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April 9, 1982

Acute Hepatitis in an Adult With Rubeola

Author Affiliations

From the Department of Preventive, Family, and Rehabilitation Medicine, University of Rochester School of Medicine, New York. Dr McLellan is now with the Gesell Institute of Human Development, New Haven, Conn.

JAMA. 1982;247(14):2000-2001. doi:10.1001/jama.1982.03320390062046

MEASLES (rubeola) is a contagious, acute, febrile illness that predominately affects children, although it may occur in any age group. Data in the United States indicate a recent shift to a greater proportion of rubeola cases in older age groups, undoubtedly a result of past and current immunization efforts.1 Typically, the symptoms and signs include cough, coryza, conjunctivitis, abdominal pain, fever, lymphadenopathy, Koplik's spots, and a diffuse, erythematous maculopapular rash. Serious complications most often occur in compromised hosts, especially malnourished children. Reported complications associated with measles include upper and lower respiratory tract infection, otitis media, encephalitis (including subacute sclerosing panencephalitis), ileocolitis, myocarditis, thrombocytopenic purpura, and complications due to bacterial superinfections.

The atypical measles syndrome was first recognized in the 1960s and is seen primarily in young adults exposed to the wild measles virus many years after immunization with the killed measles vaccine. The atypical measle syndrome is distinguished by