Introduction
Measles is a highly contagious viral illness that spreads through respiratory droplets and can lead to serious complications—especially in unvaccinated children and adults. While vaccines have dramatically reduced its global burden, measles outbreaks still occur, often due to low vaccination coverage.
Recognizing the early and classic symptoms of measles—including the hallmark rash, fever, cough, and Koplik’s spots—can help with early diagnosis and prevent further spread.
What Causes Measles?
Measles is caused by the measles virus, a member of the paramyxovirus family. It spreads through:
- Coughing or sneezing of an infected person
- Touching contaminated surfaces and then touching the face
- Being in a room where an infected person coughed or sneezed (the virus can live in the air for up to 2 hours)
Measles is extremely contagious—up to 90% of unvaccinated people in close contact with an infected person will become ill.
Stages and Timeline of Measles Symptoms
Symptoms usually appear 10–14 days after exposure, and the illness progresses through several phases:
1. Early Symptoms (Prodrome Phase)
Lasts: 2–4 days
Common signs include:
- High fever (often above 104°F / 40°C)
- Dry cough
- Runny nose
- Red, watery eyes (conjunctivitis)
- Fatigue
- Loss of appetite
These symptoms are often mistaken for a bad cold or flu, which is why measles is sometimes not diagnosed immediately.
2. Koplik’s Spots (Early Diagnostic Clue)
Appears: 1–2 days before rash
Koplik’s spots are:
- Tiny white or bluish-white dots with a red background
- Found on the inside of the cheeks, near the molars
- Unique to measles and considered an early warning sign
They disappear after a few days but are a critical clue for diagnosis, especially before the rash appears.
3. The Measles Rash (Exanthem Phase)
Appears: 3–5 days after symptoms begin, usually after fever spikes
Characteristics:
- Flat, red spots (maculopapular rash), sometimes raised
- Starts at the hairline or forehead
- Spreads downward to the face, neck, trunk, arms, legs, and feet
- May join together into larger blotches
- Often accompanied by increased fever
The rash lasts about 5–6 days, then fades in the order it appeared, sometimes leaving behind brown discoloration or peeling skin.
4. Recovery Phase (Convalescence)
After the rash fades:
- Fever and other symptoms gradually resolve
- Cough and fatigue may linger for a few weeks
- Immune suppression can persist, making the person vulnerable to other infections
Complications of Measles
While most people recover, 1 in 5 unvaccinated children with measles may develop complications, such as:
- Ear infections (can lead to hearing loss)
- Pneumonia (most common cause of measles-related deaths)
- Diarrhea
- Encephalitis (brain swelling, rare but serious)
- Blindness
- Death, especially in malnourished children and those under 5
Pregnant women with measles face increased risks of miscarriage, preterm birth, or low birth weight.
Who’s at Risk?
- Unvaccinated children and adults
- Infants under 1 year (too young to be vaccinated)
- Immunocompromised individuals
- People in communities with low vaccination coverage
- International travelers to areas with measles outbreaks
When to Seek Medical Attention
Call a doctor immediately if:
- You or your child has fever and rash after exposure to measles
- You see Koplik’s spots
- There is difficulty breathing, chest pain, or seizures
Always inform healthcare providers before visiting, to avoid exposing others in waiting areas.
Prevention of Measles
The MMR vaccine (Measles, Mumps, Rubella) is the best protection.
Vaccination schedule:
- First dose at 12–15 months
- Second dose at 4–6 years
- Adults without evidence of immunity should also be vaccinated
The MMR vaccine is safe and over 97% effective after two doses.
Conclusion
Measles is a serious illness with classic signs: fever, cough, red eyes, Koplik’s spots, and a distinctive spreading rash. Early recognition and isolation are critical to prevent further transmission—especially during outbreaks.
Thanks to vaccines, measles is preventable. Staying up to date with immunizations and being vigilant during outbreaks can protect you and your community.
FAQs:
What are Koplik’s spots, and why are they important?
Koplik’s spots are tiny white spots inside the mouth, unique to measles. They often appear before the rash, helping doctors make an early diagnosis.
How does the measles rash differ from other rashes?
The rash typically starts at the hairline and moves downward, forming flat red spots that can merge. It’s usually accompanied by high fever and other symptoms.
Can measles symptoms appear in vaccinated people?
It’s rare but possible. Vaccinated individuals may have milder symptoms or an incomplete rash, known as modified measles.
How long is a person with measles contagious?
People are contagious from 4 days before to 4 days after the rash appears. Isolation during this period is critical.
Is there a treatment for measles?
There is no antiviral treatment. Care involves rest, hydration, fever control, and vitamin A supplements in some cases. Prevention through vaccination is the best defense.
