Measles

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Definition

Measles is an infection, caused by a virus, which causes an illness displaying a characteristic skin rash. Measles is also sometimes called rubeola, 5-day measles, or hard measles.

Description

Measles infections appear all over the world. Prior to the current effective immunization program, large-scale measles outbreaks occurred on a two to three-year cycle, usually in the winter and spring. Smaller outbreaks occurred during the off-years. Babies up to about eight months of age are usually protected from contracting measles, due to immune cells they receive from their mothers in the uterus. Once someone has had measles infection, he or she can never get it again.

— Rosalyn Carson-DeWitt, MD

Dictionary: mea·sles  (mē'zəlz)

1. 1. An acute, contagious viral disease, usually occurring in childhood and characterized by eruption of red spots on the skin, fever, and catarrhal symptoms. Also called rubeola.
   2. Black measles.
   3. Any of several other diseases, especially German measles, that cause similar but milder symptoms.
2. A disease of cattle and swine caused by tapeworm larvae.
3. A plant disease, usually caused by fungi, that produces minute spots on leaves and stems.

[Middle English maseles, mesels, pl. of masel, measles-spot, of Middle Low German origin.]

An acute, highly infectious viral disease with cough, fever, and maculopapular rash. It is of worldwide endemicity.

The virus enters the body via the respiratory system, multiplies there, and circulates in the blood. Cough, sneezing, conjunctivitis, photophobia, and fever occur, with Koplik's spots (small red spots containing a bluish-white speck in the center) in the mouth.

A rash appears after 14 days' incubation and persists 5–10 days. Serious complications may occur in 1 out of 15 persons; these are mostly respiratory (bronchitis, pneumonia), but neurological complications are also found. Encephalomyelitis occurs rarely. Permanent disabilities may ensue for a significant number of persons. Measles is one of the leading causes of death among children in the world, particularly in the developing countries.

In unvaccinated populations, immunizing infections occur in early childhood during epidemics which recur after 2–3 years' accumulation of susceptible children. Transmission is by coughing or sneezing. Measles is infectious from the onset of symptoms until a few days after the rash has appeared. Second attacks of measles are very rare. Treatment is symptomatic.

Killed virus vaccine should not be used, as certain vaccinees become sensitized and develop local reactions when revaccinated with live attenuated virus, or develop a severe illness upon contracting natural measles. Live attenuated virus vaccine effectively prevents measles; vaccine-induced antibodies persist for years. See also Biologicals; Hypersensitivity; Skin test.

An infectious disease caused by a virus. There are two types: rubeola and rubella (German measles). Both have oral manifestations.

Koplik’s spots with measles. (Sapp/Eversole/Wysocki, 2004, courtesy Dr. Robert J. Achterberg)

Definition

Measles is a viral infection that causes an illness displaying a characteristic skin rash known as an exanthem. Measles is also sometimes called rubeola, five-day measles, or hard measles.

Description

Measles infections appear all over the world. Incidence of the disease in the United States is down to a record low and only 86 confirmed cases were reported in the year 2000. Of these, 62% were definitely linked to foreigners or international travel. Prior to the current effective immunization program, large-scale measles outbreaks occurred on a two to three year cycle, usually in the winter and spring. Smaller outbreaks occurred during the off-years. Babies up to about eight months of age are usually protected from contracting measles, due to antibodies they receive from their mothers in the uterus. Once someone has had measles, he or she can never get it again.

Causes & Symptoms

Measles is caused by a type of virus called a paramyxovirus. It is an extremely contagious infection, spread through the tiny droplets that may spray into the air when a person carrying the virus sneezes or coughs. About 85% of those people exposed to the virus will become infected with it. About 95% of those people infected with the virus will develop the illness. Once someone is infected with the virus, it takes about seven to 18 days before he or she actually becomes ill. The most contagious time period is the three to five days before symptoms begin through about four days after the characteristic measles rash has begun to appear.

The first signs of measles infection are fever, extremely runny nose, red, runny eyes, and a cough. A few days later, a rash appears in the mouth, particularly on the mucous membrane that lines the insides of the cheek. This rash consists of tiny white dots (like grains of salt or sand) on a reddish bump. These are called Koplik's spots, and are unique to measles infection. The throat becomes red, swollen, and sore.

A couple of days after the appearance of the Koplik's spots, the measles rash begins. It appears in a characteristic progression, from the head, face, and neck, to the trunk, then abdomen, and next out along the arms and legs. The rash starts out as flat, red patches, but eventually develops some bumps. The rash may be somewhat itchy. When the rash begins to appear, the fever usually climbs higher, sometimes reaching as high as 105°F (40.5°C). There may be nausea, vomiting, diarrhea, and multiple swollen lymph nodes. The cough is usually more problematic at this point, and the patient feels awful. The rash usually lasts about five days. As it fades, it turns a brownish color, and eventually the affected skin becomes dry and flaky.

Many patients (about 5–15%) develop other complications. Bacterial infections, such as ear infections, sinus infections, and pneumonia are common, especially in children. Other viral infections may also strike the patient, including croup, bronchitis, laryngitis, or viral pneumonia. Inflammation of the liver, appendix, intestine, or lymph nodes within the abdomen may cause other complications. Rarely, inflammation of the heart or kidneys, a drop in platelet count (causing episodes of difficult-to-control bleeding), or reactivation of an old tuberculosis infection can occur.

An extremely serious complication of measles infection is the inflammation and subsequent swelling of the brain. Called encephalitis, this can occur up to several weeks after the basic measles symptoms have resolved. About one out of every 1,000 patients develops this complication, and about 10–15% of these patients die. Symptoms include fever, headache, sleepiness, seizures, and coma. Long-term problems following recovery from measles encephalitis may include seizures and mental retardation.

A very rare complication of measles can occur up to 10 years or more following the initial infection. Called subacute sclerosing panencephalitis, this is a slowly progressing, smoldering, swelling, and destruction of the entire brain. It is most common among people who had measles infection prior to the age of two years. Symptoms include changes in personality, decreased intelligence with accompanying school problems, decreased coordination, and involuntary jerks and movements of the body. As the disease progresses, the patient becomes increasingly dependent, ultimately becoming bedridden and unaware of his or her surroundings. Blindness may develop, and the temperature may spike (rise rapidly) and fall unpredictably as the brain structures responsible for temperature regulation are affected. Death is inevitable.

Measles during pregnancy is a serious disease, leading to increased risk of a miscarriage or stillbirth. In addition, the mother's illness may progress to pneumonia.

Diagnosis

Measles is almost always diagnosed based on its characteristic symptoms, including Koplik's spots, and a rash that spreads from central body structures out towards the arms and legs. If there is any doubt as to the diagnosis, then a specimen of body fluids (mucus or urine) can be collected and combined with fluorescent-tagged measles virus antibodies. Antibodies are produced by the body's immune cells that can recognize and bind to markers (antigens) on the outside of specific organisms, in this case the measles virus. Once the fluorescent antibodies have attached themselves to the measles antigens in the specimen, the specimen can be viewed under a special microscope to verify the presence of the measles virus.

Treatment

There are a variety of general measures that can be taken to treat measles and help the patient feel more comfortable. These include:

• humidifying the air to ease cough
• drinking plenty of fluids to prevent dehydration
• keeping the room lights dim to relieve sensitivity to light
• getting plenty of rest
• eating nutritious and easily digestible food

Herbals and Chinese Medicine

There are specific acupuncture and acupressure therapies for measles. The following herbals can also help relieve the symptoms associated with measles:

• Chamomile tea for restlessness.
• Echinacea plus goldenseal to clear infection, boost the immune system, and soothe skin and mucous membranes.
• A tea of lemon balm leaf, chamomile flower, peppermint leaf, licorice root, and elder flower to reduce fever and chills and increase perspiration.
• Ginger tea to reduce fever.
• Shiitake mushrooms to boost the immune system.
• Witch hazel (Hamamelis virginiana), chickweed (Stellaria media), or oatmeal baths to reduce itching.
• Eyebright (Euphrasia officinalis) eyewash to soothe eyes.
• Garlic to fight infection and boost the immune system.
• Flos lonicerae (10 g) and Radix glycyrrhizae (3 g) decoction to wash the mouth, eyes, and nose.

Supplements

Some studies have shown that children with measles encephalitis or pneumonia benefit from relatively large doses of vitamin A. Vitamin A may also heal mucous membranes. Bioflavinoids and vitamin C boost the immune system. Zinc promotes healing and is an immune system stimulant. Zinc can cause nausea and vomiting, and chronic use can cause low levels of copper and iron-deficiency anemia.

Homeopathy

Homeopathic remedies cater to the patient's specific symptoms. Remedies for common measles symptoms are listed. The patient can take 30x or 9c of the following remedies four times daily for two days:

• Apis mellifica: for swollen throat, breathing difficulty, and painful cough.
• Arsenicum album: for restlessness, feeling worse after midnight, and thirst.
• Belladonna: for high fever, red eyes, flushed face, headache, and swallowing difficulty.
• Gelsemium: for fever, droopy eyes, cough, feeling cold, and runny nose.
• Pulsatilla: for eye problems (tears, drainage, light sensitivity), dark red rash, thick yellow nasal discharge, and dry cough.

Allopathic Treatment

There are no medications available to cure measles. Treatment is primarily aimed at helping the patient to be as comfortable as possible, and watching carefully so that antibiotics can be started promptly if a bacterial infection develops. Fever and discomfort can be treated with acetaminophen (Tylenol) or ibuprofen (Advil, Motrin, Nuprin). Children with measles should never be given aspirin, as this increases the risk of the fatal disease Reye's syndrome.

Expected Results

The prognosis for an otherwise healthy, well-nourished child who contracts measles is usually quite good. In developing countries, however, death rates may reach 15–25%, as malnutrition, especially protein deficiency, for six months prior to the onset of measles increases the risk of death. Adolescents and adults usually have a more difficult course. Women who contract the disease while pregnant may give birth to a baby with a hearing impairment. Although only one in 1,000 patients with measles will develop encephalitis, 10–15% of those who do will die, and about another 25% will be left with permanent brain damage.

Prevention

Measles is a highly preventable infection. A very effective vaccine exists, made of live measles viruses that have been treated so they cannot cause infection. The important markers on the viruses are intact and cause the immune system to produce antibodies. In the event of a future infection with measles virus the antibodies will quickly recognize the organism and eliminate it. Measles vaccines are usually given at about 15 months of age. Prior to that age, the baby's immune system is not mature enough to initiate a reaction strong enough to ensure long-term protection from the virus. A repeat injection should be given at about 10 or 11 years of age. Outbreaks on college campuses have occurred among nonimmunized or incorrectly immunized students.

Measles vaccine should not be given to a pregnant woman, however, in spite of the seriousness of gestational measles. The reason for not giving this particular vaccine during pregnancy is the risk of transmitting measles to the unborn child.

Surprisingly, new cases of measles began being reported in some countries—including Great Britain—in 2001 because of parents' fears about vaccine safety. The combined vaccine for measles, mumps, and rubella (MMR) was claimed to cause autism or bowel disorders in some children. However, the World Health Organization (WHO) says there is no scientific merit to these claims. The United Nations expressed concern that unwarranted fear of the vaccine would begin spreading the disease in developing countries, and ultimately in developed countries as well. Parents in Britain began demanding the measles vaccine as a separate dose and scientists were exploring that option as an alternative to the combined MMR vaccine. Unfortunately, several children died during an outbreak of measles in Dublin because they had not received the vaccine. Child mortality due to measles is considered largely preventable, and making the MMR vaccine widely available in developing countries is part of WHO's strategy to reduce child mortality by two-thirds by the year 2015.

Resources

Books

Gershon, Anne. "Measles (Rubeola)." In Harrison's Principles of Internal Medicine, edited by Anthony S. Fauci, et al. New York: McGraw-Hill, 1998.

Stoffman, Phyllis. The Family Guide to Preventing and Treating 100 Infectious Diseases. New York: John Wiley and Sons, Inc., 1995.

"Viral Infections: Measles." Section 19, Chapter 265 in The Merck Manual of Diagnosis and Therapy, edited by Mark H. Beers, MD, and Robert Berkow, MD. Whitehouse Station, NJ: Merck Research Laboratories, 2002.

Ying, Zhou Zhong, and Jin Hui De. "Childhood Infections." In Clinical Manual of Chinese Herbal Medicine and Acupuncture. New York: Churchill Livingston, 1997.

Periodicals

Borton, Dorothy. "Keeping Measles at Bay: Use These Four Techniques to Stop the Spread." Nursing 27, no. 12 (December 1997): 26.

Chiba, M. E., M. Saito, N. Suzuki, et al. "Measles Infection in Pregnancy." Journal of Infection 47 (July 2003): 40–44.

Hussey, Greg. "Managing Measles: Integrated Case Management Reduces Disease Severity." British Medical Journal 314, no. 7077 (February 1, 1997): 316+.

Jones, G., R. W. Steketee, R. E. Black, et al. "How Many Child Deaths Can We Prevent This Year?" Lancet 362 (July 5, 2003): 65–71.

McBrien, J., J. Murphy, D. Gill, et al. "Measles Outbreak in Dublin, 2000." Pediatric Infectious Disease Journal 22 (July 2003): 580–584.

"Measles—United States, 2000. (From the Centers for Disease Control and Prevention)." Journal of the American Medical Association 287, no. 9 (March 6, 2002): 1105–1112.

"Progress Toward Global Measles Control and Elimination, 1990-1996." Journal of the American Medical Association 278, no. 17 (November 5, 1997): 1396+.

Scott, L. A., and M. S. Stone. "Viral exanthems." Dermatology Online Journal 9 (August 2003): 4.

Sur, D. K., D. H. Wallis, and T. X. O'Connell. "Vaccinations in Pregnancy." American Family Physician 68 (July 15, 2003): 299–304.

"WHO: Vaccine Fears Could Lead to Unnecessary Deaths." Medical Letter on the CDC & FDA (March 17, 2002): 11.

Organizations

American Academy of Pediatrics (AAP). 141 Northwest Point Boulevard, Elk Grove Village, IL 60007. (847) 434-4000. .

Centers for Disease Control and Prevention. 1600 Clifton Rd., Atlanta, GA 30333. (404) 639-3311. .

Other

Zand, Janet. "Measles." HealthWorld Online [cited October 2002]. .

[Article by: Belinda Rowland; Teressa G. Odle; Rebecca J. Frey, PhD]

Definition

Measles is an infection caused by a virus, which causes an illness displaying a characteristic skin rash known as an exanthem. Measles is also sometimes called rubeola, five-day measles, or hard measles.

Description

Measles is a very contagious disease primarily characterized by cough, runny nose, red eyes (conjunctivitis), and a characteristic rash on the skin and inside of the cheeks. The most common complications are ear infection and diarrhea, although more serious complications can include pneumonia, meningitis, or encephalitis. Measles is fatal (due to complications) in about two out of every 1,000 cases.

Demographics

Measles infections appear all over the world. Prior the effective immunization program used in the early 2000s, large-scale measles outbreaks occurred on a two to three-year cycle, usually in the winter and spring. Smaller outbreaks occurred during the off years. Babies up to about eight months of age are usually protected from contracting measles, due to immune cells they receive from their mothers in the uterus. Once someone has had measles infection, he or she can never get it again.

Causes and Symptoms

Measles is caused by a type of virus called a paramyxovirus. It is an extremely contagious infection, spread through the tiny droplets that may spray into the air when an individual carrying the virus sneezes or coughs. About 85 percent of those people exposed to the virus will become infected with it. About 95 percent of those people infected with the virus will develop the illness called measles. Once someone is infected with the virus, it takes about seven to 18 days before he or she actually becomes ill. The most contagious time period is the three to five days before symptoms begin through about four days after the characteristic measles rash has begun to appear.

The first signs of measles infection are fever; extremely runny nose; red, runny eyes; and a cough. A few days later, a rash appears in the mouth, particularly on the mucous membrane that lines the cheeks. This rash consists of tiny white dots (like grains of salt or sand) on a reddish bump. These are called Koplik's spots and are unique to measles infection. The throat becomes red, swollen, and sore.

A couple of days after the appearance of the Koplik's spots, the measles rash begins. It appears in a characteristic progression, from the head, face, and neck, to the trunk, then abdomen, and next out along the arms and legs. The rash starts out as flat, red patches but eventually develops some bumps. The rash may be somewhat itchy. When the rash begins to appear, the fever usually climbs higher, sometimes reaching as high as 105°F (40.5°C). There may be nausea, vomiting, diarrhea, and multiple swollen lymph nodes. The cough is usually more problematic at this point, and the patient feels awful. The rash usually lasts about five days. As it fades, it turns a brownish color and eventually the affected skin becomes dry and flaky.

Many patients (about 5–15%) develop other complications. Bacterial infections, such as ear infections, sinus infections, and pneumonia are common, especially in children. Other viral infections may also strike the patient, including croup, bronchitis, laryngitis, or viral pneumonia. Inflammation of the liver, appendix, intestine, or lymph nodes within the abdomen may cause other complications. Rarely, inflammations of the heart or kidneys, a drop in platelet count (causing episodes of difficult-to-control bleeding), or reactivation of an old tuberculosis infection can occur.

An extremely serious complication of measles infection is swelling of the brain. Called encephalitis, this condition can occur up to several weeks after the basic measles symptoms have resolved. About one out of every thousand patients develops this complication, and about 10 to 15 percent of these patients die. Symptoms include fever, headache, sleepiness, seizures, and coma. Long-term problems following recovery from measles encephalitis may include seizures and mental retardation.

A very rare complication of measles can occur up to ten years following the initial infection. Called subacute sclerosing panencephalitis, this is a slowly progressing, smoldering swelling and destruction of the entire brain. It is most common among people who had measles infection prior to the age of two years. Symptoms include changes in personality, decreased intelligence with accompanying school problems, decreased coordination, involuntary jerks and movements of the body. The disease progresses so that the individual becomes increasingly dependent, ultimately becoming bedridden and unaware of his or her surroundings. Blindness may develop, and the temperature may spike (rise rapidly) and fall unpredictably as the brain structures responsible for temperature regulation are affected. Death is inevitable.

Measles during pregnancy is a serious disease, leading to increased risk of a miscarriage or stillbirth. In addition, the mother's illness may progress to pneumonia.

Diagnosis

Measles infection is almost always diagnosed based on its characteristic symptoms, including Koplik's spots, and a rash which spreads from central body structures out towards the arms and legs. If there is any doubt as to the diagnosis, then a specimen of body fluids (mucus, urine) can be collected and combined with fluorescent-tagged measles virus antibodies. Antibodies are produced by the body's immune cells that can recognize and bind to markers (antigens) on the outside of specific organisms, in this case the measles virus. Once the fluorescent antibodies have attached themselves to the measles antigens in the specimen, the specimen can be viewed under a special microscope to verify the presence of measles virus.

Treatment

As of 2004 there are no treatments available to stop measles infection. Treatment is primarily aimed at helping the patient to be as comfortable as possible and watching carefully so that antibiotics can be started promptly if a bacterial infection develops. Fever and discomfort can be treated with acetaminophen. Children with measles should never be given aspirin, as aspirin is correlated with the fatal disease Reye's syndrome. A cool-mist vaporizer may help decrease the cough. Patients should be given a lot of liquids to drink, in order to avoid dehydration from the fever.

Some studies have shown that children with measles encephalitis benefit from relatively large doses of vitamin A.

Prognosis

The prognosis for an otherwise healthy, well-nourished child who contracts measles is usually quite good. In developing countries, however, death rates may reach 15 to 25 percent. Adolescents and adults usually have a more difficult course. Women who contract the disease while pregnant may give birth to a baby with hearing impairment. Although only one in 1,000 patients with measles will develop encephalitis, 10 to 15 percent of those who do will die, and about another 25 percent will be left with permanent brain damage.

Prevention

Measles is a highly preventable infection. A very effective vaccine exists, made of live measles viruses that have been treated so that they cannot cause actual infection. The important markers on the viruses are intact, however, which causes an individual's immune system to react. Immune cells called antibodies are produced, which in the event of a future infection with measles virus quickly recognize the organism and kill it off. Measles vaccines are usually given to children at about 15 months of age; prior to that age, the baby's immune system is not mature enough to initiate a reaction strong enough to insure long-term protection from the virus. A repeat injection should be given at about ten or 11 years of age. Outbreaks on college campuses have occurred among students who were not immunized or who were incorrectly immunized.

Measles vaccine should not be given to pregnant women, however, in spite of the seriousness of gestational measles. The reason for not giving this particular vaccine during pregnancy is the risk of transmitting measles to the unborn child.

Parental Concerns

New cases of measles began being reported in some countries—including Great Britain—in 2001 because of parents' fears about vaccine safety. The combined vaccine for measles, mumps, and rubella (MMR) was claimed to cause autism or bowel disorders in some children. However, the World Health Organization (WHO) position is there is no scientific merit to these claims. The United Nations expressed concern that unwarranted fear of the vaccine would begin spreading the disease in developing countries and ultimately in developed countries as well. Parents in Britain began demanding the measles vaccine as a separate dose, and scientists were exploring that option as an alternative to the combined MMR vaccine. Unfortunately, several children died during an outbreak of measles in Dublin because they had not received the vaccine. Child mortality due to measles is considered largely preventable, and making the MMR vaccine widely available in developing countries is part of WHO strategy to reduce child mortality by two-thirds by the year 2015.

Resources

Books

Katz, Samuel L. "Measles (Rubeola)." In Principles andPractice of Pediatric Infectious Diseases, 2nd ed. Edited by Sarah S. Long et al. St. Louis, MO: Elsevier, 2003.

Maldonado, Yvonne. "Measles." In Nelson Textbook ofPediatrics. Edited by Richard E. Behrman et al. Philadelphia: Saunders, 2004.

Periodicals

Kerr, C. "Good response rate for MMRV vaccine." LancetInfectious Disease 3 (December 2003): 748.

Stalkup, J. R. "A review of measles virus." DermatologyClinics 20 (April 2002): 209–215.

Organizations

American Academy of Pediatrics (AAP). 141 Northwest Point Blvd., Elk Grove Village, IL 60007. Web site: www.aap.org.

Centers for Disease Control and Prevention. 1600 Clifton Rd., NE, Atlanta, GA 30333. Web site: www.cdc.gov.

[Article by: Rosalyn Carson-DeWitt, MD Rebecca J. Frey, PhD]

Measles is a viral respiratory illness characterized by high fever and generalized rash. Symptoms start ten to twelve days after airborne exposure and include fever, malaise, conjunctivitis, runny nose, and cough. About fourteen days after exposure, a maculopapular rash appears at the hairline, extends to the face and upper neck, and, over the next three days, spreads down the body to the hands and feet. Although measles is usually not severe in developed countries, it can lead to serious complications including diarrhea (8% of cases), ear infections (7%), pneumonia (6%), encephalitis (0.1%), subacute sclerosing panencephalitis (SSPE)(0.001%), and death (0.2%). Measles is much more serious in developing countries, causing about one million deaths annually during the 1990s. The case fatality rate can be as high as 25 percent, with deaths often caused by secondary infections such as diarrhea or pneumonia. Measles is also a common cause of blindness in the developing world.

Measles is one of the most contagious diseases in the world. The virus, a paramyxovirus containing a single strand of RNA, is normally spread through respiratory droplets and can be transmitted from four days before to four days after rash onset. Before vaccines were introduced, nearly everyone was infected by age ten to twelve years. Immunity is lifelong following infection.

A live attenuated vaccine was licensed in 1963, and further attenuated vaccines are now used around the world. The vaccine is about 95 percent effective in the United States when administered at the recommended age of twelve to fifteen months, and immunity is considered lifelong. It is usually given in conjunction with the mumps and rubella vaccines. Children in developing countries are vaccinated at nine months of age because of the higher risk of infection in infancy.

Routine treatment of measles includes supportive care such as oral rehydration therapy for diarrhea and respiratory care for patients with pneumonia. Antibiotics are used to treat secondary bacterial infections. Although antiviral medications have been used to treat complex measles infections, there are few studies to confirm their effectiveness. High-dose vitamin A therapy reduces mortality and prevents blindness and is recommended by the World Health Organization for children in developing countries.

Global measles eradication has been a goal since the development of an effective vaccine. Humans are the only reservoir for the measles virus, which can survive only hours in the environment. Endemic measles can be eliminated from large geographic areas using intensive vaccination programs, as seen in the United States in the late 1990s. However, measles is so infectious that immunization rates of at least 90 to 95 percent must be attained to interrupt transmission. In addition, the billions of doses required to achieve eradication highlight the need for injection safety and the potential development of needle-free vaccination methods. Finally, the HIV (human immunodeficiency virus) epidemic presents several barriers to measles eradication. HIV-infected persons have a lower response to measles vaccination, develop more severe cases of the disease, and, theoretically, may be infectious for longer periods of time. There is hope that these challenges will be surmounted and measles will be eradicated, following smallpox into the history books.

(SEE ALSO: Communicable Disease Control; Disease Prevention; Eradication of Disease; Immunizations)

Bibliography

Atkinson, W.; Wolfe, C.; Humizter, S.; and Nelson, R., eds. (2000). "Measles." In Epidemiology and Prevention of Vaccine-Preventable Diseases: The Pink Book. Atlanta, GA.: U.S. Department of Health and Human Services.

Redd, S. C.; Markowitz, L. E.; and Katz, S. L. (1999). "Measles Vaccine." In Vaccines, eds. S. A. Plotkin and W. A. Orenstein. Philadelphia, PA: W. B. Sanders.

— SONIA KLEMPERER-JOHNSON; MARK PAPANIA

For more information on measles, visit Britannica.com.

An acute and contagious disease caused by a virus and characterized by the outbreak of small red spots on the skin. Measles occurs most often in school-age children. (Compare German measles.)

1. a highly contagious disease of humans characterized by a maculopapular skin rash and caused by a morbillivirus; called also rubeola.
2. a term used in veterinary science to identify animal diseases that have a speckled appearance thought to resemble the skin rash of measles in humans. The resemblance in most diseases is superficial and highly speculative.

• beef m. — see cysticercus bovis.
• pork m. — see cysticercus cellulosae.
• sheep m. — see cysticercus ovis.
• m. vaccine — a preparation containing attenuated human measles virus that is used to immunize dogs against canine distemper virus, based on the close antigenic relationship between the two viruses. It is only administered to young puppies, in which the persistence of maternal antibodies against canine distemper virus is likely to interfere with an immune response to canine distemper vaccine. It must always be followed by the administration of canine distemper vaccine by 4 months of age.