measles Measles is an acute respiratory disease caused by infection with the measles virus. It is a self-limiting disease and highly contagious. Typical symptoms of measles usually include high fever, cough, runny nose, watery eyes, and oral mucosal spots. Generalized maculopapular rash appears 3-5 days after the onset of initial symptoms, with higher fever during the rash period. Most individuals acquire lifelong immunity after the illness. Common complications include pneumonia, laryngitis, and others.

Measles is an acute respiratory disease caused by infection with the measles virus, and it is a self-limiting disease with high infectivity. Typical symptoms of measles usually include high fever, cough, runny nose, watery eyes, and oral mucosal spots. After the initial symptoms appear, a widespread rash develops 3 to 5 days later, with an increase in fever during the rash period. Most individuals develop lifelong immunity after the illness. Common complications include pneumonia and laryngitis.

The measles virus is the pathogen responsible for measles and is known to be one of the most infectious agents. Humans are the only known hosts of the measles virus. In the early stages of infection, about 2 to 3 days after the measles virus invades the body, the virus replicates extensively in the respiratory tract. Infected individuals can spread the virus through coughing, sneezing, or talking, and the infected secretions can be released into the air or onto surfaces, potentially infecting others through contact or inhalation.

The measles virus has a weak survival capability outside the human body and is not heat-resistant. It can be rapidly inactivated by ultraviolet light, high temperatures, acidic solutions, ether, and trypsin. The virus expelled in droplets can survive indoors for at least 32 hours, but it loses its viability within half an hour in circulated air or sunlight.

Typical Symptoms during Incubation Period

The incubation period of measles typically lasts 6 to 18 days, with an average of around 10 days. At the end of the incubation period, individuals may experience low-grade fever or general discomfort.

Prodromal Symptoms

Usually lasting 3 to 4 days, the main symptoms include fever, cough, sneezing, and congestion in the upper respiratory tract. There may also be conjunctival congestion, teary eyes, and photophobia, among other signs of conjunctivitis.

Measles Mucosal Spots: This is a specific early sign of measles, often appearing 1 to 2 days before the rash. They initially manifest as small grayish-white spots the size of sand grains on the buccal mucosa opposite the upper and lower molars, surrounded by erythema. They rapidly increase in number within 1 to 2 days and gradually disappear after the rash appears.

Other manifestations include general malaise, loss of appetite, and lethargy, among others. Infants may experience symptoms such as vomiting and diarrhea.

Rash Period Symptoms

The measles rash typically appears 3 to 4 days after the onset of fever, starting on the face and then spreading downward to the trunk and limbs, eventually reaching the palms and soles, although these areas are rarely affected. The rash initially presents as blanching erythematous maculopapular eruptions, without pruritus, which later coalesce into patches, darken in color, and may have petechiae. Other symptoms worsen during the rash period, and body temperature can rise to as high as 40°C. The fever reaches its peak 2 to 3 days after the rash appears, coughing intensifies, and affected children may become lethargic or irritable.

Recovery Period Symptoms

If no complications occur, fever begins to subside 3 to 4 days after the rash appears, and overall systemic symptoms such as appetite and mental state gradually improve. The rash begins to fade in the order it appeared, leaving behind brownish pigmentation and possibly desquamation, and typically disappears completely within 7 to 10 days.

Atypical Measles Symptoms

Mild Measles Symptoms

Similar to typical measles, but with milder clinical symptoms. The main characteristics include transient fever, mild ocular and nasal symptoms, overall good condition, absence of measles mucosal spots, sparse and faint rash that disappears quickly, and no pigmentation or desquamation after the rash subsides, with no complications.

Severe Measles Symptoms

Persistent high fever, severe systemic toxicity, accompanied by convulsions and coma. Dense and merging rash, often presenting as purplish-blue hemorrhagic eruptions, may be accompanied by mucosal and gastrointestinal bleeding, or hemoptysis, hematuria, thrombocytopenia, and other symptoms. Children with this type of measles often have complications such as pneumonia, heart failure, and a high mortality rate.

Atypical Measles Symptoms

Persistent fever, fatigue, myalgia, headache, or accompanied by edema in the limbs, atypical rash, irregular rash appearance, and a tendency to develop pneumonia. This type is rare.

When caring for a measles patient, supportive treatment is essential, and parents need to provide good home care:

Ensure the patient gets plenty of rest and maintains adequate fluid intake, including water, fruit juice, electrolytes, to replenish fluids lost due to fever and sweating.

Use a humidifier to relieve cough and throat pain symptoms.

Take care to protect the eyes and allow them to rest. If there is discomfort such as photophobia, reduce the brightness of lights, draw the curtains, or wear sunglasses, and avoid reading or watching television.

Prevention After Exposure

Protective measures can be taken for susceptible individuals who may be at risk of severe consequences after infection.

Vaccination after Exposure

If susceptible individuals, such as infants who have never been vaccinated, come into contact with the measles virus, they can receive measles vaccination within 72 hours to prevent infection. If measles still develops after vaccination, the symptoms are generally milder, and the duration of illness is shorter.

Human Immunoglobulin

For pregnant women, infants, and individuals with weakened immune systems who are exposed to the measles virus, a doctor may recommend injecting human immunoglobulin to enhance resistance. When injected within 6 days after virus exposure, these antibodies can prevent or alleviate measles symptoms.

Immunization

Vaccination is the most effective method for preventing measles, and it is recommended for both children and adults. In China, measles-rubella vaccine (MR) and measles-mumps-rubella vaccine (MMR) have been included in the childhood immunization program.

Vaccination

Vaccination is the best means of preventing measles.