Measles is a highly contagious viral infection that is transmitted through air droplets of other humans. Although it affects both adults and children, it is more common in children. Despite the availability of vaccination and the vast reduction in the number of casualties, according to the WHO, about 7 million people were affected by measles and about 90,000 deaths were recorded. It has severe complications e.g. encephalitis, acute immunosuppression predisposing the patient to pneumonia.

RISK FACTORS

          -Immunodeficiency states e.g. HIV/AIDS, leukemia, steroid therapy

          -Travel to measles-endemic areas or contact with travellers to endemic areas.

          -Lack of immunization

Severe measles infection can occur in the presence of:

-Malnutrition

-Pregnancy

-Immunodeficiency

-Vitamin A deficiency

SIGNS AND SYMPTOMS

These typically present about 7-14 days after exposure to the causative organism. High-grade fever >40 degrees Celsius lasting 4-7 days is usually experienced first. Patients also experience malaise, loss of appetite and classically, a triad of cough, coryza (runny nose) and conjunctivitis. ‘Koplik’s spots’- tiny, white spots- may also appear in the mouth and last 3-5 days followed by rashes on the face, neck and behind the ears. Measles, when uncomplicated, usually last 7-10 days before resolution. Immunocompetent individuals develop lifelong immunity after exposure.

DIAGNOSIS

This is usually made clinically, however, laboratory confirmation is needed for epidemiology purposes. Tests that can be done include:

–Serologic testing for measles-specific IgM or IgG titers

-Isolation of the virus (viral culture)

-Reverse-transcriptase polymerase chain reaction (RT-PCR) evaluation

TREATMENT

Treatment mainly is supportive and involves:
          – Adequate (re)hydration and replacement of electrolytes lost to diarrhea or vomiting

          -Vitamin A supplementation

Sources: Medscape, CDC, WHO