What is Measles?

Measles, also called rubeola, is a highly contagious respiratory infection that's caused by a virus. It causes a total-body skin rash and flu-like symptoms, including a fever, cough, and runny nose. Though rare in the United States, 20 million cases occur worldwide every year. Since measles is caused by a virus, there is no specific medical treatment and the virus has to run its course. But a child who is sick should be sure to receive plenty of fluids and rest, and be kept from spreading the infection to others.

Signs and Symptoms

While measles is probably best known for the full-body rash it causes, the first symptoms of the infection are usually a hacking cough, runny nose, high fever, and red eyes. A characteristic marker of measles are Koplik's spots, small red spots with blue-white centers that appear inside the mouth.

The measles rash typically has a red or reddish brown blotchy appearance, and first usually shows up on the forehead, then spreads downward over the face, neck, and body, then down to the arms and feet. Continue Listen

Is Measles Contagious?
Measles is highly contagious 90% of people who haven't been vaccinated for measles will get it if they live in the same household as an infected person. Measles is spread when someone comes in direct contact with infected droplets or when someone with measles sneezes or coughs and spreads virus droplets through the air. A person with measles is contagious from 1 to 2 days before symptoms start until about 4 days after the rash appears. Measles is very rare in the United States. Due to widespread immunizations, the number of U.S. measles cases has declined in the last 50 years. Before measles vaccination became available in the 1960s, more than 500,000 cases of measles were reported every year. From 2000 to 2007, just an average of 63 cases per year was reported. However, in 2008 the United States saw an increase in measles cases and outbreaks (more than three or more linked cases), with 131 cases reported between January and July. More than 90% of those infected were not immunized or immunization status was unknown. The most important thing you can do to protect kids from measles is to have them vaccinated according to the schedule prescribed by your doctor.

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Prevention
Infants are generally protected from measles for 6 months after birth due to immunity passed on from their mothers. Older kids are usually immunized against measles according to state and school health regulations. For most kids, the measles vaccine is part of the measles-mumps-rubella immunizations (MMR) or measles-mumps-rubella-varicella immunization (MMRV) given at 12 to 15 months of age and again at 4 to 6 years of age. Measles vaccine is not usually given to infants younger than 12 months old. But if there's a measles outbreak, the vaccine may be given when a child is 6-11 months old, followed by the usual MMR immunization at 12-15 months and 4-6 years. As with all immunization schedules, there are important exceptions and special circumstances. Your child's doctor should have the most current information regarding recommendations about the measles immunization. Measles vaccine should not be given to pregnant women or to kids with untreated tuberculosis, leukemia or other cancers, or people whose immune systems are suppressed for any reason. Also, the vaccine shouldn't be given to kids who have a history of severe allergic reaction to gelatin or to the antibiotic neomycin, as they are at risk for serious reactions to the vaccine. During a measles outbreak, people who have not been immunized (especially those at risk of serious infection, such as pregnant women, infants, or kids with weakened immune systems) can be protected from measles infection with an injection of measles antibodies called immune globulin if it's given within 6 days of exposure. These antibodies can either prevent measles or make symptoms less severe. The measles vaccine also may offer some protection if given within 72 hours of measles exposure. BackHYPERLINK "javascript:void(0)"Continue Listen

Vaccine Side Effects

Measles vaccine occasionally causes side effects in kids who don't have underlying health problems. The most common reactions are fever between 6-12 days after vaccination (in about 5%-15% of kids getting the vaccine) and a measles-like rash, which isn't contagious and fades on its own (in about about 5% of vaccinated kids).

Treatment
There is no specific medical treatment for measles. To help manage symptoms, which usually last for about 2 weeks, give your child plenty of fluids and encourage extra rest. If

fever is making your child uncomfortable, you may want to give a non-aspirin fever medication such as acetaminophen or ibuprofen. Remember, you should never give aspirin to a child who has a viral illness since the use of aspirin in such cases has been associated with the development of Reye syndrome. Kids with measles should be closely monitored. In some cases, measles can lead to other complications, such as otitis media, croup, diarrhea, pneumonia, and encephalitis (a serious brain infection), which may require antibiotics or hospitalization. In developing countries, vitamin A has been found to decrease complications and death associated with measles infections. In the U.S., vitamin A supplementation should be considered for children between 6 months and 2 years who are hospitalized with measles and its complications. Also, all kids older than 6 months with risk factors, such as vitamin A deficiency, weakened immune system, or malnutrition may benefit from vitamin A supplementation.

Is Measles Contagious?
Measles is highly contagious 90% of people who haven't been vaccinated for measles will get it if they live in the same household as an infected person. Measles is spread when someone comes in direct contact with infected droplets or when someone with measles sneezes or coughs and spreads virus droplets through the air. A person with measles is contagious from 1 to 2 days before symptoms start until about 4 days after the rash appears. Measles is very rare in the United States. Due to widespread immunizations, the number of U.S. measles cases has declined in the last 50 years. Before measles vaccination became available in the 1960s, more than 500,000 cases of measles were reported every year. From 2000 to 2007, just an average of 63 cases per year was reported. However, in 2008 the United States saw an increase in measles cases and outbreaks (more than three or more linked cases), with 131 cases reported between January and July. More than 90% of those infected were not immunized or immunization status was unknown. The most important thing you can do to protect kids from measles is to have them vaccinated according to the schedule prescribed by your doctor.

Prevention
Infants are generally protected from measles for 6 months after birth due to immunity passed on from their mothers. Older kids are usually immunized against measles according to state and school health regulations. For most kids, the measles vaccine is part of the measles-mumps-rubella immunizations

(MMR) or measles-mumps-rubella-varicella immunization (MMRV) given at 12 to 15 months of age and again at 4 to 6 years of age. Measles vaccine is not usually given to infants younger than 12 months old. But if there's a measles outbreak, the vaccine may be given when a child is 6-11 months old, followed by the usual MMR immunization at 12-15 months and 4-6 years. As with all immunization schedules, there are important exceptions and special circumstances. Your child's doctor should have the most current information regarding recommendations about the measles immunization. Measles vaccine should not be given to pregnant women or to kids with untreated tuberculosis, leukemia or other cancers, or people whose immune systems are suppressed for any reason. Also, the vaccine shouldn't be given to kids who have a history of severe allergic reaction to gelatin or to the antibiotic neomycin, as they are at risk for serious reactions to the vaccine. During a measles outbreak, people who have not been immunized (especially those at risk of serious infection, such as pregnant women, infants, or kids with weakened immune systems) can be protected from measles infection with an injection of measles antibodies called immune globulin if it's given within 6 days of exposure. These antibodies can either prevent measles or make symptoms less severe. The measles vaccine also may offer some protection if given within 72 hours of measles exposure

Vaccine Side Effects

Measles vaccine occasionally causes side effects in kids who don't have underlying health problems. The most common reactions are fever between 6-12 days after vaccination (in about 5%-15% of kids getting the vaccine) and a measles-like rash, which isn't contagious and fades on its own (in about about 5% of vaccinated kids).

Treatment
There is no specific medical treatment for measles. To help manage symptoms, which usually last for about 2 weeks, give your child plenty of fluids and encourage extra rest. If fever is making your child uncomfortable, you may want to give a non-aspirin fever medication such as acetaminophen or ibuprofen. Remember, you should never give aspirin to a child who has a viral illness since the use of aspirin in such cases has been associated with the development of Reye syndrome. Kids with measles should be closely monitored. In some cases, measles can lead to other complications, such as otitis media, croup, diarrhea, pneumonia, and encephalitis (a serious brain infection), which may require antibiotics or hospitalization. In developing countries, vitamin A has been found to decrease complications and death associated with measles infections. In the U.S., vitamin A supplementation should be considered for children between 6 months and 2 years who are hospitalized with measles

and its complications. Also, all kids older than 6 months with risk factors, such as vitamin A deficiency, weakened immune system, or malnutrition may benefit from vitamin A supplementation.

When to Call the Doctor

Call the doctor immediately if you suspect that your child has measles. Also, it's important to get medical care following measles exposure, especially if your child: is an infant is taking medicines that suppress the immune system has tuberculosis, cancer, or a disease that affects the immune system

Remember that measles, a once common childhood disease, is preventable through routine childhood immunization

Causes
The infection is spread by contact with droplets from the nose, mouth, or throat of an infected person. Sneezing and coughing can put contaminated droplets into the air. Those who have had an active measles infection or who have been vaccinated against the measles have immunity to the disease. Before widespread vaccination, measles was so common during childhood that most people became sick with the disease by age 20. The number of measles cases dropped over the last several decades to almost none in the U.S. and Canada. However, rates have started to rise again recently. Some parents do not let their children get vaccinated because of unfounded fears that the MMR vaccine, which protects against measles, mumps, and rubella, can cause autism. Large studies of thousands of children have found no connection between this vaccine and autism. Not vaccinating children can lead to outbreaks of a measles, mumps, and rubella -- all of which are potentially serious diseases of childhood.

Back to TopSymptoms
Symptoms usually begin 8 - 12 days after you are exposed to the virus. This is called the incubation period. Symptoms may include: Bloodshot eyes

Light sensitivity (photophobia) Rash Usually appears 3 - 5 days after the first signs of being sick May last 4 - 7 days Usually starts on the head and spreads to other areas, moving down the body Rash may appear as flat, discolored areas (macules) and solid, red, raised areas (papules) that later join together Itchy

Redness and irritation of the eyes (conjunctivitis) Runny nose Sore throat Tiny white spots inside the mouth (Koplik's spots)

Measles
Fact sheet N286 December 2009

Key facts
Measles is one of the leading causes of death among young children even though a safe and cost-effective vaccine is available. In 2008, there were 164 000 measles deaths globally nearly 450 deaths every day or 18 deaths every hour. More than 95% of measles deaths occur in low-income countries with weak health infrastructures.

Measles vaccination resulted in a 78% drop in measles deaths between 2000 and 2008 worldwide. In 2008, about 83% of the world's children received one dose of measles vaccine by their first birthday through routine health services up from 72% in 2000.

Measles is a highly contagious, serious disease caused by a virus. It remains one of the leading causes of death among young children globally, despite the availability of a safe and effective vaccine. An estimated 164 000 people died from measles in 2008 mostly children under the age of five. Measles is caused by a virus in the paramyxovirus family. The measles virus normally grows in the cells that line the back of the throat and lungs. Measles is a human disease and is not known to occur in animals. Targeted vaccination campaigns have had a major impact on reducing measles deaths. From 2000 to 2008 nearly 700 million children aged 9 months to 14 years who live in high risk countries were vaccinated against the disease. Global measles deaths decreased by 78% during this period. 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 four to seven 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 three days, the rash spreads, eventually reaching the hands and feet. The rash lasts for five to six days, and then fades. On average, the rash occurs 14 days after exposure to the virus (within a range of seven to 18 days). 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. Most measles-related deaths are caused by complications associated with the disease. Complications are more common in children under the age of five, or adults over the age of 20. 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. As high as 10% of measles cases result in death among populations with high levels of malnutrition and a lack of adequate health care. People who recover from measles are immune for the rest of their lives. Who is at risk? Unvaccinated young children are at highest risk of measles and its complications, including death. Any non-immune person (who has not been vaccinated or previously

recovered from the disease) can become infected. Measles is still common in many developing countries particularly in parts of Africa and Asia. More than 20 million people are affected by measles each year. The overwhelming majority (more than 95%) of measles deaths occur in countries with low per capita incomes and weak health infrastructures. Measles outbreaks can be particularly deadly in countries experiencing or recovering from a natural disaster or conflict. Damage to health infrastructure and health services interrupts routine immunization, and overcrowding in residential camps greatly increases the risk of infection. Transmission 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 two hours. It can be transmitted by an infected person from four days prior to the onset of the rash to four 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. Treatment Severe complications from measles can be avoided though supportive care that ensures good nutrition, adequate fluid intake and treatment of dehydration with WHOrecommended 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 in developing countries diagnosed with measles should receive two doses of vitamin A supplements, given 24 hours apart. This can help prevent eye damage and blindness. Vitamin A supplements have been shown to reduce the number of deaths from measles by 50%. Prevention Routine measles vaccination for children, combined with mass immunization campaigns in countries with high case and death rates, are key public health strategies to reduce global measles deaths. The measles vaccine has been in use for over 40 years. It is safe, effective and inexpensive. It costs less than one US dollar to immunize a child against measles. The measles vaccine is often incorporated with rubella and/or mumps vaccines in countries where these illnesses are problems. It is equally effective in the single or

combined form. In 2008, about 83% of the world's children received one dose of measles vaccine by their first birthday through routine health services up from 72% in 2000. Two doses of the vaccine are recommended to ensure immunity, as about 15% of vaccinated children fail to develop immunity from the first dose. Global health response The fourth Millennium Development Goal (MDG 4) aims to reduce the under-five mortality rate by two-thirds between 1990 and 2015. Recognizing the potential of measles vaccination to reduce child mortality, and given that measles vaccination coverage can be considered a marker of access to child health services, routine measles vaccination coverage has been selected as an indicator of progress towards achieving MDG 4. The Measles Initiative is a collaborative effort of WHO, UNICEF, the American Red Cross, the United States Centers for Disease Control and Prevention, and the United Nations Foundation. The Initiative, together with other public and private partners, plays a key role in advancing the global measles strategy. This strategy includes: Strong routine immunization for children by their first birthday. A 'second opportunity' for measles immunization through mass vaccination campaigns, to ensure that all children receive at least one dose. Effective surveillance in all countries to quickly recognize and respond to measles outbreaks. Better treatment of measles cases, to include vitamin A supplements, antibiotics if needed, and supportive care that prevents complications.