Measles is a highly contagious viral disease. It remains an important cause of death among young children globally, despite the availability of a safe and effective vaccine.
Measles is transmitted via droplets from the nose, mouth or throat of infected persons. Initial symptoms, which usually appear 10 – 12 days after infection, include high fever, a runny nose, bloodshot eyes, and tiny white spots on the inside of the mouth. Several days later, a rash develops, starting on the face and upper neck and gradually spreading downwards.
Signs and symptoms
The first sign of measles is usually a high fever, which begins about 10 to 12 days after exposure to the virus, and lasts 4 to 7 days. A runny nose, a cough, red and watery eyes, and small white spots inside the cheeks can develop in the initial stage. After several days, a rash erupts, usually on the face and upper neck. Over about 3 days, the rash spreads, eventually reaching the hands and feet. The rash lasts for 5 to 6 days and then fades. On average, the rash occurs 14 days after exposure to the virus (within a range of 7 to 18 days).
Most measles-related deaths are caused by complications associated with the disease. Serious complications are more common in children under the age of 5, or adults over the age of 30. The most serious complications include blindness, encephalitis (an infection that causes brain swelling), severe diarrhoea and related dehydration, ear infections, or severe respiratory infections such as pneumonia. Severe measles is more likely among poorly nourished young children, especially those with insufficient vitamin A, or whose immune systems have been weakened by HIV/AIDS or other diseases.
In populations with high levels of malnutrition, particularly vitamin A deficiency, and a lack of adequate health care, about 3–6%, of measles cases result in death, and in displaced groups, up to 30% of cases result in death. Women infected while pregnant are also at risk of severe complications and the pregnancy may end in miscarriage or preterm delivery. People who recover from measles are immune for the rest of their lives.
The highly contagious virus is spread by coughing and sneezing, close personal contact or direct contact with infected nasal or throat secretions.
The virus remains active and contagious in the air or on infected surfaces for up to 2 hours. It can be transmitted by an infected person from 4 days prior to the onset of the rash to 4 days after the rash erupts.
Measles outbreaks can result in epidemics that cause many deaths, especially among young, malnourished children. In countries where measles has been largely eliminated, cases imported from other countries remain an important source of infection.
No specific antiviral treatment exists for measles virus.
Severe complications from measles can be avoided though supportive care that ensures good nutrition, adequate fluid intake and treatment of dehydration with WHO-recommended oral rehydration solution. This solution replaces fluids and other essential elements that are lost through diarrhoea or vomiting. Antibiotics should be prescribed to treat eye and ear infections, and pneumonia.
All children diagnosed with measles should receive two doses of vitamin A supplements, given 24 hours apart. This treatment restores low vitamin A levels of measles that occur even in well-nourished children and can help prevent eye damage and blindness. Vitamin A supplements have been shown to reduce the number of deaths from measles by 50%.
Do’s and Don’ts During Measles
- Take complete bed rest in the quiet shaded room during fever.
- Drink extra fluids to prevent dehydration caused by fever and sweating.
- Vitamin C supplements or citrus fruits may help to combat viral infection.
- Do not scratch violently or there may be a secondary infection.
- Vaccination for your child is a must. Do not ignore the booster dose.
- The period of infectivity is 4 days prior to and 5 days after the appearance of rash so avoid contact during this phase.