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December 2019

Measles

Author Affiliations
  • 1College of Medicine, Northeast Ohio Medical University, Rootstown
  • 2Division of Dermatology, Department of Internal Medicine, Northeast Ohio Medical University, Rootstown
JAMA Dermatol. 2019;155(12):1436. doi:10.1001/jamadermatol.2019.2663

What Is Measles?

Measles is an infection caused by the measles virus. It spreads through coughing, sneezing, and contact with contaminated surfaces. It usually causes coldlike symptoms and a rash, but sometimes it can be fatal.

Risk Factors

Anyone not given the measles vaccine or who has received only 1 dose can get measles. Children who are too young to be vaccinated have a high risk of infection. Unvaccinated people who travel internationally, attend college, or work in a hospital are also at increased risk. People with vitamin A deficiency may have a more severe case.

Signs and Symptoms

The first measles symptoms are high fever, runny nose, cough, loss of appetite, and conjunctivitis (red, watery eyes). After a few days, Koplik spots appear inside of the mouth and can look like grains of salt. Shortly thereafter, a rash of red, flat to slightly raised spots develops. It starts on the face and spreads downward to the rest of the body. The symptoms may last for a week after the rash appears. Some people may have a more severe case that can lead to ear infections, diarrhea, pneumonia, or encephalitis (an inflammation of the brain that can be deadly). Measles can cause miscarriage, stillbirth, or premature delivery in pregnant women. An infected mother may also deliver a newborn with measles.

Diagnosis

Measles should be considered in anyone with typical symptoms. A blood test is needed to confirm the diagnosis.

Prevention and Treatment

Measles can easily be prevented with the measles-mumps-rubella (MMR) vaccine. Some people fear that the MMR vaccine may cause autism. However, scientists around the world have done many studies that have found no association between the MMR vaccine and autism. All children should be vaccinated against measles. Adults who are unsure of their immune status should talk to their physician about vaccination. Measles is contagious for about 4 days before and 4 days after the appearance of the rash. Infected people should limit contact with others to avoid spreading the disease. There is no specific treatment for measles. Supportive treatment with medications for fever as well as plenty of fluids are recommended. Children with severe cases may be treated with vitamin A. Ribavirin is an antiviral medication that may be used to treat measles in certain circumstances. Unvaccinated people should be given the measles vaccine within 72 hours of exposure to the virus. This may protect against the disease. Pregnant women, infants, and those with a weak immune system should receive an injection of antibodies (immunoglobulin) within 6 days of exposure to the virus. This may prevent the infection and the complications.

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Section Editor: Courtney Schadt, MD.
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Conflict of Interest Disclosures: None reported.

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