Measles Rash

What is measles rash?

Measles rash occurs due to a viral infection caused by rubeola virus. Measles rash is very contagious in nature and spread, when a healthy individual exposes to infected saliva or mucus.

Rubelo is spread to the surrounding air by the affected person. During coughing, sneezing and talking air droplets are formed and spread to surrounding area. The rubelo virus also can survive for prolonged periods on contaminated surfaces. Any individual come across the contact with air droplets or contaminated surface, there is a vast possibility to get infected with measles and rash arises. ^(1,3)

Incidence Rate

According to the WHO report exposed in 2010, revealed that almost 139300 mortality worldwide is related to the measles and the fatality rate is highest among children, who are under 5 years of age, whereas according to the CDC (Centers for Disease Control and Prevention) 222 cases of measles was reported in the year 2011.  ⁽¹⁾

Symptoms

Measles rash is a typical symptom of Measles. Some common symptoms associated with Measles are:

Initial symptoms arise after 7-14 days of the invading infectious agent into the body.

1. Fever with high temperature enhancement
2. Sore throat
3. Cough
4. Coryza (runny nose)
5. General malaise and feeling like flu
6. Conjunctivitis (inflamed reddish eye with watery secretion coming out)

The final outcome of the measles are the development of the rash. Almost  2 to 3 days after the onset of initial symptoms, very small whitish color granular spots develop inside the oral cavity. This is clinically termed as Koplik spots.

Approximately 3-5 days after the onset of infection, the outbreak of the measles rash develops.

Koplik spots

Koplic spots are spread all over the internal oral cavity, and surrounded on the mucous membrane of the internal cheek wall. In 1896, Dr. Henry Koplik (pediatrician), first identified these spots as the marker of the measles. From his name these spots named as Koplik’s spot. The spots are red in color with blue-white centers.

The measles rash

The measles rashes are reddish or brownish red color. They first appear at the head, neck or face and gradually spread to other body parts and within few days entire body is fully covered with red bumpy granules like rashes. The rashes are clustered in groups and form patches on the skin. The overall duration of the rash lasts for 5 to 6 days. (1,2, 3,4)

Incubation period

After invading the rubeola virus, it takes time to lodge and multiply, this period is known as the incubation period. In incubation period, the usually no symptoms are observed, but the infected person acts as a carrier, can spread the infection to others. Usually the period is in between one to two weeks.

High risk factors

Without immunization: Immunization can prevent measles and incidence rate of measles is high for unvaccinated children, as well as adults.

International travel: Some countries are more prone towards measles incidence, visit those places can increase the risk of development of the measles.

Vitamin A deficiency: nutritional research investigates that vitamin A deficiency can promotes to the development of the measles in the exposure of the causative virus and have more severe symptomatic manifestation. (1,5)

Measles Rash Causes

Direct or indirect contact with the rubeola virus, promotes the measles. The virus is airborne microorganism and favorable sites is in the air-droplets, during sneezing, coughing or talking of the infected person, produce air bubbles or air-droplets with rubeola germ. These air-droplets are floating in the environmental air and it can easily reach to uninfected individual and infect them.

Other than this, used utensils by the infected person is also another source of measles.  Any surface contaminated with rubeola virus also spread the infection, as the causative virus can alive prolonged period in contaminated surface. ^(1,5)

Diagnosis

Diagnosis of the measles can be possible by physical examination and findings of Koplic’s spots and measles rash along with high temperature often provide an indication of measles infection. For further confirmation, blood culture test can be conducted and the presence of rubeola virus strain concludes the onset of measles infection. ^(1,5)

Treatment

Yet now no antiviral treatment is available for measles, but following measures can provide symptomatic relieve.

1. Acetaminophen can prescribe to control fever and associated muscle aches
2. Adequate rest helps in quick healing, as the immune system is boost up
3. Keep hydrated by taking plenty of fluids
4. Steam vapor can ease the release of cough and coryza
5. Supplementation therapy with vitamin A can also helpful. ^{(1,4, 5)}

Immunization

Immunization with MMR vaccine is the best possible measure to prevent measles. MMR is a combination of triple antigen – measles, mumps, and rubella. The MMR vaccine has to take two times for infants in their life span, the first dose is given at 1 year and the second dose at 4-6 years of age.

Adults who are never become immunized with measles have to take the immunization during pregnancy (women),traveling or before expose to any outbreak of the measles. The MMR vaccine is effective even after 72 hours from the exposure to any infected person or site, so within this time limit, visit a doctor and should take the measles vaccine for preventing the onset of infection. ^(1,3)

Myth of Immunization

Some people, hesitate to give immunization for their child, as they have believed that vaccination has lots of side effects. But, in very rare cases MMR vaccine provides side effects to children or adults and the included side effects are deafness, seizures, brain damage, and coma. There is also a believe that measles vaccine has close association with autism in children, But medical research has not yet established such link. ⁽¹⁾

Complications

In many cases, measles can be fatal or cause serious life-threatening complications, especially for children. According to Better Health Channel report, one of the leading causes of mortality or serious morbidity among children is due to complications of measles, which include pneumonia and encephalitis (inflammation of the brain). United States also declared that measles are not fully eradicated and due to measles, the annual ratio of mortality is 2 : 1000. Other than fatality, the following are included complications associated with measles.

• Otitis media (middle ear infection)
• http://www.webmd.com/baby/guide/pregnancy-miscarriage
• bronchitis
• blood platelets count becomes decrease
• Vision disturbance and even blindness
• Severe diarrhea (1,2)

Pictures

References

1. Measles; Healthline; Retrieve from: http://www.healthline.com/health/measles
2. Sign and Symptoms of Measles; The Center for Disease and Prevention (2015); Retrieve from: http://www.cdc.gov/measles/about/signs-symptoms.html
3. Stephanie Watson,  George T. Krucik, (2013); What Does Rubeola (Measles) Look Like? Retrieve from: http://www.healthline.com/health/rubeola-measles-pictures#Overview1
4. Measles – Symptoms; (2015); NHS choice;  Retrieve from: http://www.nhs.uk/Conditions/Measles/Pages/Symptoms.aspx
5. Measles; Mayo Clinic (2014) ; Retrieve from: http://www.mayoclinic.org/diseases-conditions/measles/basics/prevention/con-20019675