Complications
Measles
Overview
Complications occur in about 30% of measles cases and can be severe, particularly in young children, pregnant individuals, and immunocompromised people:
1. Gastrointestinal:
• Diarrhea
• Hepatitis
2. Respiratory:
• Pneumonia (primary viral or secondary bacterial)
• Croup
3. Neurological:
• Encephalitis
• Subacute sclerosing panencephalitis (a fatal condition developing years after infection)
4. Others:
• Otitis media (ear infection)
• Myocarditis
• Thrombocytopenia (low platelet count)
• Blindness due to conjunctivitis or corneal ulceration
Prevention
Can You Prevent Measles?
Vaccination is the most effective way to prevent measles. The measles vaccine is often combined with mumps and rubella vaccines (MMR) or with varicella (chickenpox) vaccine (MMRV). The MMR vaccine is given in two doses: the first dose at 12-15 months of age and the second at 4-6 years of age.
Adults without proof of immunity and those at higher risk, such as healthcare workers and international travelers, should also get vaccinated.
Risk Factors
Who Is at Risk for Measles?
Those most at risk include:
• Unvaccinated individuals
• International travelers to areas where measles is common
• People with vitamin A deficiency
• Individuals with weakened immune systems
• Infants who have lost passive immunity before their first immunization
Outlook / Prognosis
What Is the Outlook for Someone with Measles?
Most people recover from measles without serious long-term effects. However, complications can lead to severe outcomes or even death. The disease provides lifelong immunity once contracted.
Living With Measles
When to Contact a Healthcare Provider?
Contact your healthcare provider if you think you or your child have had contact with someone with measles. If you or your child has measles and seem to be getting worse instead of better, call your provider. Pregnant women and infants younger than 12 months are most susceptible to complications, so it’s important to contact a healthcare provider if either of these apply to you.
Common Questions
What Disease Mimics Measles?
Measles isn’t the only virus that causes symptoms like a skin rash and fever. There are several viruses that cause similar symptoms such as roseola and rubella. Contact your healthcare provider if you notice any skin rashes, fevers, and other symptoms that mimic measles.
What Rash Can Be Mistaken for Measles?
Other diseases that cause a rash that may be mistaken for measles include:
• Chickenpox
• Hand, foot, and mouth disease
• Roseola
• Rubella
• Scarlet fever
Preventing Measles
How to Prevent Measles During an Outbreak or Known Infection?
If someone in your household has measles, take these precautions to protect family and friends without immunity:
• Isolate: Since measles is highly contagious from about four days before to four days after the rash appears, people with measles should stay home and not return to activities where they interact with other people during this period.
• Vaccinate: Ensure that anyone who is at risk of getting measles and hasn’t been fully vaccinated receives the measles vaccine as soon as possible. This includes infants older than six months and anyone born in 1957 or later who doesn’t have proof of immunity.
Preventing New Infections
Getting vaccinated with the measles vaccine is important for promoting and preserving widespread immunity. Since the introduction of the measles vaccine, measles has virtually been eliminated in the U.S., even though not everyone has been vaccinated. This effect is called herd immunity. However, herd immunity may now be weakening due to a drop in vaccination rates, and the incidence of measles in the U.S. has recently increased significantly.
Myths and Misconceptions
No Proven Link Between the MMR Vaccine and Autism
Following the publication of a now-discredited study in 1998, concerns were raised about a possible link between the MMR vaccine and autism. However, extensive reports from the American Academy of Pediatrics, the National Academy of Medicine, and the Centers for Disease Control and Prevention (CDC) have concluded that there is no scientifically proven link between the MMR vaccine and autism.
These organizations note that autism is often identified in toddlers between the ages of 18 and 30 months, which is about the time children receive their first MMR vaccine. However, this coincidence in timing should not be mistaken for a cause-and-effect relationship.
Prevention Measures
How to Avoid Spreading or Catching Measles?
Measles spreads when an infected person breathes, coughs, or sneezes. You are infectious from when you first have symptoms (around four days before the rash appears) until four days after the rash appears. There are things you can do to reduce the risk of spreading or catching measles:
Do:
• Wash your hands often with soap and warm water
• Use tissues when you cough or sneeze
• Throw used tissues in the bin
Don’t:
• Share cutlery, cups, towels, clothes, or bedding
Measles in Pregnancy
Measles and Pregnancy
If you contract measles while pregnant, it could harm your baby. It can cause:
• Miscarriage or stillbirth
• Premature birth (before the 37th week of pregnancy)
• Low birth weight
It is important to seek medical advice if you are pregnant and have been in close contact with someone who has measles.
References
• Cleveland Clinic. (n.d.). Measles (Rubeola). Retrieved from https://my.clevelandclinic.org/health/diseases/11526-measles-rubeola
• DermNet. (n.d.). Measles. Retrieved from https://dermnetnz.org/topics/measles
• Harvard Health. (n.d.). Measles. Retrieved from https://www.health.harvard.edu/a_to_z/measles-a-to-z
• Mayo Clinic. (n.d.). Measles. Retrieved from https://www.may
oclinic.org/diseases-conditions/measles/symptoms-causes/syc-20374857
• National Health Service (NHS). (n.d.). Measles.
