Reviewed By: Dr. Kurt Kloss, MD
Last Reviewed Date: Oct 08, 2018
Last Modified Date: Oct 08, 2018
Published Date: Aug 22, 2017
Got the Measles? Why You Should Worry
Measles is a very contagious viral illness that is found all over the world. It is characterized by a rash that typically spreads over the entire body, along with fever and flu-like symptoms. While measles is typically thought of as a childhood illness, adults get measles too. In fact, according to the National Foundation for Infectious Diseases, 45 percent of measles cases in the U.S. in the first five months of 2011 were in adults age 20 or over. Additionally, when adults are infected with measles, they are typically sicker than children with measles and face a higher risk of complications and/or death.
There are two common forms of measles: rubeola, often referred to as red measles, and rubella, or German measles. Both are spread through the air by an infected individual when they cough, sneeze or breathe. It is a very infectious virus that can be caught by spending as little as 15 minutes in the same room with an infected person.
Additionally, the measles virus can remain active on surfaces for about two hours, infecting people who pick up the virus on their hands, then rub their eyes or nose. Since a person becomes contagious about 4 days before the telltale rash appears, most people transmit measles to others before they are aware that they have it, each infected person passing the disease to an average of 13 people.
Measles Symptoms and Treatment
Symptoms of measles generally appear within 7 to 14 days of infection. It begins with a high fever, cough, runny nose and red, watery eyes. Approximately two or three days after those initial symptoms begin, small white spots may appear inside the mouth.
Three to five days into the illness, the rash breaks out, usually beginning as flat red spots at the hairline, then spreading downward to the face and neck before breaking out on the arms, trunk, legs and feet. Small raised bumps may form on those flat red spots as the rash spreads, and fever generally rises during this time, sometimes spiking to more than 104 degrees.
The virus generally runs its course within a few days after the rash appears, the fever subsiding and the rash fading. Most people who become sick with measles become immune to the disease, unable to contract it again.
There is no specific treatment for measles. Doctors generally suggest bed rest and fluids to prevent dehydration, and ibuprofen or acetaminophen, to control fever. Patients who suffer with complications may be hospitalized.
According to the CDC, about thirty percent of people with measles will develop one or more complications from the disease, which include pneumonia, ear infections, diarrhea, convulsions, liver inflammation (hepatitis), brain inflammation (encephalitis), infection of the optic nerve that can lead to blindness (neuritis) and heart complications. Adults are at higher risk for measles complications than children. They are also more likely to be among the 164,000 people who die from the disease around the world every year.
Additionally, rubeola during pregnancy can have dire consequences. Premature labor, low birth weights or even miscarriage can occur. Rubella can cause fetal death in pregnant women, and among infants that survive prenatal infection, up to 85 percent infected during the first trimester will suffer birth defects and/or neurologic abnormalities, such as deafness, blindness, cataracts, heart defects, mental retardation, liver and spleen damage.
Measles In Adults: Who Is At Risk?
Since high rates of vaccination have made home-grown cases of the disease a rarity in the United States, the vast majority of cases of adult measles or German measles in adults are related to travel, with adults contracting the disease outside of the U.S. or through contact with someone who has contracted it overseas. According to the National Foundation for Infectious Diseases, the U.S., beginning in 2011, has seen an increase in measles cases related to increased infection in foreign countries frequented by American travelers. Other adults at higher risk than the average person include health care workers and college students.
How to Protect Yourself against Adult Measles
Anyone who is at risk for measles, particularly those who will be traveling internationally, should be sure they are immune to the disease, whether that immunity comes from having the disease as a child or vaccination. Adults who are not aware of their immunity status can find out via a blood test that detects antibodies to rubeola and rubella, indicating immunity. If immunity testing shows that you are not immune, getting vaccinated is your best line of protection.
Additionally, if you have recently had contact with a person who has come down with measles, getting vaccinated immediately can prevent the disease. Lastly, pregnant women cannot be vaccinated, so the only method of prevention available during pregnancy is avoidance – delaying any international travel and staying away from anyone who has been exposed to or has measles.
Some of the media in this article come from the Centers for Disease Control and Prevention's Public Health Image Library (PHIL), with identification numbers #10707 and #15401.