Rubeola
Also known as measles or morbilli, rubeola is an acute, highly contagious paramyxovirus infection. It’s one of the most common and the most serious of all communicable childhood diseases.
In temperate zones, incidence is highest in late winter and early spring.
Before the availability of measles vaccine, epidemics occurred every 2 to 5 years in large urban areas. Use of the vaccine has reduced the occurrence of measles during childhood; as a result, measles is becoming more prevalent in adolescents and adults. (See Administering measles vaccine.)
Before the availability of measles vaccine, epidemics occurred every 2 to 5 years in large urban areas. Use of the vaccine has reduced the occurrence of measles during childhood; as a result, measles is becoming more prevalent in adolescents and adults. (See Administering measles vaccine.)
Measles remains a major cause of death in children in underdeveloped countries.
Causes
Measles is spread by direct contact or by contaminated airborne respiratory droplets. The portal of entry is the upper respiratory tract.
Signs and symptoms
Incubation is from 10 to 14 days.
Prodromal phase
Initial symptoms begin and greatest communicability occurs during a prodromal phase beginning about 11 days after exposure to the virus. This phase lasts from 4 to 5 days; signs and symptoms include fever, photophobia, malaise, anorexia, conjunctivitis, coryza, hoarseness, and hacking cough.
At the end of the prodrome, Koplik’s spots, the hallmark of the disease, appear. These spots look like tiny, bluish gray specks surrounded by a red halo. They appear on the oral mucosa opposite the molars and occasionally bleed.
Progressive symptoms
About 5 days after Koplik’s spots appear, temperature rises sharply, spots slough off, and a slightly pruritic rash appears. This characteristic rash starts as faint macules behind the ears and on the neck and cheeks.
These macules become papular and erythematous, rapidly spreading over the entire face, neck, eyelids, arms, chest, back, abdomen, and thighs. When the rash reaches the feet (2 to 3 days later), it begins to fade in the same sequence it appeared, leaving a brownish discoloration that disappears in 7 to 10 days.
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