Rubeola

Also called morbilli and commonly called measles, rubeola is an acute, highly contagious infection that causes a characteristic rash. Measles is one of the most common and most serious communicable childhood diseases.

Although the measles vaccine has reduced the number of cases in children, most cases involve preschool children.

In temperate zones, incidence is highest in late winter and early spring. Before the measles vaccine, epidemics occurred every 2 to 5 years in large urban areas.

In the United States, the prognosis usually is excellent, but mortality is highest among children under age 2 and adults. Patients with impaired cellmediated immunity are at high risk for severe or even fatal measles. Mortality is as high as 10% in developing countries.

Causes

Measles is most common in school-age children with outbreaks occurring in the winter and spring.

The occurrence of measles before the age of six months is relatively uncommon because of passively acquired maternal antibodies from the immune mother.

Symptoms and Signs

Symptoms such as include:

• Fever (often high)
• Runny nose
• Red eyes
• Hacking cough
• Sore throat
• Exhaustion
• Very small spots inside the mouth (2-4 days after initial symptoms)

Raised, itchy rash:

• Starts around the ears, face, and side of neck 3-5 days after initial symptoms appear
• Generally spreads to the arms, trunk, and legs over the next two days
• Lasts about 4-6 days

Diagnostic tests

Several tests may be ordered to differentiate measles from rubella, roseola infantum, enterovirus infection, toxoplasmosis, and drug eruptions. If necessary, measles virus may be isolated from the blood, nasopharyngeal secretions, and urine during the febrile period. Serumantibodies appear within 3 days after onset of the rash and reach peak titers 2 to 4 weeks later.

Treatment

The patient should receive antipyretics to control fever. Vaporizers and a warm environment help reduce respiratory irritation, but cough preparations and antibiotics are usually ineffective. Therapy also must combat complications.

Prevention

• Wear long-sleeved shirts and long pants if you are outside between dusk and dawn.
• Refrain from unnecessary activity in places where mosquitoes are most prevalent.
• Keep mosquitoes out of your home. Repair holes in screens on doors and windows.
• Look for outdoor signs of viral disease. Keep an eye out for sick or dying birds and report them to your local health department.

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