Measles (1850-Present)

Symptoms and Treatment

A typical case of measles starts approximately 1–2 weeks after exposure to an infected individual. Humans are the only known carriers and transmitters of the measles virus, and there is no reservoir of infection in animals or insects. The illness begins with symptoms common to many viral infections: fever, cough, runny nose, and conjunctivitis (pink eye, an inflammation of the surface lining of the eye). This is also the time when the affected person is most contagious, and can infect up to 90 percent of susceptible individuals who are in close contact either with airborne, coughed droplets, or by direct contact with nasal or oral secretions. Persons who have not had measles previously and have not received the vaccine are considered susceptible. The initial symptoms gradually get worse over a few days, and are most severe about the time of rash onset. A characteristic patchy red rash that begins at the face and descends to the trunk and limbs appears within two to four days from initial symptoms. Just before the rash, pale lesions that are unique to measles (Koplik's spots) may appear on the inner lining of the mouth, and sometimes other areas (including the soft palate, vagina, and eyes). The rash may last for up to a week, Koplik's spots can appear for three days, and cough can go on for 10 days. Unfortunately, infection with measles can also produce multiple other health problems and complications.

Complications of measles can affect any organ system. Children under 5 years of age are more vulnerable to severe and life-threatening sequelae, such as pneumonia, croup (an inflammation of the upper airway that [Page 406]can cause its obstruction), and encephalitis (inflammation of the brain). Young children are at highest risk of death. Adult individuals contracting measles older than the age of 20 are also at higher risk for severe illness. A relatively common and debilitating complication of measles is blindness, which occurs more often in malnourished individuals; vitamin A deficiency impairs recovery from eye-related complications of the disease. Subacute sclerosing panencephalitis (SSPE), a degenerative disease of the central nervous system, is a very rare and debilitating complication that may occur up to 10 years after the initial illness.

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