Measles symptoms & complications of this contagious virus

CDC photo - child with measles rash

Measles causes fever, runny nose, cough and a rash all over the body — and as simple as that sounds, it is actually the most deadly of all childhood rash/fever illnesses.

Measles — also called rubeola — is a respiratory disease caused by the measles virus, which normally lives in the mucus in the nose and throat of the infected person.
Measles symptoms & complications

A typical case of measles begins with mild to moderate fever, cough, runny nose, red eyes, and sore throat. Two or three days after symptoms begin, tiny white spots may appear inside the mouth.

Three to five days after the start of symptoms, a red or reddish-brown rash appears. The rash usually begins on a person’s face at the hairline, and spreads downward to the neck, trunk, arms, legs, and feet. When the rash appears, a person’s fever may spike to more than 104 degrees Fahrenheit. After a few days, the fever subsides and the rash fades.

The symptoms of measles generally begin about 7-14 days after a person is infected, and include:

  • Blotchy rash
  • Fever
  • Cough
  • Runny nose
  • Red, watery eyes (conjunctivitis)
  • Feeling run down, achy (malaise)
  • Tiny white spots with bluish-white centers found inside the mouth (Koplik’s spots, shown below right)

Other rash-causing diseases often confused with measles include roseola and rubella, also known as German measles.

It isn’t just a little rash - Measles can be dangerous, especially for babies and young children.

Potential complications of measles

About 30% of measles cases develop one or more complications, including:

  • Pneumonia, which is the complication that is most often the cause of death in young children.
  • Ear infections occur in about 1 in 10 measles cases and permanent loss of hearing can result.
  • Diarrhea is reported in about 8% of cases.
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These complications are more common among children under 5 years of age, and adults over 20 years old.

Even in previously healthy children, measles can be a serious illness requiring hospitalization. As many as 1 out of every 20 children with measles gets pneumonia, and about 1 child in every 1,000 who get measles will develop encephalitis. (This is an inflammation of the brain that can lead to convulsions, and can leave the child deaf or developmentally disabled.)

For every 1,000 children who get measles, 1 or 2 will die from it. Measles also can make a pregnant woman have a miscarriage, give birth prematurely, or have a low-birth-weight baby.

In developing countries, where malnutrition and vitamin A deficiency are common, measles has been known to kill as many as one out of four people. In 2008, there were an estimated 164,000 measles deaths worldwide. The virus is also the leading cause of blindness among African children.

CDC infographic-consider-measles

How measles is transmitted

Measles is highly contagious, and can be spread to others from four days before to four days after the rash appears.

The virus lives in the mucus in the nose and throat of the infected person. When that person sneezes or coughs, droplets spray into the air. The droplets can get into other people’s noses or throats when they breathe or put their fingers in their mouth or nose after touching an infected surface.

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The virus can live on infected surfaces for up to two hours, and spreads so easily that people who are not immune will probably get it when they come close to someone who is infected. (Measles is a human disease, and is not spread by any other animal species.)

Measles is so contagious, in fact, that if one person has it, 90% of the people close to that person who are not immune will also become infected with the virus. Getting vaccinated is the best way to prevent measles.

Measles incidence

Measles is very rare in countries and regions of the world that are able to keep vaccination coverage high. In North and South America, Finland, and some other areas, endemic measles transmission is considered to have been interrupted through vaccination.

There are still sporadic cases of measles in the United States because visitors from other countries or US citizens traveling abroad can become infected before or during travel and spread the infection to unvaccinated or unprotected persons.

Measles remains a common disease in many countries throughout the world, including some developed countries in Europe and Asia. While the disease is almost gone from the United States, measles still kills nearly 200,000 people each year globally.

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