Measles

Clinical Signs and Symptoms

MeaslesMeasles is a highly infectious acute viral disease resulting from infection with measles virus.

Measles is transmitted via respiratory droplets, or direct contact with nasal/throat secretions, from infected individuals.

The incubation period is 7-21 days, usually 10-12 days until beginning of prodrome and 14 days until appearance of rash.

Individuals are usually infectious 5 days before to 4 days after rash onset.

Measles

The EU clinical case definition for measles is:

•any person with feverAND

•maculo-papular rash

AND at least one of the following three:

•cough•coryza•conjunctivitis

MeaslesClinical course of infectionFirst prodromal symptoms begin after a 10-12 day incubation period. These can include fever, conjunctivitis, coryza, cough and bronchiolitis.

Nearly all infected susceptible individuals develop clinical disease.

Koplik’s spots appear on the buccal mucosa 1–2 days before rash onset and may last for 2-4 days.

Measles rash, an erythematous maculopapular exanthema, develops 2–4 days after the onset of fever and spreads from the head to the body over the next 3–4 days. The rash, which blanches on pressure early in the course, fades in the order of appearance during the next 3– 4 days and assumes a nonblanching appearance. The rash is less faint than for rubella, and, unlike rubella, often coalesces.

Source: CDC

Measles complications

• Ear infections ( 1 in 20)• Pneumonia/bronchitis (1 in 25)• Convulsions (1 in 200)• Diarrhoea (1 in 6)• Meningitis/encephalitis (1 in 1000)• Immune thrombocytopenic purpura (ITP; Condition affecting blood clotting) (1 in 6000)• Late onset subacute sclerosing panencephalitis (SSPE) (1 in 8000 in children under 2 years)• Deaths (1-2 deaths in 1000 reported cases in recent years)

Complications are more common and more severe in chronically ill individuals

Koplik’s spots - white spots inside the mouth are common with measles. They may appear on the buccal mucosa 1-2 days before rash and last for 2-4 days. Courtesy of Centers for Disease Control and Prevention

Koplik’s spots - white spots inside the mouth are common with measles. They

may appear on the buccal mucosa 1-2 days before rash and last for 2-4 days.Courtesy New Zealand Dermatological Society Incorporated http://www.dermnetnz.org

Courtesy of Centers for Disease Control and Prevention

Child with severe measles rash, on face, and upper body.

Measles rash, an erythematous maculopapular exanthema, develops 2–4 days after the onset of fever and spreads from the head to the body over the next 3–4 days. The rash, which blanches on pressure early in the course, fades in the order of appearance during the next 3–4 days and assumes a nonblanching appearance.

Courtesy of Centers for Disease Control and Prevention

Face of a boy with measles rash.Measles rash, an erythematous maculopapular exanthema, develops 2–4 days after the onset of fever and spreads from the head to the body over the next 3–4 days. The rash, which blanches on pressure early in the course, fades in the order of appearance during the next 3–4 days and assumes a nonblanching appearance.

Courtesy of Centers for Disease Control and Prevention

Measles rash covering child's arms and stomach.Measles rash, an erythematous maculopapular exanthema, develops 2–4 days after the onset of fever and spreads from the head to the body over the next 3–4 days. The rash, which blanches on pressure early in the course, fades in the order of appearance during

the next 3–4 days and assumes a nonblanching appearance.

Courtesy of Centers for Disease Control and Prevention

Characteristic red blotchy rash on child's buttocks and back during third day of the measles rash. Measles rash, an erythematous maculopapular exanthema, develops 2–4 days after the onset of fever and spreads from the head to the body over the next 3–4 days. The rash, which blanches on pressure early in the course, fades in the order of appearance during the next 3–4 days and

assumes a nonblanching appearance.

Child in later stages of measles rash (probably has had rash for 4 or 5 days).Measles rash, an erythematous maculopapular exanthema, develops 2–4 days after the onset of fever and spreads from the head to the body over the next 3–4 days. The rash, which blanches on pressure early in the course, fades in the order of appearance during the next 3–4 days and

assumes a nonblanching appearance .

Courtesy of Centers for Disease Control and Prevention