Measles (also known as rubella) is an infection caused by a virus and usually affects a person in childhood. Measles was once a very common disease in the United States, but measles is rare now because of vaccination. In other parts of the world, measles is more common and can have serious and even deadly effects on young children with weakened immune systems, especially young children. Recognizing the most common signs and symptoms of measles in your child and seeking medical attention can reduce the risk of serious health consequences.
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Part 1 of 2: Recognizing the Main Signs and Symptoms
Step 1. Check for fever
Measles usually begins with non-specific signs and symptoms, such as malaise (lethargy) and mild to moderate fever. Thus, if your child seems lethargic with a decreased appetite and a slight increase in body temperature, they are more likely to have a viral infection. However, most viral infections start in the same way, so a low-grade fever by itself is not necessarily a sign of measles.
- Normal body temperature is around 37°C, so fever in children occurs when the body temperature reaches more than 38°C. Body temperature over 40°C in children requires medical attention.
- A digital ear thermometer, also known as a tympanic thermometer, is a quick and easy way to take a child's temperature.
- Measles has an incubation period of 10-14 days after infection, during which there are no signs or symptoms.
Step 2. Look for symptoms of cough, sore throat and runny nose
Once you find a mild to moderate fever in your child, other symptoms will develop rapidly in measles. A persistent cough, sore throat, runny nose and inflamed eyes (conjunctivitis) are common in the early stages of measles. This series of relatively mild symptoms can last for two or three days after the onset of the fever. These symptoms still don't confirm that your child has measles - other viral infections, such as colds and flu, cause very similar symptoms.
- The cause of measles is a paramyxovirus, which is highly contagious. The virus spreads through droplets in the air or on surfaces, then replicates in the nose and throat of an infected person.
- You can catch paramyxovirus by putting your finger in your mouth/nose or by rubbing your eyes after touching a surface that is infected with the virus. Exposure to coughing or sneezing from an infected person can also spread measles.
- People infected with measles can spread the virus to others over a period of about eight days - starting when symptoms begin and lasting up to four days after the appearance of the rash (see below).
Step 3. Watch out for the characteristic red rash
The most identifiable sign of measles is the rash it causes. This rash appears a few days after the appearance of a cough, sore throat and runny nose. The rash consists of small reddish spots and bumps that are close together, some of which appear slightly raised, but most look like large flat patches from a distance. The rash first appears on the head/face, usually the rash is found behind the ears and near the hairline. Over a few days, the rash spreads to the neck, arms and chest, then down the legs to the feet. This rash is not itchy for most people, but can be irritating to those with sensitive skin.
- People with measles usually feel the most pain on the first or second day after the rash appears, and it can take about a week for the rash to subside and completely go away.
- Shortly after the rash appears, the fever usually rises sharply and can reach or exceed 40°C. Medical attention may be required at this stage.
- Many people with measles also develop grayish-white spots in their mouths (inner cheeks), called Koplik spots.
Step 4. Identify who is at high risk
Certain groups of people are at higher risk of contracting measles than others. Those most at risk are people who: have not received the measles vaccine, have a detected vitamin A deficiency and/or travel to places where measles is common (eg Africa and parts of Asia). Other groups who are more susceptible to contracting measles are those with weakened immune systems and children under 12 months of age.
- The measles vaccine is usually combined with other vaccines that provide immunity against mumps and rubella. Once all combined, this vaccine is known as the MMR vaccine.
- People who get immunoglobulin treatment and the MMR vaccine at the same time are also at increased risk of measles.
- Vitamin A has antiviral properties and is essential for the health of the mucous membranes, which line the nose, mouth and eyes. If your diet is deficient in vitamin A, you are more susceptible to measles and have more severe symptoms.
Part 2 of 2: Getting Medical Treatment
Step 1. Make an appointment with your family doctor
If you notice any of the above-mentioned symptoms in your child or yourself, make an appointment with your family doctor or pediatrician for a consultation and examination. For more than a decade, measles in American children has been rare, so recently graduated doctors may not have much experience with the typical measles rash. However, any experienced doctor will immediately recognize the characteristic patchy skin rash, and especially Koplik's spots on the inner lining of the cheeks (if any).
- If in doubt, a blood test can confirm whether the rash is really measles. The medical laboratory will look for the presence of IgM antibodies in the blood, which are produced by the body to fight the measles virus.
- In addition, viral cultures can be grown and examined from secretions swabbed from the nasal cavity, throat and/or inside of the cheeks - if you have Koplik's spots.
Step 2. Get the right treatment
There is no specific treatment that can rule out cases of measles that have already developed, but certain measures can be taken to reduce the severity of the symptoms. People who have not been immunized (including children) can be given the MMR vaccine within 72 hours of exposure to paramyxovirus and the vaccine can prevent symptoms from developing. However, as noted above, it often takes an incubation period of 10 days before mild measles symptoms begin to appear, so there's little chance of getting measles within 72 hours unless you travel to an area where there are a lot of people with the disease.
- Immune boosters are available for pregnant women, young children and people with weakened immunity who are exposed to measles (and other viruses). This treatment involves injections of antibodies called immune serum globulins, which ideally should be given within 6 days of exposure to prevent symptoms from getting severe.
- Immune serum globulin and MMR vaccine no may be given at the same time.
- Medications to reduce aches and pains, and moderate to severe fever that accompanies the measles rash include: acetaminophen (Tylenol), ibuprofen (Advil, Motrin) and naproxen (Aleve).
Step 3. Avoid complications from measles
Although potentially lethal (especially in developing countries), measles cases are rarely serious, or require medical attention unless the fever exceeds 40°C. However, the potential complications from measles are often more severe than the initial viral infection. Common complications stemming from measles include: bacterial ear infections, bronchitis, sore throat, pneumonia (due to viruses and bacteria), encephalitis (swelling of the brain), pregnancy problems and decreased blood clotting ability.
- Consider taking antibiotics if an ear infection or bacterial pneumonia develops late in your measles infection. Antibiotics can prevent serious health complications.
- If you have low levels of vitamin A, ask your doctor for vitamin injections to reduce the seriousness of measles and any potential complications. The medical dose is usually 200,000 international units (IU) for two days.
Tips
- Less common but severe symptoms of measles include sneezing, swollen eyelids, light sensitivity, muscle aches and joint pain.
- Rest your eyes or wear sunglasses if you or your child become sensitive to bright light. For a few days, avoid watching TV or staring at a computer screen from too close up.
- Measles prevention involves vaccination and isolation - avoiding people who are infected with the virus.
