Rubeola Virus

Rubeola, also called 10-day measles, red measles, or measles , rubeola is an acute, highly contagious infection that causes a characteristic rash. Measles is one of the most common and most serious communicable childhood diseases.

It is spread from one child to another through direct contact with discharge from the nose and throat. Sometimes, it is spread through air-borne droplets from an infected child. This is a very contagious disease that usually consists of a rash, fever, and cough.

In temperate zones, incidence is highest in late winter and early spring. Before the measles vaccine, epidemics occurred every 2 to 5 years in large urban areas.

In the United States, the prognosis usually is excellent, but mortality is highest among children under age 2 and adults. Patients with impaired cellmediated immunity are at high risk for severe or even fatal measles. Mortality is as high as 10% in developing countries.

Causes

Measles is caused by the rubeola virus, a paramyxovirus. It's spread by direct contact or by contaminated airborne respiratory droplets. The portal of entry is the upper respiratory tract.

Signs and Symptoms

While measles is probably best known for the full-body rash that it causes, the first symptoms of the infection are usually a hacking cough, runny nose, high fever, and watery red eyes. Another marker of measles are Koplik's spots , small red spots with blue-white centers that appear inside the mouth.

The measles rash typically has a red or reddish brown blotchy appearance, and first usually shows up on the forehead, then spreads downward over the face, neck, and body, then down to the feet.

Diagnostic tests 

Several tests may be ordered to differentiate measles from rubella, roseola infantum, enterovirus infection, toxoplasmosis, and drug eruptions. If necessary, measles virus may be isolated from the blood, nasopharyngeal secretions, and urine during the febrile period. Serum antibodies appear within 3 days after onset of the rash and reach peak titers 2 to 4 weeks later.

Treatment

The patient should receive antipyretics to control fever. Vaporizers and a warm environment help reduce respiratory irritation, but cough preparations and antibiotics are usually ineffective. Therapy also must combat complications.

Prevention

Since the use of the rubeola (or measles) vaccine, the incidence of measles has decreased by 99 percent. About 5 percent of measles are due to vaccine failure. The measles vaccine is usually given in combination with the mumps and rubella vaccine. It is called the MMR. It is usually given when the child is 12 to 15 months old and then again between 4 to 6 years of age. Other ways to prevent the spread of rubeola:

• Children should not attend school or daycare for four days after the rash appears.
• Assure all of your child's contacts have been properly immunized.