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May 1996

Picture of the Month

Author Affiliations

From the American Board of Pediatrics, Chapel Hill, NC (Dr Tunnessen); and the Department of Pediatrics, University of Michigan Medical Center, Ann Arbor (Dr Markel).

Arch Pediatr Adolesc Med. 1996;150(5):547-548. doi:10.1001/archpedi.1996.02170300101020

FOLLOWING A 3-day history of fever, rhinorrhea, cough, and conjunctival injection, a 20-month-old boy developed the rash pictured in Figure 1. On the third day after the appearance of the rash, the lesions had become more confluent (Figure 2). Figure 3 and Figure 4 illustrate typical buccal mucosal lesions associated with this illness.

Denouement and Discussion 

Rubeola (Measles)  Before the development of the measles vaccine, rubeola was easily recognized by laypersons as well as by physicians. It was a ubiquitous, highly contagious disease that infected most of the population at some point during their lifetimes. Epidemics occurred almost yearly. Although there have been some sporadic breakthrough endemics of this infection in the last 2 decades, the clinical picture of measles is not well recognized by more recently trained physicians or the lay public. Failure to recognize early cases of this illness often leads to needless exposure of the unprotected, unimmunized,