by Jennifer Tarbutton, MD FAAP
Measles is a highly contagious viral illness that initially presents with the symptoms of fever, malaise, cough, nasal congestion and red eyes. Also, during the first few days of illness, Koplik spots, which are clustered white lesions on the inner mucosa of the mouth, may appear. Koplik spots are considered pathognomonic for measles infection. The characteristic measles rash appears approximately two-four days after the onset of fever. The tiny red spots typically begin on the face and head and spreads downward. The rash resolves in five to six days. No specific antiviral medication is available to treat the virus. Therefore, the treatment is largely supportive with antipyretics, fluids and observation for complications of the virus.
The only natural host of measles virus is humans, and the virus is transmitted by direct contact with infectious droplets or airborne spread. Following exposure to the virus, approximately 90 percent of susceptible individuals will develop measles. An individual with the virus is contagious from five days before appearance of the rash until four days after the rash has cleared. Complications from the measles virus include ear infections, pneumonia, croup and diarrhea. Acute encephalitis, which often results in permanent brain damage, occurs in approximately 1 out of every 1000 cases.
Measles can be prevented with the MMR vaccine. The measles vaccine was first licensed in 1963. As a result of the childhood and adolescent immunization program, the United States experienced a 99% decreased in the incidence of measles since that time. The measles vaccine available in the United States is given in combination formulations as the measles-mumps-rubella (MMR) or the measles-mumps-rubella-varicella (MMRV) vaccines. For measles control and elimination, two doses of vaccine are required. The two-dose schedule was adopted between 1989 and 1991. This vaccine is recommended to be administered at the 12-month-old health check and the 4-year-old health check. This vaccine is safe and effective.
In 2002, measles was declared eliminated from the Americas due to high rate of vaccination. However, cases began to rise in 2008. These cases continue to occur in under- or unvaccinated populations. Please consult with your Physician if you have questions or concerns. Children’s Healthcare Center of Sandersville is located at 601 Ferncrest Drive, Suite A, in Sandersville. Please call 478-552-0006 to schedule an appointment.