Measles (Rubeola) (cont.)
Edmond Hooker, MD, DrPH
Dr. Eddie Hooker is currently an Assistant Professor in the Department of Health Services Administration at Xavier University in Cincinnati, Ohio. He is also an Associate Clinical Professor in the Department of Emergency Medicine at the University of Louisville and at Wright State University. His areas of expertise include emergency medicine, epidemiology, health-services management, and public health.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Measles facts
- What is measles? What does measles look like?
- What is rubeola? What is rubella? What are other names for measles?
- What is the history of measles?
- What causes measles? How is measles spread?
- How does one become immune to measles?
- Who is at risk for getting measles?
- Is measles deadly?
- What are measles symptoms and signs?
- What is the danger of getting measles while pregnant?
- What is the incubation period for measles?
- What complications are seen with measles?
- What is atypical measles?
- What is modified measles?
- How is the diagnosis of measles made?
- What should someone do if he or she has been exposed to measles?
- If it is not measles, what else could it be?
- Is there any treatment for measles after symptoms and signs develop?
- What is the prognosis for measles?
- Is it possible to prevent measles with a vaccine? How effective is the measles vaccine?
- Why should people get vaccinated against measles?
- Is there any truth to the fear of getting autism from the MMR or MMRV?
- Who should not receive measles vaccinations?
- Do people need to be revaccinated against measles if they are traveling to Europe?
- What adverse reactions or side effects can occur with the measles vaccination?
- If a child has an egg allergy, can they still receive the measles vaccine?
- Who should be revaccinated against measles?
- What is herd immunity? Why should people care if others choose not to be vaccinated?
- Can the measles virus be used to cure cancer?
- Where can I find more information about measles?
What complications are seen with measles?
Some cases of measles have an associated complication. These complications can include diarrhea, middle ear infections, pneumonia, blindness, acute brain inflammation (encephalitis, which is very rare), and persistent brain inflammation (subacute sclerosing panencephalitis, which is extremely rare).
Blindness associated with measles is due to a combination of poor nutrition (specifically vitamin A deficiency) and the measles infection. Prevention is the most effective treatment. In third-world countries, post-measles blindness is the leading cause of blindness.
Acute encephalitis, although rare, is extremely dangerous and results in death in a significant percentage of patients who develop it. When it occurs, acute encephalitis generally starts six days after onset of the rash. Symptoms can include fever, headache, vomiting, stiff neck, drowsiness, seizures, and coma.
Subacute sclerosing panencephalitis (SSP) is an extremely rare degenerative condition of the brain and spinal cord (central nervous system). It is believed to be caused by a chronic infection of the central nervous system with the measles virus. Typically, symptoms start years after the patient had measles (average seven years, range one month to 27 years). The patient has a slow and progressive loss of brain function, seizures, and eventually death results. There is no known treatment for SSP.
Most deaths from measles are due to pneumonia in children and encephalitis in adults. The people most likely to have complications (including death) are those who are malnourished or who have weakened immune systems (for example, people with AIDS or other conditions that weaken the immune system).
What is atypical measles?
Atypical measles occurs in people who received the killed measles vaccine (KMV; only used from 1963 until 1967) and who are exposed to wild-type measles virus. The KMV unfortunately sensitizes the patient to the measles virus but does not offer any protection. The disease is characterized by fever, pleural effusions, pneumonia, and swelling of the extremities. The rash of atypical measles is different from measles in that it may have an urticarial component (hives) and usually appears first on the ankles and wrists.
It is recommended by the U.S. Centers for Disease Control and Prevention (CDC) that people who may have received the KMV should receive revaccination with the live measles vaccine.
What is modified measles?
Modified measles is seen in patients who, because they were unimmunized, received immune globulin after being exposed to a patient with measles. It is also seen occasionally in young infants who have limited immunity from their mothers. The immune globulin prolongs the time from exposure to onset of symptoms (incubation period). When the symptoms do occur, they are much milder than those seen with normal measles and tend to last a shorter period of time.
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