Related concepts:

Rubeola, First Disease

Introduction to measles:

We’re now in the beginning of the 21st century, and about one million children still die of measles each year around the world.

Measles has been a major cause of suffering and death at least since the societies of ancient China, Persia, and Rome. Measles epidemics ravaged Europe throughout the Middle Ages and attacked the Americas beginning in 1657. Before the measles vaccine became generally available in 1965, there were 3 to 9 million cases of measles in the United States each year. It was a common cause of pneumonia, blindness, seizures, brain damage, and death.

What is measles?

Measles is a specific virus that causes a specific disease. It was the first of the non-pox rash illnesses of childhood to be identified (first disease). It remains a major worldwide problem.

In most children, the illness is self-limited. Nevertheless, complications are common. Some are as simple as ear infections, croup, or appendicitis. Others are crippling or lethal.

Who gets measles?

In developing countries, measles is still widespread, infecting almost all unimmunized children by the age of 4. The mortality rate in unimmunized children remains about 10 percent and blindness is common if the child is unimmunized and malnourished.

The number of cases in the United States is reported to be less than 1000 per year and serious complications are far less common. Whenever immunization rates fall, the measles rates rise. This happened most recently in the US in 1986 to 1990.

Measles tends to be a winter and spring disease. There is no difference in illness rates between boys and girls, but complications are more common in boys.

Measles causes disease in humans and other primates.

What are the symptoms of measles?

During roughly the first 10 days following exposure, a child has dramatic viral and immunologic activity taking place inside her body, with virtually no outward sign of illness.

Next, typically, comes the prodromal period in which she has symptoms of a cold (tiredness, runny nose, cough, and perhaps red eyes) but with a high fever (~39.5 C or 103 F). These symptoms gradually increase over about 4 days.

During these 4 days, she has white spots in her mouth. These are called Koplik spots and are the hallmark of measles. They usually start on the inside of the cheek opposite the lower molars, then spread within 12 hours to cover most of the inside of the cheeks and lower lip. Many things can cause white spots in the mouth; Koplik spots always appear on a bright red, granular background.

The typical measles rash begins about 14 days after exposure (or 4 days after appearing ill). The fever is still at its height when the rash appears (in contrast to an infection called Roseola).

The measles rash starts as spots, which then begin to blend together. The rash begins around the ears and on the forehead at the hairline. Over three days, it spreads sequentially to cover the face, neck, trunk, arms, buttocks, and legs.