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?
How is the diagnosis of measles made?
The diagnosis of suspected measles is mostly clinical, meaning that the appearance and history of the patient suggest the diagnosis. In a person with known exposure to someone with measles or travel to a foreign country, measles should always be considered when faced with a patient who has a high fever and characteristic rash. Until the rash appears, the presence of Koplik's spots should help to suggest the diagnosis. Most cases of suspected measles in the United States turn out not to be measles (see below). It is recommended that the diagnosis be confirmed using a blood test for IgM, a type of antibody against the virus. If the IgM test is positive, viral cultures should be obtained. The state and local health department should be contacted immediately for any suspected case in order to follow the correct procedures for viral culture and isolation of the patient. Further information on laboratory testing of suspected cases is available from the CDC (http://www.cdc.gov/vaccines/pubs/surv-manual/chpt07-measles.html).
What should someone do if he or she has been exposed to measles?
People who have been appropriately vaccinated (or who have had the disease) and who are exposed to a patient with measles do not need to do anything. If an unimmunized person is exposed to a patient with measles, they should receive the vaccine as soon as possible. This may prevent the disease if given within 72 hours of exposure. Immune globulin may have some benefit if given within six days of exposure. The CDC recommends that immune globulin be utilized for household contacts of infected people, immunocompromised people, and pregnant women. It is not recommended that immune globulin be utilized to control a measles outbreak.
If it is not measles, what else could it be?
There are a large number of infectious diseases and other conditions that can cause some of the symptoms of measles. These include, but are not limited to, dengue fever, drug reactions, enteroviral infections, fifth disease, German measles (rubella), Kawasaki disease, Rocky Mountain spotted fever, roseola, and toxic shock syndrome. It is important that suspected cases be seen by a medical expert and appropriate laboratory tests be ordered.
Is there any treatment for measles after symptoms and signs 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.
What is the prognosis for measles?
Most people who contract measles will recover completely. Very few people who get measles will die. People who are malnourished or immunocompromised are more likely to have complications or die. However, it is possible for any person to die from the measles, which highlights the importance of becoming vaccinated. Almost no one who has been vaccinated has died from the disease.
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