Overview of Measles in Children

Measles vaccine
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Health experts hope to one day eradicate measles like they did for smallpox and are close to doing for polio.


Despite having measles in their target, measles is unfortunately still a big killer around the world.

In fact, the virus that causes measles is the leading cause of vaccine-preventable death in children, leading to over 400,000 deaths each year in kids under age five.

Measles is a type of paramyxovirus, is highly contagious and unfortunately, we are continuing to see cases and outbreaks, even in the United States.

After a recent record of 140 cases in 2008, we approached new records in 2011, with the most cases since 1996.

Measles Symptoms

Because measles is relatively uncommon in the United States, parents and health professionals aren't always quick to recognize measles symptoms. However, since measles is still so common in the rest of the world, and we still have regular measles outbreaks in the United States, it is important to think about measles, especially if your child hasn't had a measles vaccine, has traveled outside the United States, or has been exposed to someone who has.

Symptoms of measles usually begin about 10 to 12 days after exposure to someone with measles (this incubation period can range from 7 to 18 days) and can include:

  • fever (which begins as a low-grade fever and then continues to increase each day, until it reaches its peak of 104 or 105 F on the fourth or fifth day of being sick, and then breaks a few days later)
  • malaise (not feeling good)
  • irritability
  • coryza (sneezing, runny nose, and congestion)
  • cough
  • conjunctivitis (pink eye)
  • Koplik's spots (small bright red spots with a white center, which are found on the inside of a child's mouth, usually on the insides of the cheeks, and which are a classic symptom of measles)

Another classic symptom of measles is that these children develop a rash on the fourth day that they are sick. The measles rash begins at a child's hairline with small red flat and raised (maculopapular) spots and then spreads down to their face, arms, and trunk. By the third day after the rash appeared, it spreads down the child's legs to their feet. Once the rash begins to go away, the pattern reverses itself, as it goes away first on the child's face and upper chest, and on his legs and feet last.

The symptoms usually peak on about the fifth day after they began, and then most symptoms go away over the next 3 to 5 days. The cough may linger for a few weeks, though.

Keep in mind that unlike some other viral infections, when a child has measles, their fever usually continues when they develop the rash. In fact, the child may appear most ill during the first few days that the rash appears, and may not feel better until a few days later when the fever breaks.

Measles Treatments

Unfortunately, there is no cure for measles. Besides vitamin A for malnourished children with measles, there aren't any real measles treatments either.

Instead, treatments for measles focus on the basic treatments like for when any child is sick with a serious illness, such as bed rest, fluids, and fever reducers, like acetaminophen and ibuprofen.

Measles Complications

Although some people continue to claim that measles is a mild infection, it can have severe complications. Because of the high fever and irritability, many children end up requiring hospitalization.

Most children do recover from measles, even without treatment, but some do unfortunately have complications, which can range from ear infections and pneumonia to acute encephalomyelitis (inflammation in the brain and spinal cord that can lead to seizures, deafness, and brain damage).

And unfortunately, some children with measles die.

Measles complications can include:

  • diarrhea - 8% of cases
  • ear infections - 7% of cases
  • pneumonia - 6% of cases
  • encephalitis - 0.1% of cases
  • seizures - 0.6 to 0.7% of cases
  • death - 0.2% of cases

Even with a full recovering, people who have had measles are at later of risk for developing subacute sclerosing panencephalitis (SSPE), a rare cause of degenerative brain damage caused by a persistent measles infection.

What To Know About Measles

  • German measles is actually a totally different viral infection -- rubella -- which is also called 3-day measles. To confuse things more, measles is also known as rubeola.
  • While measles is literally just a plane ride away in the rest of the world, it can be even closer than that. In 2008, 140 measles cases were reported in the United States, as children were exposed to measles at airports, on airplane trips, at grocery stores, school, hospitals, and even in their pediatrician's office, as other people with measles unknowingly exposed people. A more recent, even larger measles outbreak was linked to Disneyland.
  • A measles vaccine has been available since 1963. It is now given as part of the MMR vaccine when children are 12 to 15 months old and then again when they are 4 to 6 years old. Kids who will be traveling overseas should get their MMR doses early though.
  • Although it is still a worry for some parents, according to the Centers for Disease Control and Prevention (CDC), several large "studies have found no relationship between MMR vaccine and autism."

CDC. Vaccine Safety Concerns. Measles, Mumps, and Rubella (MMR) Vaccine and Autism Fact Sheet.

Gershon: Krugman's Infectious Diseases of Children, 11th ed.

Plotkin: Vaccines, 5th ed.