Measels (rubeola)

Sites

  • Eyes
  • Oral mucosa
  • Lungs
  • Brain
  • Middle ear

Etiology

  • Viral infection that's spread thru respiratory droplets
  • Highly contagious

Risk Factors

  • Too young to be vaccinated (<1y)
  • Never vaccinated - either not offered or opted out
  • History of exposure to someone w/Measels, travel to country w/low vaccination rates -- and patient never vaccinated or didn't respond to vaccination
  • Main seasons: winter/spring in US
  • Higher risk for complications if malnourished, chronically ill, under resourced environments, infants, immunocompromised, pregnancy

Symptoms

  • Incubation period 7-14d
  • Then prodome lasting 2-4 days of fever, cough, conjunctivitis, runny nose, malaise
  • Erythematous macular/papular rash, starting 2-4d after fever
  • Rash tends to appear first on head/face, then trunk and extremities; can be confluent
  • Over next 3-5 days, rash fades, typically in the order in which it appeared
  • In uncomplicated cases, full recovery within 7 days of onset rash
  • Complications include: otitis media (7-9%); pneumonia (1-6%); diarrhea (8%); post infections encephalitis (.1%); death (.1%); subacute sclerosing panencephalitis (.01%) --> progressive degenerative dz w/onset 5-10 y after infection

Physical Exam Findings

  • High fever
  • Conjunctivitis, runny nose
  • Blue-white (Koplick's) plaques on oral mucosa occur in up to 70%; If complications: otitis media, lung findings of pneumonia, confusion/altered mental status/neuro deficits with encephalitis

Tests

Links