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What is Measles (Rubeola)?

Measles Rubeola
Image source: CDC PHIL

Rubeola, or “red” measles, is a respiratory disease caused by a paramyxovirus, genus Morbillivirus with a core of single-stranded RNA.1 Measles is highly contagious and causes a systemic infection that begins in the nasopharynx. The virus is shed through respiratory secretions (nasal discharge, coughing sneezing) for four days before symptoms appear until three to four days after rash onset, when it is most easily transmitted.2 Before the first measles vaccine was licensed in the U.S. in 1963, measles increases were seen generally in late winter and spring3 every two to three years.4

Although the measles virus is closely related to certain animal diseases such as distemper that is found in several animals including dogs, ferrets and wolves,5 it is a disease unique to humans, and is not found in animals.6

Rubeola (not to be confused with rubella, a less serious infection commonly known as “German measles”) symptoms begin 10-14 days after close contact with someone infected with measles. Symptoms and start with a fever, cough, runny nose, conjunctivitis, white spots in the mouth and progresses to a rash that starts on the face and spreads to the rest of the body and lasts for about a week.7 Complications include very high fever, diarrhea, otitis media, seizures, pneumonia, encephalitis (0.1% reported) and very rarely subacute sclerosing panencephalitis (SSPE - a progressive, debilitating and deadly brain disorder) and death.8 9

Other symptoms of measles include:10

  • Light sensitivity
  • Watery eyes
  • Sneezing
  • Body aches
  • Swollen eyelids

Illnesses that may also develop along with measles are ear infections, diarrhea, croup, bronchiolitis and pneumonia. Measles during pregnancy may result in a premature birth or a low birth weight infant.11 Persons who have had measles infection usually will acquire long-lasting immunity.12

Prior to the appearance of the measles rash on the fourth or fifth day after fever begins, measles can be mistaken for several illness including influenza, bronchiolitis, croup, or pneumonia.13 In the past, doctors would diagnosed measles by looking for the presence of tiny white specks surrounded by a red halo inside the cheeks of an infected person’s mouth.14  However, in recent years, measles rash has been frequently misdiagnosed by physicians as illnesses such as scarlet fever, Kawasaki Disease, and dengue.15 As a result, at the October 2012 CDC’s Advisory Committee on Immunization Practice (ACIP) meeting, the committee revised the diagnosing criteria for measles, requiring that measles be confirmed by laboratory testing only. A physician diagnoses of measles based on symptoms is no longer accepted as confirmation of infection.16

Measles virus is easily destroyed by light, high temperatures, UV radiation or disinfectants.17

IMPORTANT NOTE: NVIC encourages you to become fully informed about Measles and the Measles vaccine by reading all sections in the Table of Contents , which contain many links and resources such as the manufacturer product information inserts, and to speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child. This information is for educational purposes only and is not intended as medical advice.

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1 CDC Measles – Measles Virus. Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book). 13th ed. 2015.

2 CDC Measles (Rubeola) For Healthcare Professionals – Clinical Features. May 8, 2018

3 CDC Measles – Epidemiology Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book). 13th ed. 2015.

4 WHO Measles. Sep. 20, 2018

5 PetMD Distemper in Dogs. No Date

6 CDC Transmission of Measles Mar. 3, 2017

7 Mayo Clinic Measles Sep. 7, 2018

8 CDC Measles – Complications Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book). 13th ed. 2015.

9 Perry RT, Halsey NA. The Clinical Significance of Measles: A Review. J Infect Dis. 2004 May 1;189 Suppl 1:S4-16.

10 Nordqvist, C Understanding the causes of measles MedicalNewsToday May 15, 2017

11 CDC Measles (Rubeola) Complications of Measles. Mar. 3, 2017

12 CDC Measles Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book). 13th ed. 2015.

13 Koenig KL, Alassaf W, Burns MJ Identify-Isolate-Inform: A Tool for Initial Detection and Management of Measles Patients in the Emergency Department West J Emerg Med. 2015 Mar; 16(2): 212–219.

14 Mayo Clinic Measles – Diagnosis Sep. 7, 2018

15 Seward J Suspect Measles and Act Fast. Medscape. Updated Feb. 11, 2015

16 CDC Prevention of Measles, Rubella, Congenital Rubella Syndrome, and Mumps, 2013: Summary Recommendations of the Advisory Committee on Immunization Practices (ACIP) MMWR Jun. 14, 2013; 62(RR04);1-34

17 CDC Measles - Measles Virus Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book). 13th ed. 2015.

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