ATYPICAL measles is a term used to describe the bizarre clinical manifestations of natural measles infection in children who previously received killed measles virus vaccine.1 The syndrome consists of a two- to three-day prodrome of fever, headache, malaise, and cough, followed by a maculopapular rash that begins on the wrists and ankles. The rash has vesicular, urticarial, and petechial components; spreads to involve the palms, soles, and trunk; and fades after approximately one week. Peripheral edema and roentgenographic evidence of pneumonitis occur in all children reported. In about one half, pleural effusions develop. The white blood cell and differential cell counts are variable. A similar but less severe illness develops in those immunized with attenuated measles vaccine.2
The following case shows that atypical measles can be seen many years after immunization. Postinfectious arthralgias may be part of the syndrome.
Report of a Case
In a previously well 17-year-old