Would you know Measles if you saw it?

When I was a boy (back when the earth was cooling) every child got the measles (rubeola). Every parent knew when they saw measles. Then came measles vaccine. First introduced in 1963 and combined in MMR in 1971, and measles abruptly vanished in the U.S. (There are many parts of the world where measles is sadly still common.) Americans are no longer familiar with measles.

When increasing numbers of parents began denying rubeola vaccine to their children, the density of persons susceptible to measles became dangerously concentrated in certain corners of our country. Now, when measles is reintroduced into these areas, it can spread locally.

If measles showed up in your school, office or neighborhood, would you know it?

The rash of measles begins about 4 days after the onset of fever. Individuals with measles are contagious before the rash develops. The virus is transmitted by the airborne route.

The classic signs and symptoms of measles can be remembered as 4D + 3C. The four-day fever (the 4 D) ends when the rash comes out. The three C’s are cough, coryza (nasal congestion, sneezing, and watery eyes), and conjunctivitis (red eyes).

The characteristic measles rash is red, blotchy,and later confluent. It typically starts on the back of the ears and, after a few hours, spreads to the head and neck before spreading to cover most of the body. It is often itchy and lasts for up to eight days. The rash is said to “stain”, changing color from red to dark brown, before disappearing.

Now you are as well equipped as the modern physician (but not as sharp as some of your grandparents) in recognizing measles.

Winkler G. Weinberg, MD

I have been an ID physician for over 3 decades. I am the author of No Germs Allowed!. If you liked this article, check out the book on Amazon.

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