Signs and Symptoms

As I discussed in the last post, the measles virus follows a fairly specific trajectory of symptom presentation. For a refresher, here is a summary of the three phases:

1. Incubation Period (6-19 days): the infected individual is likely asymptomatic (no symptoms) during this time period. Some people may experience very temporary respiratory symptoms or fever. A person is usually the most contagious five days before the appearance of rash (prodrome period) to four days afterward.

2.  Prodrome Period (2-8 days): infected individuals will have a fever (up to 40 degrees Celsius), just feel icky (technical term “malaise”), have a loss of appetite, red eyes and a cough. Koplik’s spots may appear on mucosa (mainly in the mouth) and they looks like tiny grains of salt.

à You can imagine that these symptoms are incredibly uncomfortable and would cause someone to seek care, especially the high fever.

3. Exanthem Period (6-7 days): the characteristic rash appears in this phase. It typically starts on the face and spreads from the core of the body outwards and from the head downwards.

The standard set of symptoms is common when an individual contracts the measles virus. However, there can be very serious complications worth noting. These are most common in children under 5 years of age, immunocompromised patient, pregnant women, individuals with vitamin A deficiency or inadequate nutrition. 

The most severe complication is Encephalitis (brain swelling due to infection). It occurs in 1 out of 1000 cases, of those cases 25% will develop lasting neurodevelopmental deficits such as blindness and 15% will die.

Other complications include blindness, pneumonia, severe diarrhea and dehydration and ear infections. Another complication that is very rare is called Subacute sclerosing panencephalitis (SSPE). This is a progressive, neurodegenerative disease caused by the measles virus 7-10 years after initially diagnosed with the initial infection.

References:

Barinaga, J., Skolnik, P. (2015). Clinical manifestations and diagnosis of measles. Retrieved from http://www-uptodate-com.offcampus.lib.washington.edu/contents/clinical-manifestations-and-diagnosis-of-measles?source=search_result&search=measles&selectedTitle=1~150#H21

Complications of Measles (2015). CDC. http://www.cdc.gov/measles/about/complications.html