Measles / Campak

Kate Cronan, MD

Measles, also called rubeola, is a highly contagious respiratory infection that's caused by a virus. It causes a total-body skin rash and flu-like symptoms, including a fever, cough, and runny nose.
Since measles is caused by a virus, symptoms typically go away on their own without medical treatment once the virus has run its course. But while your child is sick, it's important to make sure that he or she has plenty of fluids and rest, and to keep your child from spreading the infection to others. If you have any concerns about your child's condition, talk to your
child's doctor.

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. Measles is highly contagious. When someone with measles sneezes or coughs, he or she can spread virus droplets through the air and infect others. Due to widespread immunizations, the number of measles cases has steadily declined. Most of the time, the cases occur in settings where there are lots of kids, some of whom haven't gotten vaccinated or whose immunity has diminished since they got the vaccine.
The most important thing you can do to protect your child from measles is to have him or her vaccinated according to the schedule prescribed by your child's doctor.

Prevention
Infants are generally protected from measles for 6 to 8 months after birth due to immunity passed on from their mothers. Older kids are usually immunized against measles according to state and school health regulations.
For most kids, the measles vaccine is part of the measles-mumps- rubella immunizations (MMR) given at 12 to 15 months of age and again at 4 to 6 years of age. Measles vaccine is not usually given to infants younger than 12 months old. But if there's a measles outbreak, the vaccine may be given when a child is 9 months old, followed by the usual MMR immunization at
12-15 months.
As is the case with all immunization schedules, there are important exceptions and special circumstances. Your child's doctor should have the most current information regarding recommendations about the measles immunization. Measles vaccine should not be given to pregnant women, or to kids with active tuberculosis, leukemia, lymphoma, or people whose immune systems are suppressed for some reason.
Also, the vaccine shouldn't be given to kids who have a history of severe allergic reaction to gelatin or to the antibiotic neomycin, as they are at risk for serious reactions to the vaccine. These kids can be protected from measles infection with an injection of antibodies called gamma globulin if it's given within 6 days of exposure - these antibodies can either prevent measles or make the symptoms less severe.
Measles vaccine occasionally causes side effects in kids who don't have any underlying health problems. In about 10% of cases the measles vaccine causes a fever between 5 and 12 days after vaccination, and in about 5% of cases the vaccine causes a rash, which isn't contagious and usually fades on its own.

Treatment
The symptoms of measles usually lasts for about 2 weeks. It is highly contagious, and 90% of people who haven't been vaccinated for measles will get it if they live in the same household as an infected person.
If your child has been diagnosed with measles, it's important to closely monitor him or her for fever and other symptoms to spot any complications. In some cases, measles can lead to other health problems, such as croup, and infections like bronchitis, bronchiolitis, pneumonia, conjunctivitis (pinkeye), myocarditis, and encephalitis. Measles also can make the body more susceptible to ear infections or other health problems caused by bacteria.
If fever is making your child more uncomfortable, you may want to give a non-aspirin fever medication such as paracetamol/ acetaminophen. Remember, you should never give aspirin to a child who has a viral illness since the use of aspirin in such cases has been associated with the development of Reye syndrome.
As with any viral infection, encourage your child to drink clear fluids: water, fruit juice, tea, and lemonade. These will help replace bodily fluids your child loses in the heat and sweating of fever episodes.
Use a cool-mist vaporizer to relieve cough and to soothe breathing passages. Clean the vaporizer each day to prevent mold from growing. Avoid hot-water or steam vaporizers that can cause accidental burns and scalds in children.
Children with measles should get extra rest to help them recover. It's usually safe for your child to return to school 7 to 10 days after the fever and rash go away. But to be sure, check with your child's doctor.

When to Call Your Child's Doctor
Call your child's doctor immediately if you suspect that your child has measles. Also, it's important to get medical care if your child:

• is an infant and has been exposed to measles
• is taking medicines that depress the immune system
• has tuberculosis, cancer, or a disease that affects the immune system
  

Keep track of your child's temperature. Let the doctor know if your child has an earache, since this may be a sign of an infection.
Remember that if your child is properly vaccinated it's extremely unlikely that he or she will contract the disease.