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Measles

This article is about the disease. For other uses, see Measles (disambiguation).
Not to be confused with either rubella or roseola, which are also viral diseases with comparable features.

Measles
Other namesMorbilli, rubeola, red measles, English measles[1][2]
A child showing a day-four measles rash
SpecialtyInfectious disease
SymptomsFever, cough, runny nose, inflamed eyes, rash[3][4]
ComplicationsPneumonia, seizures, encephalitis, subacute sclerosing panencephalitis, immunosuppression, hearing loss, blindness[5][6]
Usual onset10–12 days after exposure[7][8]
Duration7–10 days[7][8]
CausesMeasles virus[3]
PreventionMeasles vaccine[7]
TreatmentSupportive care[7]
Frequency20 million per year[3]
Deaths140,000+ (2018)[9][10]

Measles is a highly contagious, vaccine-preventable infectious disease caused by measles virus.[3][5][11][12] Symptoms usually develop 10–12 days after exposure to an infected person and last 7–10 days.[7][8] Initial symptoms typically include fever, often greater than 40 °C (104 °F), cough, runny nose, and inflamed eyes.[3][4] Small white spots known as Koplik's spots may form inside the mouth two or three days after the start of symptoms.[4] A red, flat rash which usually starts on the face and then spreads to the rest of the body typically begins three to five days after the start of symptoms.[4] Common complications include diarrhea (in 8% of cases), middle ear infection (7%), and pneumonia (6%).[5] These occur in part due to measles-induced immunosuppression.[6] Less commonly seizures, blindness, or inflammation of the brain may occur.[5][7] Other names include morbilli, rubeola, red measles, and English measles.[1][2] Both rubella, also known as German measles, and roseola are different diseases caused by unrelated viruses.[13]

Measles is an airborne disease which spreads easily from one person to the next through the coughs and sneezes of infected people.[7] It may also be spread through direct contact with mouth or nasal secretions.[14] It is extremely contagious: nine out of ten people who are not immune and share living space with an infected person will be infected.[5] Furthermore, measles's reproductive number estimates vary beyond the frequently cited range of 12 to 18.[15] The NIH quote this 2017 paper saying: "[a] review in 2017 identified feasible measles R0 values of 3.7–203.3".[16] People are infectious to others from four days before to four days after the start of the rash.[5] While often regarded as a childhood illness, it can affect people of any age.[17] Most people do not get the disease more than once.[7] Testing for the measles virus in suspected cases is important for public health efforts.[5] Measles is not known to occur in other animals.[14]

Once a person has become infected, no specific treatment is available,[14] although supportive care may improve outcomes.[7] Such care may include oral rehydration solution (slightly sweet and salty fluids), healthy food, and medications to control the fever.[7][8] Antibiotics should be prescribed if secondary bacterial infections such as ear infections or pneumonia occur.[7][14] Vitamin A supplementation is also recommended for children.[14] Among cases reported in the U.S. between 1985 and 1992, death occurred in only 0.2% of cases,[5] but may be up to 10% in people with malnutrition.[7] Most of those who die from the infection are less than five years old.[14]

The measles vaccine is effective at preventing the disease, is exceptionally safe, and is often delivered in combination with other vaccines.[7][18] Vaccination resulted in an 80% decrease in deaths from measles between 2000 and 2017, with about 85% of children worldwide having received their first dose as of 2017.[14] Measles affects about 20 million people a year,[3] primarily in the developing areas of Africa and Asia.[7] It is one of the leading vaccine-preventable disease causes of death.[19][20] In 1980, 2.6 million people died from measles,[7] and in 1990, 545,000 died due to the disease; by 2014, global vaccination programs had reduced the number of deaths from measles to 73,000.[21][22] Despite these trends, rates of disease and deaths increased from 2017 to 2019 due to a decrease in immunization.[23][24][25]

Video summary (script)
  1. ^ a b Milner DA (2015). Diagnostic Pathology: Infectious Diseases E-Book. Elsevier Health Sciences. p. 24. ISBN 978-0-323-40037-4. Archived from the original on 8 September 2017.
  2. ^ a b Stanley J (2002). Essentials of Immunology & Serology. Cengage Learning. p. 323. ISBN 978-0-7668-1064-8. Archived from the original on 8 September 2017.
  3. ^ a b c d e f Caserta, MT, ed. (September 2013). "Measles". Merck Manual Professional. Merck Sharp & Dohme Corp. Archived from the original on 23 March 2014. Retrieved 23 March 2014.
  4. ^ a b c d "Measles (Rubeola) Signs and Symptoms". Centers for Disease Control and Prevention. 3 November 2014. Archived from the original on 2 February 2015. Retrieved 5 February 2015.
  5. ^ a b c d e f g h Atkinson W (2011). Epidemiology and Prevention of Vaccine-Preventable Diseases (12 ed.). Public Health Foundation. pp. 301–23. ISBN 978-0-9832631-3-5. Archived from the original on 7 February 2015. Retrieved 5 February 2015.
  6. ^ a b Rota PA, Moss WJ, Takeda M, de Swart RL, Thompson KM, Goodson JL (July 2016). "Measles". Nature Reviews. Disease Primers. 2: 16049. doi:10.1038/nrdp.2016.49. PMID 27411684.
  7. ^ a b c d e f g h i j k l m n o "Measles Fact sheet N°286". World Health Organization. November 2014. Archived from the original on 3 February 2015. Retrieved 4 February 2015.
  8. ^ a b c d Bope ET, Kellerman RD (2014). Conn's Current Therapy 2015. Elsevier Health Sciences. p. 153. ISBN 978-0-323-31956-0. Archived from the original on 8 September 2017.
  9. ^ Joint News Release (5 December 2019). "More than 140,000 die from measles as cases surge worldwide". who.int. Archived from the original on 6 August 2020. Retrieved 4 September 2020.
  10. ^ "Global Measles Outbreaks". cdc.gov. 17 August 2020. Archived from the original on 7 September 2020. Retrieved 4 September 2020.
  11. ^ Guerra FM, Bolotin S, Lim G, Heffernan J, Deeks SL, Li Y, et al. (December 2017). "The basic reproduction number (R0) of measles: a systematic review". The Lancet Infectious Diseases. 17 (12): e420–e428. doi:10.1016/S1473-3099(17)30307-9. PMID 28757186. Archived from the original on 10 April 2020. Retrieved 29 January 2022.
  12. ^ "Measles (Red Measles, Rubeola)". Dept of Health, Saskatchewan. Archived from the original on 10 February 2015. Retrieved 10 February 2015.
  13. ^ Marx JA (2010). Rosen's emergency medicine: concepts and clinical practice (7th ed.). Philadelphia: Mosby/Elsevier. p. 1541. ISBN 978-0-323-05472-0. Archived from the original on 8 September 2017.
  14. ^ a b c d e f g "Measles fact sheet". World Health Organization. Archived from the original on 1 June 2019. Retrieved 20 May 2019.
  15. ^ Guerra FM, Bolotin S, Lim G, Heffernan J, Deeks SL, Li Y, et al. (December 2017). "The basic reproduction number (R0) of measles: a systematic review". The Lancet. Infectious Diseases. 17 (12): e420–e428. doi:10.1016/S1473-3099(17)30307-9. ISSN 1474-4457. PMID 28757186. Archived from the original on 30 March 2023. Retrieved 7 December 2020.
  16. ^ Delamater PL, Street EJ, Leslie TF, Yang YT, Jacobsen KH (2019). "Complexity of the Basic Reproduction Number (R0)". Emerging Infectious Diseases. 25 (1). NIH website: 1–4. doi:10.3201/eid2501.171901. PMC 6302597. PMID 30560777. [a] review in 2017 identified feasible measles R0 values of 3.7–203.3
  17. ^ Selina SP, Chen MD (6 June 2019). Measles (Report). Medscape. Archived from the original on 25 September 2011.
  18. ^ Russell SJ, Babovic-Vuksanovic D, Bexon A, Cattaneo R, Dingli D, Dispenzieri A, et al. (September 2019). "Oncolytic Measles Virotherapy and Opposition to Measles Vaccination". Mayo Clinic Proceedings. 94 (9): 1834–39. doi:10.1016/j.mayocp.2019.05.006. PMC 6800178. PMID 31235278.
  19. ^ Kabra SK, Lodha R (August 2013). "Antibiotics for preventing complications in children with measles". The Cochrane Database of Systematic Reviews. 8 (8): CD001477. doi:10.1002/14651858.CD001477.pub4. PMC 7055587. PMID 23943263.
  20. ^ "Despite the availability of a safe, effective and inexpensive vaccine for more than 40 years, measles remains a leading vaccine-preventable cause of childhood deaths" (PDF). Archived (PDF) from the original on 12 December 2019. Retrieved 16 February 2019.
  21. ^ GBD 2015 Mortality and Causes of Death Collaborators (October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/S0140-6736(16)31012-1. PMC 5388903. PMID 27733281.
  22. ^ GBD 2013 Mortality Causes of Death Collaborators (January 2015). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet. 385 (9963): 117–71. doi:10.1016/S0140-6736(14)61682-2. PMC 4340604. PMID 25530442.
  23. ^ "Measles cases spike globally due to gaps in vaccination coverage". World Health Organization (WHO). 29 November 2018. Archived from the original on 24 December 2018. Retrieved 21 December 2018.
  24. ^ "U.S. measles cases surge nearly 20 percent in early April, CDC says". Reuters. 16 April 2019. Archived from the original on 15 April 2019. Retrieved 16 April 2019.
  25. ^ "Measles – European Region". World Health Organization (WHO). Archived from the original on 8 May 2019. Retrieved 8 May 2019.

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