Measles is a highly contagious disease caused by the measles virus, primarily transmitted through airborne droplets. The virus can survive in the air for several hours, and unvaccinated individuals who come into contact with it are at high risk of infection. The World Health Organization classifies it as a preventable infectious disease, but outbreaks still occur in some regions due to insufficient vaccination coverage.
This disease is more common in children, but adults without immunity can also be infected. Typical symptoms include high fever, cough, and characteristic red rash. Severe cases may lead to complications such as pneumonia or encephalitis. The WHO states that vaccination with the MMR vaccine (measles, mumps, rubella) is currently the most effective prevention method.
The measles virus (Measles virus) has an RNA genome encapsulated within a lipid envelope, making it highly infectious. When an infected person coughs or sneezes, the virus can remain suspended in the air. Individuals who are not immune and inhale these particles typically develop symptoms approximately 7 to 18 days later. The virus can survive in the environment for several hours, facilitating outbreaks in public or enclosed spaces.
High-risk groups include:
Additionally, regions with limited healthcare resources or communities with low vaccination rates face higher outbreak risks. The virus initially replicates in the upper respiratory tract and then spreads throughout the body, causing an overreaction of the immune system. This process can damage the respiratory system and skin.
The incubation period is approximately 10 to 14 days, with initial symptoms resembling influenza, including high fever (up to 39.5°C or higher), conjunctivitis, and cough. Patients often develop the "three Cs": cough, conjunctivitis, and Koplik spots (small white spots inside the mouth), which are important clinical indicators.
The characteristic rash appears 3 to 4 days after fever onset, starting behind the ears and gradually spreading to the entire body. The skin shows red maculopapular eruptions that may merge into larger patches and are often itchy. Severe cases may be accompanied by:
About 30% of patients develop complications, with pneumonia being the most common severe complication, and mortality in unindustrialized regions can reach 1-2%. Rarely, cases may develop subacute sclerosing panencephalitis (SSPE) years after infection, a progressive neurological disease caused by reactivation of latent virus.
Diagnosis is mainly based on clinical symptoms and epidemiological history. Physicians observe for Koplik spots and the progression pattern of skin rash, and inquire about contact history or vaccination records. Laboratory tests can confirm the diagnosis during suspected outbreaks.
Common laboratory methods include:
During diagnosis, it is important to differentiate measles from rubella, chickenpox, or other febrile rash illnesses. For example, rubella tends to be milder with posterior cervical lymphadenopathy, and chickenpox presents with vesicular rash, which is distinctly different from measles' erythematous maculopapular rash.
Currently, there are no specific antiviral drugs for measles. Treatment is supportive. Hospitalization is usually reserved for severe dehydration or pneumonia. Common management includes:
Severe cases may require intensive care monitoring and antibiotics to treat secondary bacterial infections. Importantly, vaccinated individuals who contract measles generally experience milder symptoms and have a lower risk of complications.
Vaccination is the key measure for preventing measles. The MMR vaccine (measles, mumps, rubella) provides over 97% protection after two doses. The typical schedule is the first dose at 12-15 months and a booster at 4-6 years of age.
During outbreaks, high-risk groups exposed to infected individuals may consider receiving immune globulin for immediate protection. Public health measures include:
The global initiative to eliminate measles emphasizes achieving vaccination coverage of over 95% to establish herd immunity. In recent years, vaccine hesitancy has led to decreased coverage in some areas, contributing to outbreaks.
If you develop a high fever accompanied by characteristic rash, or if you have had contact with a confirmed case and develop a fever, seek medical attention immediately. Emergency situations include:
Pregnant women, immunocompromised individuals, or infants under 6 months with suspected symptoms should seek urgent medical care. Even vaccinated individuals should be evaluated if they develop atypical symptoms after exposure.
After receiving the live attenuated measles vaccine, about 5% of people may develop a mild rash within 2-3 weeks. This is a normal reaction caused by the vaccine strain and does not indicate actual infection. Usually, no treatment is needed, and the rash resolves on its own within a few days. However, other serious symptoms should still be monitored.
Are there other ways to prevent infection after exposure to a measles patient?Within 72 hours of exposure, administering measles immune globulin (MMR immunoglobulin) can reduce the risk of infection, especially in unvaccinated infants or immunocompromised individuals. If already vaccinated, protection is usually adequate, but symptoms should still be observed.
Will measles leave permanent damage after recovery?Most patients recover without sequelae, but severe complications such as encephalitis or intrauterine infections can cause neurological damage. Young or immunocompromised patients are at higher risk. Post-recovery, regular health follow-up is recommended to ensure no long-term effects.
What are the effects of measles infection during pregnancy on the fetus?Infection during pregnancy may increase the risk of miscarriage or preterm birth, and intrauterine infection can cause fetal developmental abnormalities. If infection is suspected, immediate medical consultation and reporting to health authorities are advised. Vaccination should be avoided until after delivery.
Why do measles patients need to be isolated until four days after rash onset?Measles virus is highly contagious from two days before to four days after rash appearance. During this period, droplets from coughing or contact with contaminated surfaces can spread the virus. Isolation until four days after rash onset effectively prevents transmission, especially in enclosed or densely populated areas.
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