Measles disease is one of the most contagious viral infections in the world. Despite the availability of effective vaccines, measles continues to cause thousands of deaths, particularly in regions with low immunization coverage. This article provides a comprehensive overview of measles disease, including its causes, symptoms, diagnosis, treatment, prevention, and global impact.
1. What is Measles Disease?
Measles disease, also known as rubeola, is a highly contagious viral infection caused by the measles virus—a member of the Paramyxoviridae family. It mainly affects children but can occur at any age if a person is not vaccinated or has never had measles before.
2. History and Global Significance
Measles has been documented for centuries and was once a common childhood illness worldwide. With the introduction of the measles vaccine in the 1960s, cases dramatically decreased. However, in recent years, measles outbreaks have resurfaced in various regions due to vaccine hesitancy and declining immunization rates.
3. Causes and Transmission
The measles virus spreads through respiratory droplets when an infected person coughs or sneezes. It can remain airborne for up to two hours and infects others even before the symptoms appear.
Transmission routes:
- Direct contact with nasal or throat secretions
- Breathing in contaminated air
- Touching surfaces with virus particles and then touching the mouth or nose
A person with measles is contagious four days before and after the rash appears.
4. Risk Factors
Several factors can increase the risk of contracting measles disease:
- Lack of vaccination
- Traveling to regions with outbreaks
- Immunocompromised conditions (HIV, cancer)
- Malnutrition, especially Vitamin A deficiency
- Living in crowded or unsanitary environments
5. Signs and Symptoms
Measles symptoms usually appear 10 to 14 days after exposure and follow a characteristic pattern.
Early symptoms:
- High fever (often over 104°F or 40°C)
- Runny nose
- Cough
- Red, watery eyes (conjunctivitis)
- Sore throat
- Fatigue
Later symptoms:
- Koplik’s spots (tiny white spots inside the mouth)
- Red rash starting at the face and spreading down the body
- Skin peeling or darkening in severe cases
6. Stages of Measles
- Incubation Period: No visible symptoms; virus replicates.
- Prodrome Stage: Mild fever, cough, and conjunctivitis develop.
- Exanthem Stage: Rash appears, usually on the face, then spreads.
- Recovery Stage: Symptoms begin to subside; immunity develops.
7. Complications of Measles
Measles can lead to serious complications, particularly in young children and adults.
Common complications:
- Diarrhea
- Ear infections
- Laryngitis
Severe complications:
- Pneumonia
- Encephalitis (brain inflammation)
- Blindness
- Severe dehydration
- Subacute sclerosing panencephalitis (SSPE) – a fatal brain disorder
8. Diagnosis
Diagnosing measles disease involves:
- Clinical evaluation: Typical rash, fever, and Koplik’s spots.
- Laboratory tests:
- Measles-specific IgM antibodies
- RT-PCR (detects viral RNA)
- History of exposure or unvaccinated status.
Doctors may also consider differential diagnoses like rubella, roseola, scarlet fever, or dengue.
9. Treatment Options
There is no specific antiviral treatment for measles. Supportive care is the mainstay of treatment.
Supportive measures:
- Rest and hydration
- Paracetamol or ibuprofen to reduce fever
- Humidified air for sore throat and cough
- Vitamin A supplements (especially in children)
- Antibiotics (if secondary bacterial infections occur)
Hospitalization may be required in severe or complicated cases.
10. Role of Vaccination
Vaccination is the most effective way to prevent measles disease.
MMR vaccine (Measles, Mumps, Rubella):
- First dose: 9–12 months of age
- Second dose: 15–18 months or before school age
Some countries also offer MR (Measles-Rubella) or MMRV (includes varicella) vaccines.
Effectiveness:
- One dose: ~93% effective
- Two doses: ~97% effective
11. Measles in Children
Children under five are most vulnerable to complications. The rash in children may be more widespread, and symptoms like diarrhea or ear infections are common. Timely vaccination and good nutrition are essential.
12. Measles in Adults
Adults can experience more intense symptoms and complications, especially if not vaccinated. Pneumonia and liver involvement are more common. Pregnant women with measles may face risks like miscarriage, preterm birth, or stillbirth.
13. Measles During Pregnancy
Pregnant women are particularly at risk. Measles can lead to:
- Miscarriage
- Premature labor
- Low birth weight
- Congenital measles (very rare but severe)
Vaccination is not given during pregnancy but should be administered before conception during pre-pregnancy planning.
14. Preventing Measles Outbreaks
Outbreak prevention requires a combination of high vaccination coverage and public awareness.
Key strategies:
- Mass immunization campaigns
- Rapid identification and isolation of cases
- Public education against vaccine misinformation
- Strengthening routine immunization programs
15. Measles Elimination and Challenges
The World Health Organization (WHO) aims to eliminate measles globally. Some countries have achieved this, but resurgence is due to:
- Vaccine hesitancy
- Conflict zones disrupting healthcare
- Misinformation via social media
- Weak healthcare infrastructure
16. Myths and Facts About Measles
| Myth | Fact |
|---|---|
| Measles is harmless | Measles can be fatal or cause serious complications |
| Natural infection is better than vaccination | Vaccines provide immunity without risking complications |
| Measles only affects children | Adults can get measles too |
| One dose is enough | Two doses ensure optimal protection |
17. Measles vs. Rubella
| Feature | Measles | Rubella |
|---|---|---|
| Virus | Measles virus | Rubella virus |
| Rash | Darker, confluent | Lighter, separate spots |
| Fever | High | Mild |
| Contagiousness | Very high | Moderate |
| Complications | Pneumonia, encephalitis | Congenital rubella syndrome (CRS) in pregnancy |
18. Herd Immunity and Community Protection
Herd immunity occurs when a high percentage of the population is immune, reducing the likelihood of disease spread.
- Threshold for measles: ~95% vaccination coverage
- Protects those who cannot be vaccinated (infants, immunocompromised)
19. Nutritional Support in Measles
Nutrition plays a vital role in recovery from measles.
Key recommendations:
- Vitamin A supplementation
- Hydration with oral rehydration solution (ORS)
- Easily digestible, high-calorie foods
- Continued breastfeeding for infants
20. Final Thoughts
Measles disease, though preventable, remains a public health concern due to gaps in immunization. The virus is highly contagious and can lead to severe complications, especially in vulnerable populations. The key to measles control lies in widespread vaccination, public education, and early diagnosis. As global citizens, it is our shared responsibility to protect one another by ensuring immunization and advocating science-based health practices.
FAQs About Measles Disease
1. Is measles curable?
There is no cure, but it is manageable with supportive treatment.
2. How long does measles last?
Typically 7–10 days from rash onset to recovery.
3. Can I get measles more than once?
Usually not. Natural infection gives lifelong immunity.
4. Is measles airborne?
Yes, it can linger in the air for up to 2 hours.
5. Are two vaccine doses necessary?
Yes, for full protection and long-term immunity.
6. What should I do if I’ve been exposed to measles?
Get medical advice; a vaccine or immunoglobulin may help within 72 hours.
7. Can adults get the measles vaccine?
Yes, especially if they haven’t been vaccinated or had measles before.
8. What does the measles rash look like?
It starts on the face as flat red spots and spreads downward, sometimes becoming raised.
9. Is measles deadly?
It can be, especially in young children or the immunocompromised.
10. How is measles diagnosed?
Through clinical signs and confirmed with antibody tests or PCR.
