Measles is a paramyxovirus transmitted via a respiratory route in droplets of infectious secretions. Infected individuals are asymptomatic during a 10 to 11 day period following initial exposure. Although generally a self-limited illness, complications can include otitis media, pneumonia, encephalitis and purpura.
Patients with measles experience a prodromal phase three to four days prior to rash onset, characterized by fever, malaise, coryza, conjunctivitis and cough.
Measles rash is erythematous, discrete, macular and papular. It appears first on the ears and forehead, spreading down over the neck and drunk, and then distally over the upper and lower extremities. Exanthem begin fading in order of appearance.
Small, irregular bright-red spots with a minute bluish-white speck in the center, known as Koplik’s spots, appear on the inside of the mouth of patients with measles two days prior to rash.
Mumps, or epidemic parotitis, is a contagious viral infection that causes painful swelling of the salivary gland, and can occur in children aged 2 to 12 years that have not been vaccinated with MMR. Symptoms include face pain, fever, headache, sore throat, swelling of the parotid glands and the temporomandibular region. Infection is self-limited and confers life long immunity to mumps.
Rubella, or German measles, is another common communicable viral infection that has been dramatically reduced by the MMR vaccine. Rubella rash consists of pink-red macules and papules that remain discrete on the extremities but coalesce on the trunk to form a uniform blush, and lasts two to three days. Rubella can cause birth defects in infants including low birth weight, microcephaly, cataracts, nerve deafness and congenital heart disease.
MMR is routinely recommended for all children aged 12 to 15 months, with a second dose recommended at age 4 to 6 years. For adults without evidence of measles immunity, one dose of MMR is recommended. For high-risk adults, such as health care workers, college students and international travelers, two doses are recommended.
In the past, measles, mumps and rubella were common childhood diseases, causing illness and death worldwide. Since the 1990s, high uptake of the measles, mumps and rubella vaccine (MMR) in the United States eradicated endemic transmission of these highly contagious, acute viral diseases. However, waning vaccination coverage in some U.S. communities continues to put vulnerable populations at risk. As of May 2011, the CDC reported 118 confirmed cases of measles in 23 U.S. states, with unvaccinated individuals accounting for 105 of the cases. The largest single outbreak occurred among 21 people in a Minnesota community where many parents reported concerns about the safety of MMR vaccine. The CDC currently advises health-care providers to suspect measles in any person with a febrile rash illness and clinically compatible symptoms who recently traveled abroad or had contact with travelers. View the slideshow below to learn more about measles signs and symptoms below.