Measles Signs and Symptoms
Introduction
- Also known as rubeola, is a highly contagious viral disease characterized by fever, an enanthem, cough, coryza & a distinct exanthem
Etiology
- Measles virus is a paramyxovirus, genus Morbillivirus
- Transmission is through resp tract or conjunctivae following contact w/ droplet aerosols
- Highly communicable from 4 days before the rash up to 4 days after its onset
- Incubation period from exposure to prodrome averages 7-21 days
Signs and Symptoms
Typical Measles
- Prodrome begins w/ fever followed by conjunctivitis w/ photophobia, coryza, cough; cough usually lasts for 10 days
- Koplik spots found on the inner aspects of the cheeks at the level of the premolars, may also spread in the labial mucosa, hard & soft palate & gingiva
- Appear as punctate bluish white spots on an erythematous base
- Pathognomonic for measles
- Erythematous maculopapular rash initially appears around the forehead or posterior occipital area, spreads downward & outward
- Begins at the peak of resp symptoms, about 2-3 days after emergence of Koplik spots
- May become confluent on the face & upper trunk
- Rash diminishes in the same progression as it appeared, followed by fine desquamation
- Generalized lymphadenopathy esp prominent in the cervical & occipital areas
- Gastrointestinal symptoms may occur eg diarrhea, loss of appetite, vomiting, abdominal pain
Atypical Measles
- Occurs in patients who received inactivated or killed measles vaccine
- Characterized by fever, pneumonia, pleural effusions & edema
- Rash may be maculopapular, petechial, urticarial, purpuric or vesicular & it appears initially on the wrists or ankles
Black Measles or Severe Hemorrhagic Measles
- High-grade fever
- Seizures
- Changes in mental status
Modified Measles
- An attenuated form of measles that may occur in patients who were previously given immunoglobulin (Ig) as post exposure prophylaxis to measles
- Signs & symptoms are milder than those of typical measles