Measles

Measles, also called rubeola, acute, highly contagious, fever-producing disease caused by a filterable virus, different from the virus that causes the less serious disease German measles, or rubella. Measles is characterized by small red dots appearing on the surface of the skin, irritation of the eyes (especially on exposure to light), coughing, and a runny nose. About 12 days after first exposure, the fever, sneezing, and runny nose appear. Coughing and swelling of the neck glands often follow. Four days later, red spots appear on the face or neck and then on the trunk and limbs. In two or three days the rash subsides and the fever falls; some peeling of the involved skin areas may take place. Infection of the middle ear may also occur.

Measles was formerly one of the most common childhood diseases. Since the development of an effective vaccine in 1963, it has become much less frequent. By 1988 annual measles cases in the United States had been reduced to fewer than 3,500, compared with about 500,000 per year in the early 1960s. However, the number of new cases jumped to more than 18,000 in 1989 and to nearly 28,000 in 1990. Most of these cases occurred among inner-city preschool children and recent immigrants, but adolescents and young adults, who may have lost immunity (see Immunization) from their childhood vaccinations, also experienced an increase. The number of new cases declined rapidly in the 1990s and early 21st century, and by 2004 fewer than 40 cases were reported in the United States. The reasons for this resurgence and subsequent decline are not clearly understood.

In other parts of the world measles is still a common childhood disease, and in developing countries it kills as many as 30 percent of the children it infects. A global campaign began in 2001 to immunize children and reduce the number of deaths from the disease. In 2006 the World Health Organization (WHO) reported that the number of measles deaths worldwide had dropped by 60 percent, from 873,000 per year in 1999 to 345,000 in 2005. In Africa deaths from measles fell by 75 percent between 1999 and 2005. Health officials have a goal of reducing measles deaths by 90 percent by 2010. In the United States measles is rarely fatal. Should the virus spread to the brain, however, it can cause death or brain damage (see Encephalitis).

No specific treatment for measles exists. Patients are kept isolated from other susceptible individuals, usually resting in bed, and are treated with aspirin, cough syrup, and skin lotions to lessen fever, coughing, and itching. The disease usually confers immunity after one attack, and an immune pregnant woman passes the antibody in the globulin fraction of the blood serum, through the placenta, to her fetus. These maternal antibodies can protect infants from measles infection for a period of months after birth but this temporary immunity will eventually disappear. Infants under 15 months of age may fail to respond to the measles vaccine because of these residual antibodies, and may require revaccination after 15 months. Mothers who have never had the measles but have been vaccinated do not pass antibodies to their fetuses, and their babies will be vulnerable to measles at birth.