Measles: Symptoms & Signs, Transmission, Risk Factors, Complications, Prevention and Treatment

Measles is a highly contagious disease caused by a virus. It spreads easily when an infected person breathes, coughs or sneezes. It can cause severe disease, complications, and even death.

Measles can affect anyone but is most common in children.

Measles infects the respiratory tract and then spreads throughout the body. Symptoms include a high fever, cough, runny nose and a rash all over the body.

Being vaccinated is the best way to prevent getting sick with measles or spreading it to other people. The vaccine is safe and helps your body fight off the virus.

Before the introduction of measles vaccine in 1963 and widespread vaccination, major epidemics occurred approximately every two to three years and caused an estimated 2.6 million deaths each year.

Signs and Symptoms :

Symptoms of measles usually begin 10–14 days after exposure to the virus. A prominent rash is the most visible symptom.

Early symptoms usually last 4–7 days. They include:

Running nose

Cough

Red and Watery eyes

Small white spots inside the cheeks.

The rash begins about 7–18 days after exposure, usually on the face and upper neck. It spreads over about 3 days, eventually to the hands and feet. It usually lasts 5–6 days before fading.

Complications can include :

Blindness

Encephalitis (an infection causing brain swelling and potentially brain damage)

Severe diarrhoea and related dehydration

Ear infections

Severe breathing problems including pneumonia.

Most deaths from measles are from complications related to the disease.

If a woman catches measles during pregnancy, this can be dangerous for the mother and can result in her baby being born prematurely with a low birth weight.

Complications are most common in children under 5 years and adults over age 30. 

They are more likely in children who are malnourished, especially those without enough vitamin A or with a weak immune system from HIV or other diseases. 

Measles itself also weakens the immune system and can make the body “forget” how to protect itself against infections, leaving children extremely vulnerable.

Who is at risk?

Any non-immune person (not vaccinated or vaccinated but did not develop immunity) can become infected. 

Unvaccinated young children and pregnant persons are at highest risk of severe measles complications.

Measles is still common, particularly in parts of Africa, the Middle East and Asia. 

The overwhelming majority of measles deaths occur in countries with low per capita incomes or weak health infrastructures that struggle to reach all children with immunization.

Damaged health infrastructure and health services in countries experiencing or recovering from a natural disaster or conflict interrupt routine immunization and overcrowding in residential camps increases the risk of infection. 

Children with malnutrition or other causes of a weak immune system are at highest risk of death from measles.

Transmission :

Measles is one of the world’s most contagious diseases, spread by contact with infected nasal or throat secretions (coughing or sneezing) or breathing the air that was breathed by someone with measles. 

The virus remains active and contagious in the air or on infected surfaces for up to two hours. 

For this reason, it is very infectious, and one person infected by measles can infect nine out of 10 of their unvaccinated close contacts. 

It can be transmitted by an infected person from four days prior to the onset of the rash to four days after the rash erupts.

Measles outbreaks can result in severe complications and deaths, especially among young, malnourished children. 

In countries close to measles elimination, cases imported from other countries remain an important source of infection.

Treatment :

There is no specific treatment for measles. Caregiving should focus on relieving symptoms, making the person comfortable and preventing complications. 

Drinking enough water and treatments for dehydration can replace fluids lost to diarrhoea or vomiting. Eating a healthy diet is also important.

Doctors may use antibiotics to treat pneumonia and ear and eye infections.

All children or adults with measles should receive two doses of vitamin A supplements, given 24 hours apart. 

This restores low vitamin A levels that occur even in well-nourished children. It can help prevent eye damage and blindness. 

Vitamin A supplements may also reduce the number of measles deaths.

Prevention :

Community-wide vaccination is the most effective way to prevent measles. All children should be vaccinated against measles. 

The vaccine is safe, effective and inexpensive.

Children should receive two doses of the vaccine to ensure they are immune. 

The first dose is usually given at 9 months of age in countries where measles is common and 12–15 months in other countries. 

A second dose should be given later in childhood, usually at 15–18 months.

The measles vaccine is given alone or often combined with vaccines for mumps, rubella and/or varicella.

Routine measles vaccination, combined with mass immunization campaigns in countries with high case rates are crucial for reducing global measles deaths.