The Clinical Course of Measles

Pediatricians have long known of one diagnostic sign—Koplik spots.  When a physician sees them, he or she has confirmed the diagnosis of measles.  These are bluish-white raised lesions with a reddened base, and they may be present on the buccal mucosa of the oral cavity.  Moreover, they may appear on the soft palate, conjunctivae of the eye, and the vaginal mucosa as well.  In any event, Koplik spots are only evident for a few days [1, 2].

The well-known erythematous skin rash which parents and medical books have described for many decades occurs a day after the emergence of Koplik spots.  It first covers the face and neck of the child and ultimately the entire body.  It will last for 3 to 7 days.  It is this period--a few days before the rash appears and during its first few days of visibility--that the patient is highly contagious [2].

Complications may include pneumonia, croup, otitis media, collapse of a lung, and inflammation of the brain.  In rare instances, the patient can develop subacute sclerosing panencephalitis, a fatal degenerative disease of the central nervous system which occurs many years after the measles infection took place [2].

There is no specific cure for measles or, for that matter, most other viral illnesses which afflict children.  However, supportive therapy with fluids and antipyretic agents such as acetaminophen will help to resolve the fever.  The American Academy of Pediatrics and World Health Organization have long recommended the administration of vitamin A to these clients as it lowers mortality from the infirmity as well as prevents eye damage and blindness.

The use of oral rehydration solution is another well-known tool for these cases as it is another effective method of supportive care.

Measles is a contagious medical condition which health care practitioners can often manage well.  However, there are still many deaths from it in poor countries, and vaccination and adequate medical facilities are necessary to control the infection.

1. Centers for Disease Control.  (2015).  Measles (Rubeola).  Retrieved June 4, 2016.
2. Kumar, D. and Sabella, C.  (2015).  Measles:  Back again.  Cleveland Clinic Journal of Medicine, 83, 340-344.
3. World Health Organization.  (2016).  Measles.  Fact Sheet.  Retrieved June 4, 2016.
4. The photo shows a child with measles rash on the third day of the disease course.  Reprinted with permission from U.S. Centers for Disease Control.

The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact their physician for advice.