Clinical Features:

 

ÝÝÝÝÝÝÝÝÝÝÝ …        Prodrome ñ Incubation period 10-12 days Ý Stepwise fever to 103ƒ F Ý Cough, conjunctivitis, and/or coryza (general cold)ÝÝÝÝÝÝÝÝÝÝÝ Ý Koplikís spots (blue-white spots on buccal mucosa) …        RashÝÝÝÝÝÝÝÝ - 2-4 days after prodrome, 14 days after exposure Ý Maculopapular (small spots) at first, becomes confluentÝÝÝÝÝÝ Ý Begins on face and head, spreads downward to trunk, arms, legs Ý Persists 5-6 days Ý Fades in order of appearance Other Symptoms ñ anorexia, diarrhea, generalized lymphadenopathy

Courtesy of Johns Hopkins School of Public Health

 

 

Complications:Ý 30% of reported measles cases have complications.Ý They occur most

ÝÝ commonly in children <5 yrs. and adults >20 yrs.

 

…        Diarrhea ñ occurred in 8% of reported cases 1985-1992

…        Otitis Media (middle ear infection) ñ 7%, almost exclusively in children

…        Pneumonia ñ 6%, most common cause of measles-related deaths

…        Seizures ñ 0.6% - 0.7%

…        Acute Encephalitis --Ý 0.1%, 15% case fatality rate

…        Death ñ 1-2 per 1,000 in recent years

 

…        Measles during pregnancy causes a higher risk of premature labor, spontaneous abortion, and low birth weight in infants

 

…        Measles in immunosuppressed persons may cause increased severity of disease and prolonged course of disease.Ý Patients may shed virus for several weeks after acute illness

 

**Ý In developing countries, complications may include diarrhea, dehydration, and/or bacterial infections.Ý Measles is a leading cause of blindness in African children.Ý Severity of disease is greatest among malnourished or vitamin A deficient children.Ý The case fatality rate in such cases may be as high as 25%