Measles is a highly contagious viral illness that spreads easily from person to person, especially among individuals who haven’t been vaccinated. Measles is particularly dangerous for children. Fortunately, it follows a characteristic sequence of symptoms across all pediatric age groups, aiding in early diagnosis and treatment.
What are typical measles symptoms?
When people think of measles, they typically think of the distinctive rash. However, the rash doesn’t typically appear for several days after the infection. The initial phase typically lasts two to four days and is marked by fever, cough, runny nose, and conjunctivitis. Small, bluish-white spots may appear on the inside of the child’s mouth one to two days before the rash and are considered a strong sign for measles. Then the rash appears, typically starting on the face and spreading down the body. The rash is characterized by small, flat, red spots and small raised bumps.
How does measles affect infants?
Infants often have more severe symptoms. The rash appears two to four days after fever onset, starting on the face and spreading to the trunk and extremities. Infants are at higher risk for complications such as pneumonia, ear infection, and dehydration. Up to 59% of pediatric cases require hospital admission during outbreaks. Death rates are approximately 1-3 per 1,000 measles cases but are higher in infants and those with underlying health conditions.
How does measles affect preschoolers?
Preschool-aged children (1–5 years) typically experience the classic symptoms and rash. Complications remain common, including ear infection (7–9%), diarrhea (8–10%), and pneumonia (1–6%). Neurological complications such as brain swelling (encephalitis) occur in about 1 per 1,000 cases. Hospitalization rates in this group are significant, especially among the unvaccinated, with complications reported in up to 67% of hospitalized children during outbreaks. Death rates are similar to those in infants, but the risk increases in undernourished or immunocompromised children.
How does measles affect school-aged children?
Older children (school-aged and adolescents) generally experience similar symptoms and rash, but the severity of illness and risk of complications decrease with age, especially in those who are vaccinated. Hospitalization and death rates are lower in older children compared to infants and preschoolers, but severe complications such as pneumonia and encephalitis can still occur, particularly in those with immune system suppression or underlying health conditions.
What can parents do?
The single best treatment is prevention. Vaccination with two doses of measles vaccine prevents 95 to 97% of all infections. Treatments after infection has occurred have significantly lower success rates and more complications than the measles vaccine. If you suspect your child has measles, call your healthcare provider before going to the clinic. Measles is highly contagious, and your provider’s office will need to take precautions to lower the risk of you or child spreading it. Follow your provider’s instructions for treatment to ease symptoms and reduce the risk of spreading the illness further.
Overall, measles remains a significant cause of illness and death in children, especially in populations with low vaccination coverage. The most common causes of hospitalization are pneumonia and dehydration, while death is most often due to respiratory or neurological complications. Vaccination remains the best way to protect against measles infection.
– Dr. Greg Kostur is a pediatrician at Health West Pediatrics. He champions a holistic approach to children’s healthcare and is an advocate for Health West’s integrated behavioral health model. Dr. Kostur earned his MD from the Uniformed Services University of Health Sciences in Bethesda, Maryland in 1999.
