis. Encephalitis has a mortality of 15%.

How is Measles (Rubeola) Treated?

  • Treatment is supportive and antibiotics should only be used if secondary bacterial infection occurs.
  • Immunity is conferred after the first measles disease and second attacks are uncommon.

Measles (Rubeola) Prevention

The disease can be prevented by immunising children with MMR vaccine (which also confers resistance against mumps and rubella).

Measles (Rubeola) References

  1. Kumar P, Clark M. Clinical Medicine. Fourth Ed. WB Saunders, 2002.
  2. Murray PR, Rosenthal KS., Kobayashi GS., Pfaller MA., Medical Microbiology 3rd Ed Mosby 1998.

More information

Doctor giving a child an intramuscular injection in arm, shallow DOF For more information on the vaccines available to protect against Measles, Mumps and Rubella, as well as the administration, side effects and components of each vaccine, see Measles, Mumps and Rubella (MMR) Vaccine.