Measles

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Measles is a highly contagious viral illness caused by the measles virus, part of the Paramyxoviridae family. It primarily affects children but can occur at any age in unvaccinated individuals. Measles spreads rapidly and can lead to serious complications, especially in malnourished individuals and those with weakened immune systems.

🦠 CAUSATIVE AGENT

Virus: Measles morbillivirus

Transmission: Airborne droplets (coughing, sneezing)

Survivability: Can live in the air or on surfaces for up to 2 hours

🌍 CONTAGIOUSNESS

R₀ (basic reproduction number): 12–18

One of the most contagious diseases known

An infected person can spread it 4 days before and 4 days after rash onset

⏱️ INCUBATION PERIOD

7 to 14 days, with symptoms typically appearing in two phases

😷 SYMPTOMS

🔹 Phase 1: Prodrome (early symptoms)

High fever (up to 40°C / 104°F)

Cough, coryza (runny nose), conjunctivitis (3 C’s)

Koplik spots (small white lesions inside the mouth – early hallmark)

Fatigue, loss of appetite

🔹 Phase 2: Rash stage

Maculopapular rash starting at hairline, spreading to face, trunk, then limbs

Rash lasts about 5–6 days and fades in the order it appeared

Fever typically peaks when rash appears

🔬 DIAGNOSIS

Test Description

Clinical Rash + fever + cough/coryza/conjunctivitis

Serology Detects IgM antibodies (usually positive by day 3–5 of rash)

RT-PCR Detects viral RNA from throat swab, urine, or nasopharyngeal sample

CBC May show leukopenia (low WBC)

💊 TREATMENT

No specific antiviral treatment; care is supportive.

🔹 Supportive care

Fever management: Paracetamol or ibuprofen

Hydration

Isolation to prevent spread

Nutritional support

 Vitamin A therapy

hown to reduce severity and mortality, especially in children

Recommended doses:

6–11 months: 100,000 IU

12 months+: 200,000 IU

Given on two consecutive days

🚨 COMPLICATIONS

Occur in ~30% of measles cases (higher in young children, adults, pregnant women)

Complication Details

Ear infections (otitis media) Most common complication

Pneumonia Leading cause of measles-related death

Encephalitis Swelling of the brain (1 in 1,000 cases)

Diarrhea & dehydration Can be severe

Subacute sclerosing panencephalitis (SSPE) Rare, fatal brain degeneration occurring years later

Blindness Especially in vitamin A-deficient children

💉 PREVENTION

Method Details

MMR vaccine Measles, Mumps, Rubella combo

Schedule 1st dose at 9–12 months, 2nd dose at 15–18 months or 4–6 years (varies by country)

Effectiveness ~93% after 1 dose, ~97% after 2 doses

Herd immunity threshold: ~95%

Vaccination is the most effective strategy to eliminate measles globally.

⚕️ POST-EXPOSURE PROPHYLAXIS (PEP)

Option Time Window Who

MMR vaccine Within 72 hours Non-immune individuals

Immunoglobulin (IG) Within 6 days Infants <6 months, pregnant women, immunocompromised