What is measles?

Measles is a highly contagious viral disease that can kill you. Although an uncommon disease in the United States of America, in 2006, measles killed 242,000 children worldwide. In most people, the disease produces fever (temperature > 101 F [38.3 C]), a generalized rash that last greater than three days, cough, runny nose (coryza), and red eyes (conjunctivitis). The complications of measles that result in most deaths include pneumonia and inflammation of the brain (encephalitis)

What is the history of measles?
Cases of measles were described as early as the seventh century. However, it was not until 1963 that researchers first developed a vaccine to prevent measles. Before the vaccine was made available, almost every child became infected with the virus because it is so easily spread. Before routine vaccination, there were approximately 3-4 million cases of measles and 500 deaths due to measles each year in the United States of America.

There were initially two types of vaccines developed against measles. One was developed from a virus that had been killed, and the other was developed using a live measles virus that was weakened (attenuated) and could no longer cause the disease. Unfortunately, the killed measles virus (KMV) vaccine was not effective in preventing people from getting the disease, and its use was discontinued in 1967. The live virus vaccine has been modified a number of times to make it safer (further attenuated) and today is extremely effective in preventing the disease. The currently used vaccine is a live attenuated vaccine.

Causes, incidence, and risk factors
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.

Symptoms
Symptoms usually begin 8 - 12 days after you are exposed to the virus. This is called the incubation period.

Symptoms may include:
• Bloodshot eyes
• Cough
• Fever
• Light sensitivity (photophobia)
• Muscle pain
• 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)
Signs and tests
• Measles serology
• Viral culture (rarely done)

Is there any treatment for measles after symptoms develop?
The treatment of patients with measles is mostly focused upon symptom relief. Specific complications like pneumonia may require antibiotics. Patients should be on bed rest until the fever has resolved and should remain well hydrated. In malnourished patients, vitamin A supplementation is recommended. Patients should be isolated to prevent spread of the disease.

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.