Measles: General Information

by CDC

Measles: Background of disease

The disease of measles and the organism that causes it (a virus) share the same name. The disease is also called rubeola. Other rash-causing diseases often confused with measles are roseola (roseola infantum) and rubella (German measles), among others.

The virus is spread from person to person through direct contact with respiratory droplets. Measles is a disease of humans; there is no reservoir of measles virus in any other animal species.

One of the earliest written descriptions of measles as a disease was provided by an Arab physician in the 9th century who described differences between measles and smallpox in his medical notes.

A Scottish physician, Francis Home, demonstrated in 1757 that measles was caused by an infectious agent present in the blood of patients. In 1954 the virus that causes measles was isolated in Boston, Massachusetts, by John F. Enders and Thomas C. Peebles.

Measles: Incidence

In countries and regions of the world that are able to keep vaccination coverage high-- around 95%-- measles is very rare. In North and South America, Finland, and some other areas, endemic measles transmission is considered to have been interrupted through vaccination. There are still sporadic cases of measles in the United States because visitors from other countries can become infected before or during travel and spread the infection to unvaccinated or unprotected persons.

Worldwide, there are estimated to be 30 million cases and 700,000 deaths each year. More than half of the deaths occur in Africa. During 1997-1998, about 100 deaths were attributed to measles in Argentina and Brazil during large outbreaks in those countries.

Measles Vaccine (MMR)

The National Immunization Program of the Centers for Disease Control and Prevention maintains a website with many informative articles and references on measles and the MMR vaccine.

Measles: Description of "classic" measles

When reference is made to "classic" measles, it means a case of measles that follows the typical, uncomplicated clinical course that is described in medical texts on childhood illnesses. When measles was common, most physicians readily recognized the disease and the clinical diagnosis was usually accurate. A typical case of measles includes 2-3 days of respiratory symptoms- coryza, cough, conjunctivitis and fever. A maculopapular rash appears first on the hairline and over the face, moving down gradually to the trunk and limbs. The temperature may also rise during the time when rash appears. After a few days, the fever subsides and the rash fades in the order of its appearance.

Measles: Complications

About 20% of measles cases develop one or more complications, including pneumonia, which is the complication that is most often the cause of death in young children. Ear infections occur in about 1 in 10 measles cases and permanent loss of hearing can result. Diarrhea is reported in about 8% of cases.

Even in previously healthy children, measles can be a serious illness requiring hospitalization. For about 1-2 children per 1,000 children infected with measles, the disease is fatal. Measles can cause a brain infection (encephalitis) which can result in subsequent mentalimpairment or deafness. This complication occurs within two weeks of the onset of rash and is diagnosed in about one in 1,000 cases of measles.

What is SSPE? (Subacute sclerosing panencephalitis)

SSPE is a rare, but fatal degenerative disease of the central nervous system that results from a measles virus infection acquired earlier in life. The first signs of SSPE may be changes in personality, a gradual onset of mental deterioration and myoclonia (muscle spasms or jerks). The diagnosis of SSPE is based on clinical presentation as well as typical changes observed in electroencephalographs, an elevated anti-measles antibody (IgG) in the serum and cerebrospinal fluid, and typical histologic findings in brain biopsy tissue. There are variations in the progression of the various stages of the disease. In some cases, the cognitive decline may continue for years before progression to more severe neuromuscular disorders are observed, and thus the diagnosis may be delayed or missed. There are reports of remission and some treatments are treatments are available; however, the average survival is 1-2 years.

About the Author

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