Measles (Rubeola)

Until the mid-1970s, when measles immunization became routine, this viral infection was an extremely common childhood illness. Over the next 10 to 15 years, outbreaks of measles became less common but occasionally occurred, mainly among schoolchildren and college students who had neither been immunized nor had the illness. In the late 1980s, however, there was an alarming resurgence of measles, particularly in certain urban areas, including Chicago, Dallas, Houston, Los Angeles, New York, Philadelphia and San Diego. As a result, immunization efforts have been stepped up, and a decision was made to add a second immunization for school aged children. This has helped control the problem.

Why all the fuss about what used to be considered a routine illness? The fact is, measles is potentially dangerous—not just to tiny infants and chronically ill children, but to strong, healthy children, in whom the infection can lead to pneumonia, brain inflammation and other complications. For that reason, immunization is absolutely essential. (For a rundown of the recommended immunization schedule for all infectious diseases, see immunizations.)

WHEN SHOULD I SUSPECT THAT MY CHILD HAS MEASLES?
Measles outbreaks are most common in late winter and early spring. The primary characteristic of the disease is a red rash that begins behind the ears and around the hairline and spreads downward, eventually covering the body. Coldlike symptoms, including fever, nasal congestion, red eyes and coughing, develop three to five days before the rash and last throughout the illness. A few days after the onset of these symptoms, tiny, white spots (called Koplik's spots) appear on the tongue and the lining of the mouth.

HOW DO MEASLES DEVELOP?
The virus (which is called rubeola virus) is highly contagious. It passes from person to person in moisture droplets expelled during coughing and sneezing. The infection takes hold in the respiratory tract, undergoing an incubation period of about ten days before spreading to the lymph nodes and bloodstream and causing symptoms. From start to finish, an uncomplicated bout of measles lasts about 10 to 14 days, but the rash itself lasts only about six.

IS MEDICAL ATTENTION NECESSARY?
Yes. It's important to know whether your child has measles or some other illness that causes a rash.

HOW CAN THE PEDIATRICIAN TELL IF MY CHILD HAS MEASLES?
The pediatrician will examine the child carefully to look for the typical rash of Koplik's spots.

WHAT TREATMENTS ARE AVAILABLE?
There is no specific treatment for measles, but the doctor may recommend measures such as giving the child acetaminophen to reduce fever and offering fluids every hour or so. Severe coughing, which commonly develops in the course of measles, may be relieved with a cool mist humidifier. If you use a humidifier, though, be sure to fill it with distilled water and clean it regularly.

GETTING HELP
Call your doctor if your child:

• Has not been immunized and is exposed to measles. If the vaccine is given promptly, it may prevent severe disease from developing. Alternatively, a gamma globulin injection—which is made up of antibodies from patients recovering from measles—may offer protection after exposure.

• Develops any unexplained high fever or rash.

Excerpt from THE DISNEY ENCYCLOPEDIA OF BABY & CHILD CARE, © 1995 DSH Communications, Inc. This material is based on current medical research and, to the best of the editors' knowledge and understanding, is accurate and valid. However the reader should not use information contained in this material to alter a medically prescribed regimen or as a form of self-treatment, without seeking the advice of a licensed physician.