Measles (Rubeola)

What is Measles?

Measles is a viral respiratory illness that remains one of the leading causes of childhood death globally. It is highly infectious and spreads rapidly through respiratory droplets. A single infected person can transmit the virus to 90% of nearby unvaccinated individuals.

Did you know? Before vaccination, measles caused over 2.6 million deaths annually.

Transmission & Virus Biology

The measles virus is part of the Morbillivirus genus and is spread through coughing, sneezing, or direct contact with nasal secretions. The virus remains active in the air or on surfaces for up to two hours.

Incubation: 7–14 days
Infectious period: 4 days before to 4 days after rash onset
Mode of transmission: Airborne droplets & contact

Critical fact: Measles is more contagious than Ebola, influenza, or COVID-19.

Symptoms & Disease Progression

Measles progresses in clear stages and presents with a recognizable combination of symptoms. It may also result in post-infectious immune suppression.
Stage 1 (Prodrome): High fever, cough, runny nose, conjunctivitis
Stage 2 (Koplik spots): Tiny white lesions inside cheeks
Stage 3 (Exanthem): Rash starts at hairline and spreads downwards

Visual cue: Rash appears 3–5 days after symptoms start and may last 6 days.

Who is Most at Risk?

Children under 5
Unvaccinated individuals of any age
Pregnant women
People with weakened immune systems (HIV, cancer)
Malnourished children (especially Vitamin A deficiency)

Complications of Measles

Measles can result in several life-threatening complications:

Pneumonia – leading cause of death in children with measles
Encephalitis – brain swelling that can cause seizures or disability
Blindness – especially in Vitamin A deficient children
SSPE – a fatal degenerative brain disease appearing years later
Severe diarrhea – leads to dehydration and malnutrition

Diagnosis & Laboratory Testing

Diagnosis involves clinical evaluation followed by confirmation with laboratory tests:

IgM ELISA: Detects recent infection in blood
RT-PCR: Detects measles RNA in respiratory specimens or urine
Genotyping: Helps trace origin of outbreak
Saliva samples: Common for field surveys

Treatment & Vitamin A Supplementation

No specific antiviral exists for measles. Supportive care is the mainstay of treatment. WHO recommends high-dose Vitamin A for all measles cases.

Fever and hydration management
Antibiotics for complications (pneumonia, ear infection)
Vitamin A: given 24 hours apart, reduces mortality by 50%
Hospitalization: needed for respiratory failure, malnutrition

Age Group	Vitamin A Dose
Under 6 months	50,000 IU
6–11 months	100,000 IU
12 months and older	200,000 IU

Prevention & Vaccination

Prevention depends on immunization and public health infrastructure. The MMR vaccine (Measles, Mumps, Rubella) is highly effective and safe.

First dose: 12–15 months
Second dose: 4–6 years
Catch-up campaigns during outbreaks
MMRV version includes varicella for young children

Effectiveness: Two doses provide 97% protection against measles.

Global Impact and Outbreak Data

Global resurgence of measles has been fueled by misinformation, reduced vaccination, and healthcare disruptions from COVID-19.

107,500 measles deaths globally in 2023
Over 22 million infants missed their first dose of vaccine
884 cases in the US (as of April 2025)
Outbreaks linked to travel, undervaccinated communities

References

CDC: Measles Signs, Symptoms, Complications, 2024–2025
WHO: Measles Elimination Strategy & Vaccine Guidelines
NHS: Measles Information & Immunization Services
MedlinePlus: Complications & Long-term Effects

Made with Verified sources from WHO, CDC, and NHS | Last updated: April 2025