Measles is a disease which usually produces
fever,
cougmon betwen the two viruses.
Measles is a disease which usually produces
,
conjunctivitis
("pink eye", but not quite the same as the "pink eye" seen with colds and
earaches), a red, bumpy rash, and a rash ("Koplik spots") inside the
cheeks. The measles virus affects only primates (humans, as well as
monkeys and similar species); it does not affect animals.
It takes 1-1/2 to 2 weeks after exposure before someone develops
the initial signs of infection, which include fever (which starts low but
increases, sometimes to as high as 105 F) followed by cough, runny nose,
and conjunctivitis (pink
eye). The rash can appear anywhere from 1 to 7 days (but usually 2-4
days) after the "prodrome" (the fever and other initial signs of infection);
it usually starts at the patient's hairline, then spreads to the face and
neck and from there to the rest of the body, finally reaching the hands and
feet, and then fades with the oldest rash lesions disappearing first.
Koplik spots are tiny blue-white spots which appear up to 2 days before or
after the rash shows up. Measles infection can also cause loss of appetite,
swelling of lymph nodes, and diarrhea (which is more common in babies with
measles). It can be complicated by secondary
ear infections,
croup, and pneumonia.
In some cases (about 1 out of 1,000) patients with measles develop
inflammation of the brain tissue, or "encephalitis". Very rarely, a
persistent rubeola infection can produce SSPE, a disease in which nerves
and brain tissue degenerate (sometimes many years after the original case
of measles); now that we vaccinate most children against measles, SSPE is
almost never seen. Up to 6% of patients with measles develop pneumonia,
which can be either viral (from the measles virus) or bacterial, and this
is the most common cause of death from measles (60% of deaths; acute
encephalitis causes another 15% of measles-related deaths, while SSPE is
responsible for death in only 5 to 10 of every 1 million cases of measles).
Before the vaccine came along, measles epidemics occurred about every 2
years, usually in winter and early spring when unimmune children were
together in school, and most measles patients were preschoolers and
young elementary-school kids. Nowadays most cases are seen in unvaccinated
children (kids younger than 15 months who haven't had the vaccine yet,
and preschool kids who should have had the vaccine but haven't) and older
children -- some in college -- who received one dose of vaccine but did
not become immune as a result. Measles outbreaks in the United
Stateshaven't had the vaccine yet,
and preschool kids who should have had the vaccine but haven't) and older
children -- some in college -- who received one occur only in people -- children or adults -- who were never
vaccinated and are still susceptible to measles infection,, or in those
people who do not become immune after vaccination. Up to 5% of children who
get a single dose of vaccine will not become immune: because of this we now
give a second dose of vaccine to all children, usually when they start
kindergarten. Measles immune globulin is available and can prevent measles,
or at least make it milder than it otherwise would be, if it is given to
someone who isn't yet immune within 6 days of exposure.
There are no antibiotics available for treatment of measles. Children who
are deficient in vitamin A seem to be more likely to have severe measles
(and more likely to die from the infection) than are children with enough
vitamin A; therefore the World Health Organization and UNICEF recommend
giving 1 to 3 doses of vitamin A to children older than 6 months who have
measles and are hospitalized because of measles or its complications or who
are malnourished, have immune system problems, or who are proven
to have a vitamin A deficiency. Since vitamin A can be toxic in excessive
doses, the supplement should only be given on the advice of the child's
doctor. Antibacterial antibiotics can be used to treat bacterial pneumonia
occuring during a measles infection.
Rubella is a pretty benign disease as viral diseases go: your symptoms
usually include a red, bumpy rash, swollen lymph nodes (most often around
the ears and neck), and a mild fever; some people also feel achy for a
little while. Adolescents and adults, especially women, are much more
likely than children to have muscle and joint aches with rubella, but these
go away fairly quickly. (It is also possible to have rubella encephalitis, but
this is rare.) It takes around 2 to 3-1/2 weeks after exposure to develop
rubella. The rubella virus is not related to the rubeola
virus, and being immune to one kind of measles does not make you immune
to the other kind.
Unfortunately, if a woman has rubella during the first 3-4 months of
her pregnancy, the virus can induce many different birth defects, some of
which are quite severe. Among the defects doctors have seen in "congenital
rubella" are eye defects (cataracts, glaucoma, and "microphthalmia" (small
non-functional eyes) ), heart problems (defects of the wall between the two
sides of the heart, narrowing of the arteries to the lungs, and an open
duct bypassing the lungs), ear problems (deafness caused by defects in
the nerves and sound sensing organs), and neurologic problems (including
mental retardation) -- amoween the two
sides of the heart, narrowing of the arteries to the lungs, and an open
duct bypassing the lungs), ear problems (deafness caused by defecng others. For that reason, obstetricians test
every pregnant woman to make sure that she is immune to rubella, and
we try to immunize every child to the virus. A single dose of the vaccine
usually gives lifelong protection; we usually give two doses (as the
combined measles-mumps-rubella, or "MMR", vaccine) to be sure that every
child is immune. This helps protect non-immune pregnant women too, by
reducing the chances of their being exposed to rubella by sick children.
Rubella immune globulin is available and can help decrease the symptoms of
rubella, but does not necessarily prevent infection and birth defects in
the developing baby: there have been babies born with congenital rubella
to mothers who received rubella immune globulin shortly after being exposed
to rubella.
We now have a single vaccine that protects against measles,
mumps, rubella,
and chickenpox.
This vaccine, known as "MMRV", is given at the same time as the MMR
vaccine is usually given (at age 12-18 months and at age 4-5 years).
It appears in trials to work just as well as the separate MMR and
chickenpox vaccines, and means fewer needle pokes for a child (which
I certainly would have been in favour of when I was that age...). For
more information, ask your child's d 4-5 years).
It appears in trials to work just as well as the separate MMR and
chickenpox vaccines, and means fewer needle pokes for a child (which
I octor.
Rubeola ("ordinary" measles)
Rubella ("German measles")
Search the Office for:
Back to Dr. Reddy's Pediatric Office on the Web
Sources We Use in the Office
We welcome your
comments and questions.
PLEASE NOTE: As with all of this Web site, I try to give
general answers to common questions my patients and their parents ask me
in my (real) office. If you have specific questions about your
child you must ask your child's regular doctor. No doctor can give
completely accurate advice about a particular chil answers to common questions my patients and their parents ask me
in my (real) office. If you have specific questions about your
child you musd without knowing and
examining that child. I will be happy to try and answer
general questions
about children's health, but unless your child is a regular patient of
mine I cannot give you specific advice.
We subscribe to the
Health on the Net Foundation
HONcode standard for trustworthy health information.
Written 09/02/96; major revision 04/24/05; major revision 10/21/08;
last revised 08/16/10