What is Measles?

Measles is an acute, generalized, highly communicable viral disease caused by a measles virus. Rubeola is the scientific term used for measles. The virus multiplies in the nose, throat, and lymph nodes and can spread throughout the body. One third of measles cases lead to other serious complications, and measles can rarely cause death and encephalitis. Past experience in New Jersey indicates that during measles outbreaks, up to 40 percent of infected persons require hospitalization.

Who gets Measles?

Generally people of any age who have not had measles or who have not been appropriately vaccinated can acquire measles.

How is Measles spread?

Measles is transmitted from person-to-person by upper respiratory airborne transmission or droplets and direct contact from the respiratory secretions of infected persons. Transmission has also been documented when a person enters a room or closed space within 2 hours of the space being previously occupied by an infected person.

What are the symptoms of Measles?

Early or prodromal symptoms are often mild or not apparent. Generally the first obvious symptoms will be a rising high body temperature (over 101E F), followed by cold symptoms such as cough, runny nose, and inflamed watery eyes. These symptoms are later followed by a flat, raised, and confluent rash which may first appear on the face and spread throughout the body to include the hands and feet. Other symptoms can be diarrhea, lack of appetite, and swollen lymph glands.

How soon do symptoms occur?

Approximately 10 days following exposure to an infected person, fever and cold symptoms may appear, however, these symptoms are not unusual enough for a person to suspect measles. The tell-tale symptom of a body rash usually appears 7-18 days, or an average of 14 days, following exposure. The rash can last up to one week.

How is Measles diagnosed?

Measles can be a difficult disease for a physician to clinically diagnose because it sometimes resembles other rash illnesses. A laboratory test to confirm a diagnosis is necessary. There are two blood tests measuring antibody levels which are used. Viral isolations of throat swabs, urine, or other body fluids are also used more rarely to confirm a diagnosis or to learn more about the origin of the specific measles virus strain affecting a person.

What is the treatment for Measles?

There is no treatment for this viral illness.

How long is an infected person infectious to others?

An infected person is infectious to other susceptible persons for about 4 days prior to the rash onset until about 5 days after the rash onset. The most communicable period occurs with the onset of fever and cold symptoms before measles is even suspected and during the first several days of the rash.

Should an infected person be excluded from work or school?

Infected persons should be excluded from work or school for about 5-7 days after the onset of rash.

Susceptible and unimmunized persons should be excluded from an outbreak setting for up to 14 days after the rash onset of the last case, or until they receive a measles containing vaccine, whichever comes first.

How can Measles be prevented?

For persons born after 1956, measles can only be prevented by receiving at least two doses of a measles containing vaccine, preferably the combination measles, mumps, and measles (MMR) vaccine, on or after the first birthday. Since 1989, two doses of a measles containing vaccine separated by at least one month has been recommended in the United States. The first dose is routinely given at 12-15 months of age. The second dose can be given as soon as one month later, but is more routinely given prior to school entry at 4-6 years of age. It can also be given at any older age.

Sometimes, providing a dose of measles vaccine within 72 hours of exposure may help to prevent disease. In some cases the administration of immune globulin (IG) within 6 days of exposure may also prevent or modify the disease course.

Are there any side effects to the measles vaccine?

A safe and effective weakened live measles virus vaccine has been available since 1963. Some mild side effects following measles vaccination can occur within 5-12 days. Following vaccination, transient rash may occur in 5 percent and fever may occur in 5-15 percent of persons vaccinated. Other side effects can occur but are very rare.

Some persons should not be vaccinated routinely with measles vaccine. These include pregnant women, persons with a severe life-threatening allergy to eggs or neomycin, persons with moderate/severe illness, persons with severe immunosuppression or immunodeficiency, and persons with symptomatic HIV infection. These persons should be evaluated by a physician prior to vaccination.