Causes and Symptoms (Magill’s Medical Guide, Sixth Edition)
Measles is a highly contagious viral disease characterized by a maculopapular (pimply) rash that develops on the skin and spreads rapidly over much of the cutaneous surface of the body. Measles virus is classified with the paramyxoviruses, a class of viruses in which ribonucleic acid (RNA) serves as the genetic material. Closely related viruses in the same group include rinderpest and distemper virus, agents associated with disease in ruminants such as cows and in dogs or cats, respectively. It is likely that measles originated when one of these other animal viruses became adapted to humans several thousand years ago.
In modern times but before the advent of measles vaccination, measles was a common disease of childhood, usually appearing between the ages of five and ten. The illness is among the most contagious of infections, and the virus was generally spread among children in schools. Widespread immunization of children, begun in the 1960’s, tended to push the age of exposure into the teenage years. Most outbreaks since the 1980’s have occurred among college students. Since recovery from the disease confers lifelong immunity, infection among older adults is infrequent. In developing nations, places where vaccination may be haphazard, measles is still a disease of early childhood; malnutrition and related problems of poverty have resulted in a significant level of mortality among infected children.
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Treatment and Therapy (Magill’s Medical Guide, Sixth Edition)
No specific treatment for measles is available; therapy consists of symptomatic intervention. Bed rest is recommended, and the patient should not come into contact with persons not previously exposed to the virus through either natural infection or immunization.
Itching of the rash is common and may be treated with cool water or the standard regimen of cornstarch or baking soda applications. The most common complications result from secondary bacterial infections, which generally take the form of otitis media (middle-ear infection), pharyngitis, or pneumonia. Appropriate use of antibiotics is usually sufficient to prevent or treat such complications.
Immunization with the measles virus may be either passive or active. Children less than one year of age and patients who are immunocompromised or chronically ill may be protected if human immunoglobulin is administered within a week after exposure. While effective immunity is short term, it is capable of protecting these individuals during this period. Since no active disease or infection develops, however, immunity to future infection remains minimal in these cases.
During the early 1960’s, an effective vaccine was developed to immunize children against measles. The vaccine consists of an attenuated form of the virus. Although early forms of the vaccine were inconsistent in producing a lifelong immunity, they were effective in decreasing the prevalence of...
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Perspective and Prospects (Magill’s Medical Guide, Sixth Edition)
The origin and early history of measles is uncertain, as the first authentic description of measles as a specific entity was that by the Arab physician al-Razi (Rhazes) in a 910 c.e. treatise on smallpox and measles. Rhazes quoted earlier work by the Hebrew physician El Yehudi, so it is likely that familiarity with these respective illnesses had existed for some time.
Measles is entirely a human disease, with no known animal reservoir. Consequently, the paucity of human populations of sufficient size to maintain transmission means that the spread of such an epidemic disease would have been unlikely before 2500 b.c.e. It is probable that the disease entered the human species through adaptation of the similar animal viruses of rinderpest or distemper. The absence of any description of a disease like measles in the writings of Hippocrates (c. fourth century b.c.e.) likewise renders it unlikely that the disease was widespread before that date.
Epidemic disease with a rash characteristic of measles is known to have spread through the Roman Empire during the early centuries of the common era. The difficulty in differentiating measles from smallpox by the physicians of the time contributes to the difficulty in understanding the history of the illness. It is certain that by the time of Rhazes, measles had become common in the population.
The terminology of measles lent further confusion during the Middle Ages....
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For Further Information: (Magill’s Medical Guide, Sixth Edition)
American Medical Association. American Medical Association Family Medical Guide. 4th rev. ed. Hoboken, N.J.: John Wiley & Sons, 2004. An excellent general source for information about illnesses and questions about medical problems.
Bernstein, David, and Gilbert Schiff. “Viral Exanthems and Localized Skin Infections.” In Infectious Diseases, edited by Sherwood L. Gorbach, John G. Bartlett, and Neil R. Blacklow. Philadelphia: W. B. Saunders, 2004. This book contains extensive discussions of bacterial and viral illnesses. The section addressing measles contains much information about the symptoms and progression of the disease.
Biddle, Wayne. A Field Guide to Germs. 2d ed. New York: Anchor Books, 2002. This comprehensive book is easily accessible to the nonspecialist and includes a discussion of nearly every virus, bacterium, and fungus known to cause human and nonhuman animal disease. The history of the microbe and the treatment of diseases are included.
Kiple, Kenneth F., ed. The Cambridge World History of Human Disease. New York: Cambridge University Press, 1999. In addition to being an encyclopedia describing human diseases, this book provides an epidemiological history of disease and discusses possible origins and treatments. The authors target a general population.
Madigan, Michael T., and John M. Martinko. Brock Biology of Microorganisms....
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Measles (Encyclopedia of Medicine)
Measles is an infection, caused by a virus, which causes an illness displaying a characteristic skin rash. Measles is also sometimes called rubeola, 5-day measles, or hard measles.
Measles infections appear all over the world. Prior to the current effective immunization program, large-scale measles outbreaks occurred on a two to three-year cycle, usually in the winter and spring. Smaller outbreaks occurred during the off-years. Babies up to about eight months of age are usually protected from contracting measles, due to immune cells they receive from their mothers in the uterus. Once someone has had measles infection, he or she can never get it again.
Causes and symptoms
Measles is caused by a type of virus called a paramyxovirus. It is an extremely contagious infection, spread through the tiny droplets that may spray into the air when an individual carrying the virus sneezes or coughs. About 85% of those people exposed to the virus will become infected with it. About 95% of those people infected with the virus will develop the illness called measles. Once someone is infected with the virus, it takes about 7-18 days before he or she actually becomesill. The most contagious time period is the three to five days before symptoms begin through about four days after...
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Measles (Encyclopedia of Children's Health)
Measles is an infection caused by a virus, which causes an illness displaying a characteristic skin rash known as an exanthem. Measles is also sometimes called rubeola, five-day measles, or hard measles.
Measles is a very contagious disease primarily characterized by cough, runny nose, red eyes (conjunctivitis), and a characteristic rash on the skin and inside of the cheeks. The most common complications are ear infection and diarrhea, although more serious complications can include pneumonia, meningitis, or encephalitis. Measles is fatal (due to complications) in about two out of every 1,000 cases.
Measles infections appear all over the world. Prior the effective immunization program used in the early 2000s, large-scale measles outbreaks occurred on a two to three-year cycle, usually in the winter and spring. Smaller outbreaks occurred during the off years. Babies up to about eight months of age are usually protected from contracting measles, due to immune cells they receive from their mothers in the uterus. Once someone has had measles infection, he or she can never get it again....
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Measles (Encyclopedia of Alternative Medicine)
Measles is a viral infection that causes an illness displaying a characteristic skin rash known as an exanthem. Measles is also sometimes called rubeola, five-day measles, or hard measles.
Measles infections appear all over the world. Incidence of the disease in the United States is down to a record low and only 86 confirmed cases were reported in the year 2000. Of these, 62% were definitely linked to
foreigners or international travel. Prior to the current effective immunization program, large-scale measles outbreaks occurred on a two to three year cycle, usually in the winter and spring. Smaller outbreaks occurred during the off-years. Babies up to about eight months of age are usually protected from contracting measles, due to antibodies they receive from their mothers in the uterus. Once someone has had measles, he or she can never get it again.
Causes & symptoms
Measles is caused by a type of virus called a paramyxovirus. It is an extremely contagious...
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Measles (Encyclopedia of Public Health)
Measles is a viral respiratory illness characterized by high fever and generalized rash. Symptoms start ten to twelve days after airborne exposure and include fever, malaise, conjunctivitis, runny nose, and cough. About fourteen days after exposure, a maculopapular rash appears at the hairline, extends to the face and upper neck, and, over the next three days, spreads down the body to the hands and feet. Although measles is usually not severe in developed countries, it can lead to serious complications including diarrhea (8% of cases), ear infections (7%), pneumonia (6%), encephalitis (0.1%), subacute sclerosing panencephalitis (SSPE)(0.001%), and death (0.2%). Measles is much more serious in developing countries, causing about one million deaths annually during the 1990s. The case fatality rate can be as high as 25 percent, with deaths often caused by secondary infections such as diarrhea or pneumonia. Measles is also a common cause of blindness in the developing world.
Measles is one of the most contagious diseases in the world. The virus, a paramyxovirus containing a single strand of RNA, is normally spread through respiratory droplets and can be transmitted from four days before to four days after rash onset. Before vaccines were introduced, nearly everyone was infected by age ten to twelve years. Immunity is lifelong following infection.
A live attenuated vaccine was licensed in 1963, and further attenuated vaccines are now used around the world. The vaccine is about 95 percent effective in the United States when administered at the recommended age of twelve to fifteen months, and immunity is considered lifelong. It is usually given in conjunction with the mumps and rubella vaccines. Children in developing countries are vaccinated at nine months of age because of the higher risk of infection in infancy.
Routine treatment of measles includes supportive care such as oral rehydration therapy for diarrhea and respiratory care for patients with pneumonia. Antibiotics are used to treat secondary bacterial infections. Although antiviral medications have been used to treat complex measles infections, there are few studies to confirm their effectiveness. High-dose vitamin A therapy reduces mortality and prevents blindness and is recommended by the World Health Organization for children in developing countries.
Global measles eradication has been a goal since the development of an effective vaccine. Humans are the only reservoir for the measles virus, which can survive only hours in the environment. Endemic measles can be eliminated from large geographic areas using intensive vaccination programs, as seen in the United States in the late 1990s. However, measles is so infectious that immunization rates of at least 90 to 95 percent must be attained to interrupt transmission. In addition, the billions of doses required to achieve eradication highlight the need for injection safety and the potential development of needle-free vaccination methods. Finally, the HIV (human immunodeficiency virus) epidemic presents several barriers to measles eradication. HIV-infected persons have a lower response to measles vaccination, develop more severe cases of the disease, and, theoretically, may be infectious for longer periods of time. There is hope that these challenges will be surmounted and measles will be eradicated, following smallpox into the history books.
(SEE ALSO: Communicable Disease Control; Disease Prevention; Eradication of Disease; Immunizations)
Atkinson, W.; Wolfe, C.; Humizter, S.; and Nelson, R., eds. (2000). "Measles." In Epidemiology and Prevention of Vaccine-Preventable Diseases: The Pink Book. Atlanta, GA.: U.S. Department of Health and Human Services.
Redd, S. C.; Markowitz, L. E.; and Katz, S. L. (1999). "Measles Vaccine." In Vaccines, eds. S. A. Plotkin and W. A. Orenstein. Philadelphia, PA: W. B. Sanders.
Measles (World of Microbiology and Immunology)
Measles is an infectious disease caused by a virus of the paramyxovirus group. It infects only man and the infection results in life-long immunity to the disease. It is one of several exanthematous (rash-producing) diseases of childhood, the others being rubella (German measles), chicken pox, and the now rare scarlet fever. The disease is particularly common in both pre-school and young school children.
The measles virus mainly infects mucous membranes of the respiratory tract and the skin. The symptoms include high fever, headache, hacking cough, conjunctivitis, and a rash that usually begins inside the mouth on the buccal mucosa as white spots, (called Koplik's spots) and progresses to a red rash that spreads to face, neck, trunk and extremities. The incubation period varies but is usually 10 to 12 days until symptoms appear. Four to five days before the onset of the rash, the child has fever or malaise and then may develop a sore throat and cough. The duration of the rash is usually five days. The child is infectious throughout the prodromal (early) period and for up to four days after the first appearance of the rash. The virus is highly contagious and is transmitted through respiratory droplets or though direct contact. Measles is also sometimes called rubeola or the nine-day measles.
Although certain complications can arise, in the vast majority of cases, children make a full recovery from measles. Acute local complications can occur if there is a secondary infection, for example pneumonia due to bacteria such as staphylococci, Streptococcus pyogene, pneumococci, or caused by the virus itself. Also, ear infections and secondary bacterial otitis media can seriously aggravate the disease. Central nervous system (CNS) complications include post-measles encephalitis, which occurs about 10 days after the illness with a significant mortality rate. Also, sub-acute sclerosing panencephalitis (SSPE), a rare fatal complication, presents several years after the original measles infection. Because hemorrhagic skin lesions, viraemia, and severe respiratory tract infection are particularly likely in malnourished infants, measles is still frequently a life-threatening infection in Africa and other underdeveloped regions of the world. The microbiological diagnosis of measles is not normally required because the symptoms are characteristic. However, if an acute CNS complication is suspected, paired sera are usually sent for the estimation of complement fixing antibodies to measles. If SSPE is suspected, the measles antibody titres in the CSF (determining the level of antibodies present) are also estimated.
Epidemiological studies have shown that there is a good correlation between the size of a population and the number of cases of measles. A population of at least 500,000 is required to provide sufficient susceptible individuals (i.e. births) to maintain the virus within the population. Below that level, the virus will eventually die out unless it is re-introduced from an outside source. On the geological time-scale, man has evolved recently and has only existed in large populations in comparatively modern times. In the past, when human beings lived in small populations, it is concluded that the measles virus could not exist in its present form. It may have had another strategy of infection such as to persist in some form and infect the occasional susceptible passer-by, but this remains unproven. It has been suggested that the modern measles virus evolved from an ancestral animal virus, which is also common to the modern canine distemper and the cattle disease rinderpest. This theory is based on the similarities between these viruses, and on the fact that these animals have been commensal (living in close proximity) with man since his nomadic days. The ancestral virus is thought to have evolved into the modern measles virus when changes in the social behavior of man gave rise to populations large enough to maintain infection. This evolutionary event would have occurred within the last 6000 years when the river valley civilizations of the Tigris and Euphrates were established. To our knowledge, measles was first described as a disease in ninth century when a Persian physician, Rhazes, was the first to differentiate between measles and smallpox. The physician Rhazes also made the observation that the fever accompanying the disease is a bodily defense and not the disease itself. His writings on the subject were translated into English and published in 1847.
The measles virus itself was first discovered in 1930, and John F. Enders of the Children's Hospital in Boston successfully isolated the measles virus in 1954. Enders then began looking for an attenuated strain, which might be suitable for a live-virus vaccine. A successful immunization program for measles was begun soon after. Today measles is controlled in the United States with a vaccination that confers immunity against measles, mumps, and rubella and is commonly called the MMR vaccine. Following a series of measles epidemics occurring in the teenage population, a second MMR shot is now sometimes required by many school-age children as it was found that one vaccination appeared not to confer life-long immunity.
In October 1978, the Department of Health, Education, and Welfare announced their intention of eliminating the measles virus from the U.S.A. This idea was inspired by the apparently successful global elimination of smallpox by the World Health Organization vaccination program, which recorded its last smallpox case in 1977.Death from measles due to respiratory or neurological causes occurs in about 1 out of every 1000 cases and encephalitis also occurs at this frequency, with survivors of the latter often having permanent brain damage. Measles virus meets all the currently held criteria for successful elimination. It only multiplies in man; there is a good live vaccine (95 % effective) and only one sero-type of the virus is known. Usually measles virus causes an acute infection but, rarely (1 out of every million cases), the virus persists and reappears some 2-6 years causing SSPE. However, measles virus can only be recovered with difficulty from infected tissue and
See also Antibody-antigen, biochemical and molecular reactions; History of immunology; History of public health; Immunity, active, passive and delayed; Immunology; Varicella; Viruses and responses to viral infection