Measles | Understanding and definition of Measles | Need for measles vaccination as early as possible

Measles is a highly contagious disease. It is caused by a virus—an extremely tiny organism that can only reproduce itself by residing within living cells. Humans are the only living creatures who can develop measles, and they can only get it if they are exposed to the measles virus.

The most common way that people get infected with the disease is by breathing in tiny droplets of water vapor containing the measles virus. An uninfected person can get measles just by breathing the air in a room that was previously occupied by an infected person. The measles virus can live in the air for two hours after an infected person leaves the room. People can also get measles if they have direct contact with fluid from the nose or mouth of an infected person.

Once introduced into a person's respiratory system, the measles virus proceeds to attach itself to the lining of the airways. Drawing energy from this new host, the virus begins to multiply and spread throughout the body.

Symptoms of Measles

About ten to fourteen days after exposure to the measles virus, people infected with measles will get a rash, high fever, cough, runny nose, and watery eyes. The eye symptoms can develop into conjunctivitis (pink eye), a condition that causes swelling and redness of the eye, tearing, and sensitivity to light. The skin rash often takes the form of bright red spots that are distinct and separate from each other. They may multiply so rapidly, however, that they appear to be a solid red mass. The rash usually starts behind the ears and along the hairline, and then quickly spreads to the rest of the face, moving downward to the rest of the body. In addition to this red rash, light spots resembling grains of salt may appear on the inside of the patient's cheeks near the back of the mouth. Doctors call these Koplik's spots. These typical measles symptoms last for one to two weeks.

Most people recover from measles within ten to fourteen days. After they are well again, they are no longer contagious, which means they can no longer infect other people with the disease. In addition, people who have had measles develop an immunity to it—they will never catch measles again, even if someone with the disease sneezes or coughs right in their face.

Complications of Measles

For most people who are otherwise healthy and well nourished, measles is not a serious illness. However, a small percentage of those who get the disease suffer complications that can be painful or even deadly. These complications are the reason the U.S. Centers for Disease Control and Prevention (or the CDC, which is in charge of tracking and controlling the spread of disease in the United States) strongly recommends that all children be vaccinated against measles. Vaccination involves the injection of a weakened form of the measles virus into a person's body. Following the injection, the virus grows and causes a harmless infection in the vaccinated person, who shows very few, if any, symptoms. The person's immune system fights the mild infection caused by the weakened measles virus and an immunity to the disease develops that lasts throughout that person's life. Complications of measles can include:

1. Ear infections: Most people have experienced at least one ear infection in their lives. These are sometimes painful and occur when germs multiply in the ear.
2. Pneumonia: This is an infection or inflammation of lung tissue. Pneumonia can occur in many different diseases and can be mild or very serious, even fatal.
3. Bronchitis: Bronchitis is an inflammation and congestion of the bronchial tubes that lead into the lungs.
4. Diarrhea: This condition is characterized by frequent and loose bowel movements.

There is no specific treatment for measles. Most patients with uncomplicated measles will recover with rest and supportive treatment. It is, however, important to seek medical advice if the patient becomes more unwell, as they may be developing complications.

Some patients will develop pneumonia as a sequel to the measles. Other complications include ear infections, bronchitis, and encephalitis. Acute measles encephalitis has a mortality rate of 15%. While there is no specific treatment for measles encephalitis, antibiotics are required for bacterial pneumonia, sinusitis, and bronchitis that can follow measles.

All other treatment addresses symptoms, with ibuprofen, or acetaminophen (paracetamol) to reduce fever and pain and, if required, a fast-acting bronchodilator for cough. As for aspirin, some research has suggested a correlation between children who take aspirin and the development of Reye's syndrome. Some research has shown aspirin may not be the only medication associated with Reye's, and even antiemetics have been implicated, with the point being the link between aspirin use in children and Reye's syndrome development is weak at best, if not actually nonexistent. Nevertheless, most health authorities still caution against the use of aspirin for any fevers in children under 16

The use of vitamin A in treatment has been investigated. A systematic review of trials into its use found no significant reduction in overall mortality, but it did reduce mortality in children aged under two years.

While the vast majority of patients survive measles, complications occur fairly frequently, and may include bronchitis, and panencephalitis which is potentially fatal. Also, even if the patient is not concerned about death or sequela from the measles, the person may spread the disease to an immunocompromised patient, for whom the risk of death is much higher, due to complications such as giant cell pneumonia. Acute measles encephalitis is another serious risk of measles virus infection. It typically occurs two days to one week after the breakout of the measles exanthem, and begins with very high fever, severe headache, convulsions, and altered mentation. Patient may become comatose, and death or brain injury may occur.