Disease Information for Measles (rubeola): Definition

Measles is a childhood exanthem, caused by an RNA virus called Morbillivirus, belonging to the family Paramyxoviridae; SYNONYM; Rubeola; ICD-9CM CODES: 055.9 Measles; 055.0 Encephalitis;055.1 Pneumonia; V04.2 Vaccination; Before the introduction of an effective vaccine in 1963, measles was one of the most common childhood illnesses, and in developing countries, where it strikes mostly children under age 5 yr, it remains a leading cause of childhood mortality; In developed countries, measles outbreaks occur occasionally in adolescents and young adults who have not been immunized; Incubation: 10 to 14 days (up to 3 wk in adults); Prodrome: 2 to 4 days; malaise, fever, rhinorrhea, conjunctivitis, cough; Exanthem phase: 7 to 10 days; The fever increases and peaks at 104° to 105° F together with the rash; it persists for 5 or 6 days. The patient’s fever decreases over 24 hr; Rash: Erythematous maculopapular eruption begins behind the ears, progresses to the forehead and neck (Fig 1-240), then spreads to face, trunk, upper extremities, buttocks, and lower extremities in that order; After 3 days the rash fades in the same sequence by becoming copper brown and then desquamates; Enanthem: Koplik spots are white papules of 1 to 2 mm in diameter or an erythematous base; They first appear on the buccal mucosa opposite the lower molar 2 days before the rash and spread over 24 hours to involve most of the buccal and lower labial mucosa; They fade after 3 days; Other symptoms and signs: malaise, anorexia, vomiting, diarrhea, abdominal pain, pharyngitis, lymph-adenopathy, and occasional splenomegaly; Atypical measles (in vaccinated persons); Incubation: 10 to 14 days; Prodrome: 1 to 3 days; high fever and headache; Rash: maculopapular, urticarial, or petechial rash that begins peripherally and progresses centrally; Modified measles applies to patients who have received immune serum globulin and develop a milder illness; Complications:Otitis media; Laryngitis, tracheitis; Pneumonia (accounts for 90% of measles deaths); Encephalitis with lethargy, irritability, and seizures; 60% recover completely, 25% have neurologic sequelae (mental retardation, hemiplegia, paraplegia, epilepsy, deafness), and 15% die; Myocarditis, pericarditis, and hepatitis; Complications more common in immunocompromised hosts and persons with AIDS [Ferri Clinical Advisor]-----------------------------------------.

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