Measles is one of the leading causes of death among young children even though a safe and cost-effective vaccine is available. In 1980, before widespread vaccination, measles caused an estimated 2.6 million deaths each year.
Measles is a highly contagious, serious disease caused by a virus and it is normally passed through direct contact and through the air. The virus infects the respiratory tract , then spreads throughout the body. Measles is a human disease and is not known to occur in animals.
Signs and symptoms
The first sign of measles is usually a high fever often greater than 40 °C (104.0 °F), which begins about 10 to 12 days after exposure to the virus, and lasts 4 to 7 days.
A runny nose, cough, red watery eyes, and two or three days after the start of symptoms small white spots inside the cheeks can develop in the initial stage.
Three to five days after the start of symptoms, a red, flat rash erupts, usually on the face and upper neck.
Over about 3 days, the rash spreads, eventually reaching the hands and feet. The rash lasts for 5 to 6 days, and then fades. On average, the rash occurs 14 days after exposure to the virus (within a range of 7 to 18 days). Symptoms usually develop 10–12 days after exposure to an infected person and last 7–10 days.
Most measles-related deaths are caused by complications associated with the disease. Complications are more common in children under the age of 5, or adults over the age of 20. The most serious complications include blindness, encephalitis (an infection that causes brain swelling), severe diarrhea and related dehydration, ear infections, or severe respiratory infections such as pneumonia.
In populations with high levels of malnutrition and a lack of adequate health care, up to 10% of measles cases result in death. Women infected while pregnant are also at risk of severe complications and the pregnancy may end in miscarriage or preterm delivery. People who recover from measles are immune for the rest of their lives.
Who is at risk?
Unvaccinated young children are at highest risk of measles and its complications, including death.
Unvaccinated pregnant women are also at risk.
Any non-immune person (who has not been vaccinated or was vaccinated but did not develop immunity) can become infected.
Severe measles is more likely among poorly nourished young children, especially those with insufficient vitamin A, or whose immune systems have been weakened
The highly contagious virus is spread by coughing and sneezing, close personal contact or direct contact with infected nasal or throat secretions.
The virus remains active and contagious in the air or on infected surfaces for up to 2 hours. It can be transmitted by an infected person from 4 days prior to the onset of the rash to 4 days after the rash erupts.
No specific antiviral treatment exists for measles virus.
Severe complications from measles can be avoided through supportive care that ensures good nutrition, adequate fluid intake and treatment of dehydration with WHO-recommended oral rehydration solution. This solution replaces fluids and other essential elements that are lost through diarrhea or vomiting. Antibiotics should be prescribed to treat eye and ear infections, and pneumonia.
All children in developing countries diagnosed with measles should receive two doses of vitamin A supplements, given 24 hours apart. This treatment restores low vitamin A levels during measles that occur even in well-nourished children and can help prevent eye damage and blindness. Vitamin A supplements have been shown to reduce the number of deaths from measles by 50%.
The measles vaccine is often incorporated with rubella and/or mumps vaccines. It is equally effective in the single or combined form.
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