Measles

Symptoms Of Measles

Measles symptoms usually begin 7 to 14 days after exposure to the virus. The illness starts with:

• High fever (can reach up to 104°F / 40°C)
• Cough
• Runny nose
• Red, watery eyes (often sensitive to light)
• Swollen eyelids
• Tiredness and weakness
• Loss of appetite
  
  

Koplik spots

• Appears 1–2 days before the skin rash

• Look like small grayish-white spots inside the cheeks or on the roof of the mouth

• May be present for a few days

• Not seen in all patients
  
  

Measles rash

• Typically develops 3–5 days after initial symptoms, around 2 weeks post-infection

• Begins as red spots, progressing to small red-brown patches that may join together

• Usually starts on the face and neck, then spreads to the rest of the body

• Rash fades in the same order it appeared

• In malnourished children, skin peeling (desquamation) may follow rash resolution

• Immunocompromised individuals may not develop a rash due to a weak immune response
  
  

Other symptoms

Some patients may also experience:

• Headache
• Stomach pain
• Vomiting
• Diarrhea
• Muscle pain (myalgia)

When is Measles Contagious?

• A person with measles is contagious from 4 days before the appearance of the rash to about 4 days after the rash develops.
  
  

• During this time, the infected person can easily transmit the virus to others, even before they realize they are sick.

Causes Of Measles

Measles is caused by the morbillivirus, a highly contagious virus that belongs to the Paramyxoviridae family. The virus spreads easily from person to person through:

• Airborne droplets are released when an infected person coughs, sneezes, or talks

• Direct contact with the nasal or throat secretions of an infected person

• Touching contaminated surfaces and then touching your eyes, nose, or mouth, the virus can remain infectious in the air or on surfaces for up to two hours

• Sharing food, drinks, or utensils with an infected person

• Close physical contact, such as kissing, hugging, or handshakes

• Mother-to-child transmission during pregnancy, childbirth, or breastfeeding.

Risk Factors Of Measles

While measles can affect anyone, certain risk factors increase the likelihood of contracting the disease. Some of these risk factors include:

1. Lack of vaccination

• Not receiving the MMR (measles, mumps, rubella) vaccine is the most significant risk factor.
• Unvaccinated children and adults are highly susceptible during outbreaks.
  
  

2. Travel to areas with low vaccination coverage

• Visiting or living in regions with frequent measles outbreaks increases risk, especially where immunization rates are low.
  
  

3. Weakened immune system

• People with HIV/AIDS, cancer, or those on immunosuppressive therapy (e.g., chemotherapy, organ transplant recipients) are at higher risk of infection and complications.
  
  

4. Vitamin A deficiency

• Increases the severity of measles, especially in children. It is also linked to a higher risk of complications like blindness and pneumonia.
  
  

5. Age

• Infants and young children are at the highest risk of severe disease.
• Older adults may also have complications if they were never immunized.
  
  
  

6. Close contact with an infected person

• Measles is extremely contagious. The majority of non-immune people in close contact with an infected person will contract the virus.

Diagnosis Of Measles

Measles is diagnosed based on clinical symptoms, history of exposure, and laboratory tests. Here’s a breakdown of how the diagnosis is made:

1. Clinical diagnosis

• The doctor will evaluate the symptoms, vaccination status, recent travel, exposure to infected individuals, immune status, and nutritional deficiencies like vitamin A, especially in children.

• A rash, high fever, and Koplik spots are key clinical signs that suggest measles, especially if the patient has been exposed to someone with the disease or is in an area with active measles transmission.

2. Laboratory tests

While a clinical diagnosis may be sufficient in many cases, laboratory tests are often used for confirmation, especially in areas where measles is not common.

Serology: Blood tests to detect measles-specific IgM antibodies or a fourfold rise in IgG antibodies are commonly used.

• IgM antibodies appear shortly after the onset of the rash and are usually detectable within 3 days of the rash onset.
• IgG antibodies indicate past infection or immunity.

Polymerase chain reaction (PCR): A PCR test can detect the measles virus's genetic material (RNA) in samples, typically from the throat, urine, or blood. This is especially helpful during outbreaks.

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Specialist To Visit

Patients showing signs and symptoms of measles should first consult a general physician. The doctor can often diagnose measles based on a combination of symptoms, particularly the characteristic rash. If the condition worsens or complications arise, the doctor may refer the patient to a specialist such as:

• Infectious disease specialist 
• Internal medicine specialist
• Pediatrician

Infectious disease specialists help confirm diagnosis through advanced testing, oversee isolation procedures, and manage care in high-risk patients. 

An internal medicine specialist is a key physician involved in managing measles in adults, especially those with complex health conditions.

For infants and children, a pediatrician should be involved, as they are experienced in managing childhood illnesses and complications like ear infections, pneumonia, and seizures.

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Prevention Of Measles

Measles is a highly contagious virus, but there are several effective measures to prevent its spread. The best methods of prevention include:

1. Vaccination

MMR Vaccine (Measles, Mumps, Rubella):

• The MMR vaccine is the most effective way to prevent measles.
• Children should receive their first dose at 12–15 months and a second dose at 4–6 years.
• Adults who are not vaccinated or don’t have evidence of immunity should get at least one dose of the MMR vaccine.
• Herd immunity: Widespread vaccination helps protect those who cannot be vaccinated, such as infants or those with weakened immune systems.

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2. Immunoglobulin for high-risk individuals

• After exposure to measles, individuals who are at high risk (e.g., pregnant women, infants, or immunocompromised individuals) may receive immune globulin (IG) within six days of exposure to prevent or lessen the severity of the illness.
  
  

3. Avoiding exposure

• Isolation: If infected, stay at home and avoid public places for at least 4 days after the rash appears to prevent spreading the virus.

• Minimize contact: Avoid close contact with people who have measles, especially in areas where outbreaks are occurring.
  
  

4. Good hygiene practices

• Frequent handwashing and using hand sanitizers can help reduce the spread of respiratory droplets that carry the virus.

• Cover your mouth and nose with a tissue or your elbow when coughing or sneezing.

• Disinfect shared surfaces that may be contaminated with droplets.

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5. Isolation during outbreaks

• In areas with measles outbreaks, ensure isolation of infected individuals to limit spread, especially in households, schools, and healthcare settings.
  
  

6. Travel precautions

• If you’re traveling to areas where measles is common or where outbreaks are occurring, ensure that you are fully vaccinated with the MMR vaccine. Travelers—especially infants and young children—should receive the vaccine before traveling.

Treatment Of Measles

There is no specific antiviral treatment for measles, so management mainly focuses on supportive care to relieve symptoms and prevent complications. Here's an overview of the treatment approach:

1. Symptom Management

Fever

• Over-the-counter medications such as paracetamol or ibuprofen can help reduce fever and discomfort.

Cough and congestion

• Use of a humidifier or saline nasal spray can relieve nasal congestion.
• Cough suppressants may be considered, but it’s important to consult a doctor before using them, especially for children.

Eye care

• Lubricating eye drops can help ease discomfort from conjunctivitis (red eyes).
• Avoiding bright lights can reduce sensitivity.

2. Vitamin A supplementation

• Supplementation is recommended, especially for young children and undernourished individuals, as it has been shown to reduce the severity of the illness and prevent complications like pneumonia and blindness.
  
  
• The World Health Organization (WHO) recommends two doses of vitamin A for children diagnosed with measles.
  
  

3. Antibiotics (for secondary infections)

• Measles weakens the immune system, which can lead to secondary bacterial infections like pneumonia, otitis media (ear infection), or sinus infections.
  
  
• Antibiotics may be prescribed if a bacterial infection develops as a complication.
  
  

5. Hospitalization (in severe cases)

• Hospitalization may be required for individuals with severe complications, such as measles pneumonia, encephalitis, or severe dehydration.
  
  
• In the hospital, patients may receive intravenous fluids, oxygen therapy, or other supportive treatments as needed.
  
  

6. Post-exposure prophylaxis

• Post-exposure prophylaxis (PEP) with immune globulin (IG) can be administered within 6 days of exposure for those at high risk (e.g., infants, pregnant women, immunocompromised individuals) to prevent or lessen the severity of the disease.

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Home-care For Measles

While there’s no specific treatment for measles, proper home care can help manage symptoms, prevent complications, and speed up recovery. Here’s how you can care for someone with measles at home:

1. Rest and comfort

• Encourage the patient to get plenty of rest to support the immune system.

• Keep the patient in a calm, quiet, well-ventilated room to avoid overstimulation.
  
  

2. Hydration

• Measles can lead to dehydration due to fever and potential diarrhea. Encourage frequent fluid intake, such as water, clear soups, and oral rehydration solutions.

• Offer small, frequent sips of fluids to make drinking easier for the patient.
  
  
  

3. Isolation

• To prevent the spread of measles, keep the patient in isolation at home, especially during the contagious period (from 4 days before to 4 days after the rash appears).

• Limit contact with other family members and avoid public spaces.

4. Rash care

• Apply cool, damp cloths to the affected areas to help soothe the skin and reduce itching.
  
  
• Applying a fragrance-free, hypoallergenic moisturizer to the rash after a bath can help lock in moisture and prevent the skin from becoming too dry, which can worsen itching.
  
  
• Aloe vera gel may also help soothe irritated skin. Ensure it is pure aloe vera without added fragrances or alcohol.
  
  
• Colloidal oatmeal baths are often recommended for soothing itching caused by rashes.
  
  
• Avoid tight clothing or fabrics that can irritate the rash, such as wool. Opt for loose, soft cotton clothing to help reduce friction and irritation.
  
  
• Avoid scratching. Encourage the patient (especially children) not to scratch the rash, as this can lead to infection and scarring.
  
  
• Hot water can irritate the skin and worsen itching. Opt for cool or lukewarm showers instead.

5. Nutritional support

• Vitamin A: Vitamin A supplementation is crucial for measles, especially for children. It has been shown to reduce the risk of complications like pneumonia.

• If a doctor recommends it, ensure that you are following the correct dosage as per their guidelines.
  
  

• Vitamin C: Known for its immune-supporting properties, vitamin C may help reduce the duration and severity of cold-like symptoms that can accompany measles.

• Consume foods rich in vitamin C, such as citrus fruits, bell peppers, and leafy greens, or take a supplement under the guidance of a healthcare provider.

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Complications Of Measles 

Measles is a highly contagious viral infection that can lead to serious complications, especially in young children, adults with weakened immune systems, and pregnant women. While many people recover from measles without lasting effects, the following complications can arise and may lead to severe health issues or even death:

• Pneumonia: Pneumonia is the most common cause of death from measles. The virus can infect the lungs, leading to inflammation, fluid buildup, and difficulty breathing.
  

• Encephalitis (Brain inflammation): Encephalitis is a rare but potentially life-threatening complication where the brain becomes inflamed, leading to neurological issues.
  

• Ear infections (Otitis media): Measles can lead to bacterial infections in the middle ear, causing pain and discomfort.

• Blindness: Measles can cause damage to the eyes and, in severe cases, lead to blindness. This is more common in developing countries where vitamin A deficiency is prevalent.

• Pregnancy-related complications: Pregnant women who contract measles are at risk for complications like premature labor, miscarriage, and low birth weight.

• Subacute sclerosing panencephalitis (SSPE): SSPE is a rare but fatal complication that occurs many years after a measles infection (usually 7-10 years later). It results in progressive brain degeneration.

Alternative Therapies For Measles

While there is no cure for measles, certain alternative therapies may help alleviate some symptoms and support recovery. However, it's important to note that these should be used in conjunction with medical care and not as a substitute for conventional treatments. Always consult a healthcare provider before starting any alternative treatments, especially for children and individuals with underlying health conditions.

Here are some alternative therapies that may provide relief for measles symptoms:

1. Herbal remedies

• Turmeric (Haldi): Turmeric is known for its anti-inflammatory and antioxidant properties. Consuming turmeric in warm milk or as part of a healthy diet may help reduce inflammation and support immune function

How to use?

Mix 1 teaspoon of turmeric powder in warm water or milk. You can also add honey and black pepper for enhanced benefits.

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• Ginger (Adrak): Ginger is commonly used for its ability to relieve nausea, promote digestion, and soothe cough. It can be consumed as ginger tea.

How to use?

Fresh ginger root boiled in water and consumed with honey can help manage a cough and sore throat.

• Tulsi (Holy Basil): Tulsi leaves are considered highly beneficial for boosting immunity. 

How to use?

You can brew fresh tulsi leaves into a tea and drink it to relieve cold and cough symptoms.

• Neem: Neem has antibacterial and anti-allergic properties. It is used to relieve the itching sensation caused due to measles rashes. 

How to use?

Take fresh neem leaves, crush them to make a paste, and apply the paste to the affected skin areas to help soothe itching and reduce inflammation.

2. Acupressure or acupuncture

Some individuals find relief from symptoms like fever or congestion through acupressure (which targets pressure points) or acupuncture. However, it’s essential to seek a trained professional if choosing this approach.