How to tell if your child has measles

Measles - Symptoms and causes

Overview

Measles

Measles causes a red, blotchy rash that usually appears first on the face and behind the ears, then spreads downward to the chest and back and finally to the feet.

Measles is a childhood infection caused by a virus. Once quite common, measles can now almost always be prevented with a vaccine.

Also called rubeola, measles spreads easily and can be serious and even fatal for small children. While death rates have been falling worldwide as more children receive the measles vaccine, the disease still kills more than 200,000 people a year, mostly children.

As a result of high vaccination rates in general, measles hasn't been widespread in the United States in about two decades. Most recent measles cases in the U.S. originated outside the country and occurred in people who were unvaccinated or who didn't know whether or not they had been vaccinated.

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Symptoms

Measles signs and symptoms appear around 10 to 14 days after exposure to the virus. Signs and symptoms of measles typically include:

Fever
Dry cough
Runny nose
Sore throat
Inflamed eyes (conjunctivitis)
Tiny white spots with bluish-white centers on a red background found inside the mouth on the inner lining of the cheek — also called Koplik's spots
A skin rash made up of large, flat blotches that often flow into one another

The infection occurs in stages over 2 to 3 weeks.

Infection and incubation. For the first 10 to 14 days after infection, the measles virus spreads in the body. There are no signs or symptoms of measles during this time.
Nonspecific signs and symptoms. Measles typically begins with a mild to moderate fever, often with a persistent cough, a runny nose, inflamed eyes (conjunctivitis) and a sore throat. This relatively mild illness may last 2 to 3 days.
Acute illness and rash. The rash is made up of small red spots, some of which are slightly raised. Spots and bumps in tight clusters give the skin a splotchy red appearance. The face breaks out first.

Over the next few days, the rash spreads down the arms, chest and back, then over the thighs, lower legs and feet. At the same time, the fever rises sharply, often as high as 104 to 105.8 F (40 to 41 C).
Recovery. The measles rash may last about seven days. The rash gradually fades first from the face and last from the thighs and feet. As other symptoms of the illness go away, the cough and darkening or peeling of the skin where the rash was may stay for about 10 days.

When can a person spread the measles virus?

A person with measles can spread the virus to others for about eight days, starting four days before the rash appears and ending when the rash has been present for four days.

When to see a doctor

Call your health care provider if you think you or your child may have been exposed to measles or if you or your child has a rash that looks like measles.

Review your family's vaccination records with your provider, especially before your children start day care, school or college and before international travel outside of the U.S.

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Causes

Measles is a highly contagious illness. This means it's very easily spread to others. Measles is caused by a virus found in the nose and throat of an infected child or adult. When someone with measles coughs, sneezes or talks, infectious droplets spray into the air, where other people can breathe them in. The infectious droplets can hang in the air for about an hour.

The infectious droplets may also land on a surface, where they can live and spread for several hours. You can get the measles virus by putting your fingers in your mouth or nose or rubbing your eyes after touching the infected surface.

Measles is highly contagious from about four days before to four days after the rash appears. About 90% of people who haven't had measles or been vaccinated against measles will become infected when exposed to someone with the measles virus.

Risk factors

Risk factors for measles include:

Being unvaccinated. If you haven't had the measles vaccine, you're much more likely to get measles.
Traveling internationally. If you travel to countries where measles is more common, you're at higher risk of catching measles.
Having a vitamin A deficiency. If you don't have enough vitamin A in your diet, you're more likely to have more-severe symptoms and complications of measles.

Complications

Complications of measles may include:

Diarrhea and vomiting. Diarrhea and vomiting can result in losing too much water from the body (dehydration).
Ear infection. One of the most common complications of measles is a bacterial ear infection.
Bronchitis, laryngitis or croup. Measles may lead to irritation and swelling (inflammation) of the airways (croup). It can also lead to inflammation of the inner walls that line the main air passageways of the lungs (bronchitis). Measles can also cause inflammation of the voice box (laryngitis).
Pneumonia. Measles can commonly cause an infection in the lungs (pneumonia). People with weakened immune systems can develop an especially dangerous type of pneumonia that sometimes can lead to death.
Encephalitis. About 1 in 1,000 people with measles can develop a complication called encephalitis. Encephalitis is irritation and swelling (inflammation) of the brain. The condition can be especially dangerous for people with weakened immune systems. Encephalitis may occur right after measles, or it might not occur until months later. Encephalitis can cause permanent brain damage.
Pregnancy problems. If you're pregnant, you need to take special care to avoid measles because the disease can cause premature birth, low birth weight and fetal death.

Prevention

The U.S. Centers for Disease Control and Prevention (CDC) recommends that children and adults receive the measles vaccine to prevent measles.

Measles vaccine in children

The measles vaccine is usually given as a combined measles-mumps-rubella (MMR) vaccine. This vaccine may also include the chickenpox (varicella) vaccine — MMRV vaccine. Health care providers recommend that children receive the MMR vaccine between 12 and 15 months of age, and again between 4 and 6 years of age — before entering school.

The MMR vaccine's two doses are 97% effective in preventing measles and protecting against it for life. In the small number of people who get measles after being vaccinated, the symptoms are generally mild.

Keep in mind:

If you'll be traveling internationally outside the U.S. when your child is 6 to 11 months old, talk with your child's health care provider about getting the measles vaccine earlier.
If your child or teenager didn't get the two doses of the vaccine at the recommended times, your child may need two doses of the vaccine four weeks apart.

Babies born to women who have received the vaccine or who are already immune because they had measles are usually protected from measles for about 6 months after birth. If a child requires protection from measles before 12 months of age — for example, for foreign travel — the vaccine can be given as early as 6 months of age. But children who are vaccinated early still need to be vaccinated at the recommended ages later.

Providing a child with the MMR vaccine as a combination of recommended vaccines can prevent a child's delay in protection against infection from measles, mumps and rubella — and with fewer shots. The combination vaccine is as safe and effective as the vaccines given separately. Side effects are generally mild and may include a sore arm where the shot was given and fever.

Measles vaccine in adults

You may need the measles vaccine if you're an adult who does not have proof of immunity and:

Has an increased risk of measles, such as attending college, traveling internationally outside the U.S. or working in a hospital environment.
Was born in 1957 or later. If you've already had measles, your body has built up its immune system to fight the infection, and you can't get measles again. Most people born or living in the U.S. before 1957 are immune to measles, simply because they've already had it.

Proof of immunity — protection from getting measles infection — includes:

Written documentation of appropriate measles vaccinations
Lab tests that show evidence of immunity
Lab tests that show you've had measles in the past

If you're not sure if you need the measles vaccine, talk to your health care provider.

Preventing measles during an outbreak or known infection

If someone in your household has measles, take these precautions to protect family and friends without immunity:

Isolate. Because measles is highly contagious from about four days before to four days after the rash appears, people with measles should stay home and not return to activities where they interact with other people during this period.

People who aren't vaccinated — siblings, for example — should also stay away from the infected person.
Vaccinate. Be sure that anyone who's at risk of getting measles who hasn't been fully vaccinated receives the measles vaccine as soon as possible. This includes infants older than 6 months and anyone born in 1957 or later who doesn't have proof of immunity.

Preventing new infections

Getting vaccinated with the measles vaccine is important for:

Promoting and preserving widespread immunity. Since the introduction of the measles vaccine, measles has virtually been eliminated in the U.S., even though not everyone has been vaccinated. This effect is called herd immunity.

But herd immunity may now be weakening a bit, likely due to a drop in vaccination rates. The incidence of measles in the U.S. recently increased significantly.
Preventing a resurgence of measles. Steady vaccination rates are important because soon after vaccination rates decline, measles begins to come back.

Here's one example. In 1998, a now-discredited study was published incorrectly linking autism to the measles-mumps-rubella (MMR) vaccine. In the United Kingdom, where the study originated, the rate of vaccination dropped to an all-time low of about 80% of all children in 2003 to 2004. In 2008, there were nearly 1,400 lab-confirmed cases of measles in England and Wales.

No proven link between the MMR vaccine and autism

After the MMR study in 1998, some drops in vaccine numbers were found in the UK and elsewhere, and some people believed there was a possible link. Since then, widespread concerns have been raised about a possible link between the MMR vaccine and autism. However, extensive reports from the American Academy of Pediatrics, the National Academy of Medicine, and the CDC conclude that there is no scientifically proven link between the MMR vaccine and autism.

These organizations note that autism is often identified in toddlers between the ages of 18 and 30 months, which is about the time children are given their first MMR vaccine. But this coincidence in timing shouldn't be mistaken for a cause-and-effect relationship.

More Information

Measles vaccine: Can I get the measles if I've already been vaccinated?

By Mayo Clinic Staff

Measles (for Parents) - Nemours KidsHealth

What Is Measles?

Measles is a very contagious infection that causes a total-body skin rash and flu-like symptoms. Measles is rare in the United States thanks to widespread immunization. But millions of cases happen worldwide every year.

Measles (also called rubeola) is caused by a virus, so there's no specific medical treatment for it. The virus has to run its course. A child who is sick should drink plenty of liquids, get lots of rest, and stay home from school or daycare to prevent spreading the infection.

What Are the Signs & Symptoms of Measles?

The first symptoms of a measles infection are usually a hacking cough, runny nose, high fever, and red eyes. Kids also may have Koplik's spots (small red spots with blue-white centers) inside the mouth before the rash starts.

The rash breaks out 3–5 days after symptoms start, sometimes along with a high fever up to 104°F (40°C). The red or reddish-brown rash usually begins as flat red spots on the forehead. It spreads to the rest of the face, then down the neck and torso to the arms, legs, and feet. The fever and rash slowly go away after a few days.

Is Measles Contagious?

Measles is very contagious. In fact, 9 out of 10 people who aren't vaccinated for measles will get it if they are near an infected person.

How Do People Get Measles?

Measles spreads when people breathe in or have direct contact with virus-infected fluid. It can pass through droplets sprayed into the air when someone with measles sneezes or coughs. Someone exposed to the virus usually shows symptoms 7–14 days later.

People with measles can spread the disease as early as 4 days before the rash starts. They're most contagious while they have a fever, runny nose, and cough. Those with weak immune systems due to other conditions (like HIV and AIDS) can spread the measles virus until they recover.

How Is Measles Treated?

There is no specific medical treatment for measles. To help manage symptoms:

give your child plenty of fluids
encourage extra rest
give a non-aspirin fever medicine, such as acetaminophen or ibuprofen if a fever makes your child uncomfortable. Never give aspirin to a child or teen who has a viral illness, as such use is linked to Reye syndrome, which can be life-threatening.

Kids with measles should be closely watched by a doctor. In some cases, measles can lead to other problems, such as:

ear infections
croup
diarrhea
pneumonia
encephalitis (irritation and swelling of the brain)

Children with measles should be kept away from others for 4 days after their rash appears. For those with a weak immune system, this should continue until they make a full recovery and all symptoms are gone.

How Long Does Measles Last?

A measles infection and the medical problems that may follow can last for several weeks in all.

Can Measles Be Prevented?

The best way to protect your kids is to make sure they're immunized against measles.

For most kids, measles protection is part of the measles-mumps-rubella vaccine (MMR) or measles-mumps-rubella-varicella vaccine (MMRV) given when they're 12 to 15 months old and again when they're 4 to 6 years old. About 95% of people achieve immunity during their first vaccine, and the rest develop it the second time they're vaccinated. Immunity lasts a lifetime.

The first vaccine can be given to babies as young as 6 months old if they will be traveling internationally. Talk to your doctor to see when the vaccine is needed.

Why Is Vaccination Important?

Widespread immunization has made measles rare in the U.S. But outbreaks do still happen. An outbreak is when a disease happens in greater numbers than expected in a particular area. Measles outbreaks have been increasing worldwide, mostly spreading from people who are not vaccinated.

It's important for all kids who can get the vaccine to get it on time. At-risk people (such as those with weak immune systems) can't get the vaccine. But when a lot of other people are immunized against a disease, it protects them, prevents the disease from spreading, and helps prevent outbreaks.

At highest risk during a measles outbreak are:

infants who aren't old enough to get the vaccine
pregnant women
people with poor nutrition or weak immune systems

Doctors can give an injection of measles antibodies (called immune globulin) to at-risk people who are exposed to measles. It's most effective when given within 6 days of contact. These antibodies can either prevent measles or make symptoms less severe.

The measles vaccine also can help protect unvaccinated people from getting sick after exposure to measles if they get it within 3 days.

When Should I Call the Doctor?

Call the doctor right away if you think that your child has measles. Also call if your child was around someone who has measles, 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

Measles - signs, symptoms, treatment of measles in children - Murmansk City Children's Clinic No. 1

By smaweb 08/16/2020 Healthy child

Measles is an acute infectious disease, the distinguishing features of which are a typical rash, as well as damage to the conjunctiva of the eyes and mucous membranes of the upper respiratory tract.

Nature, development and spread of infection
Measles is a viral infection spread by airborne droplets. The measles virus enters the body through the mucous membrane of the upper respiratory tract, from where it spreads through the blood throughout the body. The virus selectively damages the cells of the skin, mucous membranes of the eyes, respiratory tract and oral cavity, which causes typical manifestations of the disease.

The source of measles infection is only a sick person capable of shedding the virus into the external environment from the last two days of the incubation period to the fourth day after the onset of the rash. People who have not received prophylactic measles vaccination and have not had measles throughout their lives remain susceptible to infection, so the disease can develop at any age.

Before the introduction of measles vaccine, 95% of cases were in children under 16 years of age. After the widespread vaccination of children, a significant decrease in the incidence of measles was noted, but individual cases and limited outbreaks were noted constantly, and now there is a tendency for them to increase. Complete protection against measles requires immunization 94-97% of children under 15 months of age. However, this level of vaccination is practically unfeasible even for developed countries.

Measles outbreaks can also occur among vaccinated individuals (67-70% of all outbreaks). As a rule, they are typical for older age groups (children of school age, teenagers, military personnel, students, etc.). The nature of such cases of the disease is associated with a drop in the intensity of immunity after a long period (10-15 years) after vaccination.

Signs and course of the disease
The duration of the latent period of infection is 9-11 days. The introduction of immunoglobulin for prophylactic purposes can contribute to its lengthening up to 15-21 days (sometimes more). From the second half of the latent period, the initial symptoms of the disease may be noted (weight loss in a child under one year old, evening subfebrile condition, slight cough and runny nose, swelling of the lower eyelid, redness of the conjunctiva).

The initial non-specific period begins with an increase in body temperature to 38-39°C, weakness, lethargy, loss of appetite are noted. Cough acquires a rough "barking" character, runny nose and redness of the conjunctiva intensify. During this period, the doctor can identify a specific sign of measles - small whitish spots on the mucous membrane of the cheeks, soft and hard palate, similar to semolina or bran (Filatov-Koplik spots).

On the 3rd-4th day, the fever decreases somewhat, but from the moment the rash appears, it increases again. The same applies to signs of damage to the respiratory system. The period of the rash is characterized by a strict staging. First, the elements appear on the face and neck, on the 2nd day - on the trunk, thighs, arms, on the 3rd day, the elements of the rash appear on the feet and legs, and on the face they already turn pale. As a rule, the maximum number of elements of the rash is localized on the face, upper chest and neck.

The rash is represented by irregularly shaped patches, slightly elevated in the center above the surface of the skin. The spot diameter usually does not exceed 10 mm, the spots show a tendency to merge. The fading of the rashes begins on the 3-4th day after their appearance, they leave behind a brownish pigmentation, later peeling occurs on the face and trunk in these places.

A typical sign of measles is conjunctivitis, which in most cases is purulent. Often there is gluing of eyelashes in the morning (when waking up) with purulent discharge. The layering of a purulent infection can cause the development of pneumonia. A severe complication is damage to the central nervous system, which is quite rare.

Measles in children. Symptoms and treatment of measles in children

Measles in children is a disease transmitted by airborne droplets when sneezing, coughing, talking with a sick child. Measles in children is characterized by fever, lethargy, weakness, headaches, a small-spotted rash, conjunctival lesions, and a runny nose.

The only source of measles is a sick person. Individuals who have not had measles or been vaccinated against measles remain highly susceptible to measles throughout their lives and can become ill at any age. If there are unvaccinated children in the family, it is better to send them to their grandmother or other relatives during the illness of their brother or sister.

Immunity after a natural measles infection is persistent. Recurrent infections with measles are rare. Immunity after vaccination is more short-lived (10 years after vaccination, only 36% of those vaccinated retain protective antibody titers). The incubation period for measles is 9-11 days.

Symptoms of measles in children.

Day 1 . Initial signs of measles. The temperature rises (usually up to 38-39 °). Appear lethargy, cough, sore throat, sometimes conjunctivitis, photophobia.

Day 2-3 . The temperature usually drops. This period of illness lasts 3-4 days, in adolescents sometimes longer. It makes itself felt a sure sign of measles - the mucous membrane of the mouth becomes bright red, spotty. A measles rash appears, which is accompanied by a new jump in temperature.

First, the rash occurs behind the ears, then in the center of the face, during the day it spreads to the entire face, neck, and partly the upper chest. The next day, it goes to the trunk, forearm, thighs, then covers the entire surface of the arms and legs. The rash looks like small pink papules the size of buckwheat or millet grains - specific nodules or elevations on the skin without watery contents. Literally a few hours later they are surrounded by a red zone, and a little later everything merges, forming large irregularly shaped spots with a papule in the very center.

4th day . The rash will not change color for a few more days and will fade in the order in which it appeared. Sometimes rashes only appear on the legs and arms, and the face is already turning pale.

The elements of the rash tend to merge, forming complex shapes with scalloped edges. However, even with the thickest rash, you can find areas of completely normal skin. After 3-4 days, the elements of the rash turn pale, brownish spots remain in their place - pigmentation, especially pronounced and prolonged in the presence of hemorrhagic transformations of the rash. At the site of the rash, later pityriasis peeling is observed (on the face and trunk). The expressed conjunctivitis is characteristic, sometimes with the separated pus sticking together eyelashes in the morning. Some patients have abdominal pain, loose stools.

Treatment of measles in children.

If you suspect your child has measles, put him to bed immediately and call a doctor right away. Be sure to exclude all contact with children, especially unvaccinated ones. You can give an antipyretic: aspirin, paracetamol. But in no case should you give your child antibiotics - they do not work on the measles virus! Antibacterial drugs can only be prescribed by a doctor and only in case of complications.