September 4, 2015
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Measles (Rubeola) (cont.)

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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.

Medically Reviewed by a Doctor on 2/6/2015

Source: MedicineNet.com
http://www.medicinenet.com/measles_rubeola/article.htm

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