Measles
Measles Key Points
- RNA paramyxovirus
- Spread via aerosol transmission (droplets)
- incubation period = 10-14 days
- Patients are infectious from 4 days before the rash to 4 days after.
- Pneumonia, otitis media and encephalopathy are well documented complications.
- SSPE is a rare fatal complication
Features
- prodrome: irritable, conjunctivitis, fever
- Koplik spots (before rash): white spots ('grain of salt') on buccal mucosa
- rash: starts behind ears then to whole body, discrete maculopapular rash becoming blotchy & confluent
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Koplik spots
Complications
- encephalitis: typically occurs 1-2 weeks following the onset of the illness)
- subacute sclerosing panencephalitis: very rare, may present 5-10 years following the illness
- febrile convulsions
- giant cell pneumonia
- keratoconjunctivitis, corneal ulceration
- diarrhoea
- increased incidence of appendicitis
- myocarditis
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| © Image used on license from DermNet NZ | |
The rash typically starts behind the ears and then spreads to the whole body
Management of contacts
- if a child not immunized against measles comes into contact with measles then MMR should be offered (vaccine-induced measles antibody develops more rapidly than that following natural infection)
- this should be given within 72 hours