Measles is a highly contagious virus spread through the air that can stay in a room for up to two hours. It is preventable with the MMR vaccine, yet outbreaks still occur in under-vaccinated communities and it can cause pneumonia and brain inflammation.
Key symptoms
- High fever with cough, runny nose and red, watery eyes
- Rash that starts on the face and spreads down the body
- Feeling very unwell; poor eating in children
- Diarrhea or ear pain
What you find on exam
- Koplik spots: tiny white spots on the inside of the cheeks
- Red, blotchy rash that merges, starting at the hairline
- Conjunctivitis and swollen lymph nodes
- Lung exam for pneumonia; check hydration and vaccine status
Tests
- Measles IgM serology
- PCR from a throat or nasopharyngeal swab and urine
- Report suspected cases to public health right away
- Chest X-ray if breathing problems
Treatment basics
- Supportive care: fluids, fever control, rest
- Vitamin A for all children with measles
- Airborne isolation until 4 days after rash onset
- MMR vaccine within 72 hours or immune globulin within 6 days for exposed contacts
- Treat complications such as pneumonia or ear infection
Red flags
- Trouble breathing or low oxygen
- Confusion, seizures or decreased consciousness
- Signs of dehydration in a young child
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Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations; CDC, Guideline for Isolation Precautions (2007) and PPE sequence. Written by Making Synapses. Making Synapses is not affiliated with these organizations.