Measles is best known for causing a rash in childhood, but measles can affect other parts of the body and sometimes occurs in adults. Vaccination has significantly reduced the number of cases in the United States, although isolated outbreaks continue to occur.


There are two types of measles, each caused by a different virus. Although both produce a rash and fever, they are really different diseases:

  • The rubeola virus causes "red measles", also known as "hard measles" or just "measles". Although most people recover without problems, rubeola can lead to pneumonia or inflammation of the brain (encephalitis).
  • The rubella virus causes "German measles", also known as "three-day measles". This is usually a milder disease than red measles. However, this virus can cause significant birth defects if an infected pregnant woman passes the virus to her unborn child.


Rubeola ("red measles" or "hard measles")


Symptoms appear about 10-14 days after a person is infected with the rubeola virus. This is called the incubation period. During this period, the virus is multiplying. Symptoms occur in two phases.


  • The early phase begins with these symptoms:

- Fever.

- A run-down feeling.

- Cough.

- Red eyes (conjunctivitis).

- Runny nose.

- Loss of appetite.

  • The red measles rash develops from two to four days later.

- The rash usually starts on the face, spreading to the trunk and then to the arms and legs.

- The rash is initially small red bumps that may blend into each other as more appear. From a distance, the rash often looks uniformly red.

- People with measles may develop small grayish spots on the inside of the cheek, called "Koplik spots".

- The rash is usually not itchy, but as it clears up, the skin may shed (this looks like skin that is peeling after sunburn).

- Although red measles is usually a mild disease, a few serious complications may occur. Red measles makes patients more vulnerable to pneumonia and bacterial ear infections. Pneumonia as a complication of measles is especially serious in infants and is responsible for most deaths in this age group. Inflammation of the brain (encephalitis) occurs about once in every thousand cases and is a serious complication that can be fatal.

- Red measles is particularly severe in patients with weakened immune systems, including people who are malnourished or have HIV.


Rubella ("German measles")


German measles causes milder symptoms than red measles. The incubation period between getting the virus and getting sick is 10 days to two weeks.

  • Initially, some people experience fatigue, low-grade fever, headache, or red eyes several days before the rash appears. These symptoms are more common in adults than in children.
  • Swollen, tender lymph nodes may occur in the back of the neck.
  • The rash is light red to pink. It starts as individual spots which may merge together over time. The rash usually starts on the face and moves down to the trunk.
  • The rash does not usually itch, but as it clears up, the skin may shed.
  • Adult women who get rubella may get painful joints for days to weeks after the infection. This affects the hands, wrists, and knees.
  • Symptoms may be so mild that they are not even noticed, especially in children. Most symptoms resolve in a few days, but swollen lymph nodes may persist for a few weeks.
  • The most feared complication of rubella is "congenital rubella", which occurs when an infected pregnant woman passes the virus to her unborn child. Among other problems and birth defects, affected infants may have cataracts, heart defects, hearing impairment, and learning disabilities. The risk of transmission is highest early in pregnancy. The virus may also causemiscarriage or stillbirth.


Both the rubeola and rubella viruses are spread through the respiratory route. This means they are contagious through coughing and sneezing. In fact, the rubeola virus is one of the most contagious viruses known to man.


As a result, it can spread rapidly in a susceptible population. Infected people carry the virus in their respiratory tract before they get sick, so they can spread the disease without being aware of it. If people are immune to the virus (either through vaccination or by having had measles in the past), they cannot get the disease caused by that virus.


For example, someone who had rubeola as a child would not be able to get the disease again. Remember that rubella and rubeola are different viruses. An infection with one of these viruses does not protect against infection with the other.


Although there is no cure for measles, there are steps that can make the disease more tolerable.


These include the following:

  • Get plenty of rest.
  • Sponge baths with lukewarm water may reduce discomfort due to fever.
  • Drink plenty of fluids to help avoiddehydration.
  • A humidifier or vaporizer may ease the cough.
  • Pain relievers and fever reducers such asacetaminophen (Tylenol, Liquiprin Drops, and other brands) and ibuprofen (Advil, Motrin and other brands) can help with symptoms when used according to directions.


Remember never to give aspirin to children or teenagers because it may cause a disease known as Reye syndrome.


There is no specific treatment or cure for measles. Children should stay at home and out of school until they are cleared to return by their health-care provider.

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