I. Overview

Measles is an acute, highly contagious infectious disease caused by the measles virus (family Paramyxoviridae, genus Morbillivirus). The disease can lead to severe complications and even death. It is most commonly seen in children under 3 years old; however, adults who are unvaccinated or incompletely vaccinated are also at risk.

Measles spreads through airborne transmission, respiratory droplets, or direct contact with respiratory secretions. Typical symptoms include fever, upper respiratory inflammation (cough, runny nose), conjunctivitis, and rash.

The disease may cause serious complications such as pneumonia, encephalitis, otitis media, corneal ulceration, diarrhea, and potentially death.

II. Signs and Symptoms of Measles

The typical clinical course progresses through four stages:

Incubation period:

- Lasts 7–21 days (average: 10 days)

- Symptoms usually appear 10–14 days after exposure

Prodromal stage (catarrhal stage)

- Lasts 2–4 days

- Symptoms include:
+ High fever
+ Upper respiratory symptoms (cough, runny nose)
+ Conjunctivitis (red, watery eyes)

Rash stage (exanthem stage)

- Lasts 2–5 days

- Characteristics:
+ Rash typically appears after 3–4 days of high fever
+ Maculopapular rash that fades when stretched
+ Begins behind the ears, then spreads to face, neck, trunk, and limbs, including palms and soles
+ Rash may become confluent, especially on the face and trunk
+ Fever usually subsides as the rash fully develops

Recovery stage

- Rash gradually fades, turns darker, and may cause fine scaling

- Temporary skin discoloration (“tiger-skin” pattern) may occur before resolving

- Cough may persist for 1–2 weeks

- In uncomplicated cases, the disease resolves spontaneously

Risk factors for severe disease

- Children under 12 months

- Unvaccinated or incompletely vaccinated individuals

- Immunocompromised patients

- Patients with severe underlying diseases

- Severe malnutrition

- Vitamin A deficiency

- Pregnant women

III. Treatment of Measles

There is no specific antiviral treatment; management is mainly supportive:

- Isolate the patient, limit contact, and wear a mask

- Administer high-dose vitamin A as indicated

- Antipyretics for fever control

- Symptomatic relief for cough

- Ensure adequate nutrition:
+ Provide small, frequent meals
+ Continue breastfeeding if applicable

- Keep the child in a cool, dry, well-ventilated environment

- Maintain good hygiene to prevent secondary infections

Warning signs – seek medical care immediately

- Poor feeding or refusal to eat/breastfeed

- Persistent vomiting

- Cyanosis (bluish lips or extremities)

- Rapid or difficult breathing

- Altered consciousness

IV. Prevention

1. Vaccination (most effective measure)

Children should receive 2 doses of measles vaccine starting from 9 months of age, according to immunization schedules

2. Infection prevention

- Patients should limit contact with others for at least 4 days after rash onset

- Unvaccinated individuals or those without prior infection should avoid contact with measles patients

- If contact is unavoidable:
+ Wear a mask
+ Practice proper hand hygiene

- Environmental hygiene:
+ Ensure good ventilation in living, working, and learning environments
+ Regularly clean and disinfect frequently touched surfaces

- Personal hygiene and immunity:
+ Maintain good personal hygiene, especially nasal and throat care
+ Keep warm and maintain good nutritional status
+ Strengthen immunity, especially during measles outbreaks