• Also known as rubeola, is a highly contagious viral disease characterized by fever, an enanthem, cough, coryza & a distinct exanthem

• 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

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