[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Conditions](https://durgical.com/en/conditions/) › Measles [Conditions](https://durgical.com/en/conditions/) · [Pediatrics and neonatology](https://durgical.com/en/conditions/) # Measles A very contagious viral infection with fever, cough, red eyes and a rash. Preventable with two vaccine doses; can cause pneumonia and death. Updated 2026-11-01 ## Structures involved Tap one to see what it is and open it in 3D. - [Skin](https://durgical.com/en/anatomy/skin/) - [Right lower lobe](https://durgical.com/en/anatomy/inferior-lobe-of-right-lung/) - [Left lower lobe](https://durgical.com/en/anatomy/inferior-lobe-of-left-lung/) - [Main bronchi](https://durgical.com/en/anatomy/right-main-bronchus/) - [Cornea](https://durgical.com/en/anatomy/cornea/) - [Temporal lobe](https://durgical.com/en/anatomy/middle-temporal-gyrus/) - [Frontal lobe](https://durgical.com/en/anatomy/superior-frontal-gyrus/) ## Microorganisms that cause it - [Measles virus](https://durgical.com/en/microbiology/measles-virus/) ## In the clinical exam - [Mouth and pharynx examination](https://durgical.com/en/clinical-exam/mouth-and-pharynx-examination/) - [Pediatric history: perinatal, growth, development and vaccines](https://durgical.com/en/clinical-exam/pediatric-history-perinatal-growth-development-and-vaccines/) ## Why it happens - [Severe acute malnutrition: marasmus and kwashiorkor](https://durgical.com/en/general-pathology/severe-acute-malnutrition-marasmus-and-kwashiorkor/) - [Innate and adaptive immunity: overview](https://durgical.com/en/physiology/innate-and-adaptive-immunity-overview/) ## What it is An acute, highly contagious infection by the measles virus (a paramyxovirus) that causes fever, cough, coryza, conjunctivitis and a maculopapular rash. It is a notifiable disease and is prevented with the measles-containing vaccine (MMR). ## Who gets it One of the most contagious human diseases. The Americas were declared free of endemic measles in 2016, but falling vaccine coverage has brought imported cases and outbreaks back to the region in recent years. In Colombia, any suspected case (fever plus rash) is reported immediately to public health surveillance. ## Causes - Measles virus, an RNA virus of the genus Morbillivirus - Airborne spread through droplets and aerosols that stay infectious in a room for up to two hours - Infectious from about four days before to four days after the rash appears ## Risk factors - No vaccination or only one dose - Infants too young to be vaccinated - Vitamin A deficiency and malnutrition (risk of severe disease) - Immunosuppression, including HIV infection - Pregnancy - Travel or contact with outbreak areas; crowded settings ## Pathophysiology The virus enters through the respiratory tract and conjunctiva, infects immune cells and spreads through the [lymphatic system](https://durgical.com/en/anatomy/system/lymphatic-system/) and blood to [skin](https://durgical.com/en/anatomy/skin/), lungs, gut and brain. The rash reflects the immune response against infected endothelial cells. The virus wipes out memory lymphocytes ('immune amnesia'), leaving the child vulnerable to other infections for months, and it depletes vitamin A, which damages the [cornea](https://durgical.com/en/anatomy/cornea/). ## Classification - Typical measles - Modified measles in partially immune people (milder) - Complicated measles (pneumonia, encephalitis, keratitis, severe diarrhoea) ## Symptoms and signs - Incubation of about 10 to 14 days - Prodrome of high fever with the three Cs: cough, coryza and conjunctivitis - Koplik spots: small white spots on a red base on the inner cheek, just before the rash - Maculopapular rash starting behind the ears and on the face, spreading downward to trunk and limbs over 3 days and fading in the same order, sometimes with fine peeling - Malaise, sensitivity to light and poor appetite ## Red flags - Fast breathing, chest indrawing or low oxygen saturation (pneumonia) - Seizures, drowsiness or altered consciousness (encephalitis) - Corneal clouding or ulceration, or loss of vision - Severe diarrhoea with dehydration or inability to drink - Infant, malnourished child, pregnant woman or immunosuppressed patient ## Diagnosis **Clinical** Fever with maculopapular rash and cough, coryza or conjunctivitis in a person without documented immunity is a suspected case that must be notified and isolated at once. **Tests** Serum measles-specific IgM and detection of viral RNA by RT-PCR in throat or nasopharyngeal swab or urine, sent through the national public health laboratory network; genotyping traces the source. **Imaging** [Chest](https://durgical.com/en/anatomy/region/chest/) X-ray when pneumonia is suspected; brain MRI for encephalitis. ## Differential diagnosis - Rubella and other viral exanthems (parvovirus B19, roseola, enterovirus) - Dengue and other arboviral infections with rash - Scarlet fever - Kawasaki disease - Drug eruption ## Goal of treatment Support the child through the illness, prevent and treat complications, give vitamin A to reduce eye damage and death, and stop transmission through isolation, notification and vaccination of contacts. ## Treatment **Conservative** Supportive care: fluids, nutrition, fever control, eye care, and airborne isolation until four days after rash onset. **Medical** Vitamin A for every child with measles, given on two consecutive days (with a third dose later when there are eye signs of deficiency), as recommended by WHO. **Medical** Antibiotics for secondary bacterial pneumonia, otitis media or eye infection; oxygen and intensive care when needed. There is no specific antiviral of proven routine benefit. **Follow-up** Public health and nursing: immediate notification, airborne precautions in a negative-pressure or single room, tracing of contacts, post-exposure vaccine within 72 hours or immunoglobulin within 6 days for susceptible high-risk contacts, monitoring of breathing, hydration and level of consciousness. ## Complications - Pneumonia, the main cause of death in children - Acute otitis media and laryngotracheobronchitis - Diarrhoea with dehydration and worsening malnutrition - Keratitis and corneal ulceration leading to blindness, especially with vitamin A deficiency - Acute encephalitis and, years later, subacute sclerosing panencephalitis (SSPE) - Febrile seizures - Miscarriage, preterm birth or low birth weight in pregnancy ## Prognosis Most well-nourished children recover in about two weeks, but measles still kills tens of thousands of children a year worldwide, mostly under five. Risk of death is highest in infants, malnourished children and the immunosuppressed; immune amnesia raises the risk of other infections for months. ## Prevention - Two doses of measles-containing vaccine (MMR in Colombia's schedule, at 1 year and a booster in early childhood) - High, even vaccination coverage (about 95%) to maintain herd immunity - Immediate notification and investigation of every suspected case - Post-exposure vaccination or immunoglobulin for susceptible contacts ## Test yourself Think of the answer, then tap the question to see it. ## What are the classic prodromal features of measles? High fever with cough, coryza and conjunctivitis (the three Cs), plus Koplik spots on the buccal mucosa. ## How does the measles rash spread? It starts on the face and behind the ears and spreads downward to the trunk and limbs, fading in the same order. ## Which supplement reduces eye damage and deaths in children with measles? Vitamin A. ## What is the most common cause of death from measles in children? Pneumonia. ## Which late fatal brain complication can appear years after measles? Subacute sclerosing panencephalitis (SSPE). [Add to my cards (5)](https://durgical.app/estudiar/?add=/en/conditions/measles/) ## Related conditions - [Community-acquired pneumonia](https://durgical.com/en/conditions/community-acquired-pneumonia/) - [Acute otitis media](https://durgical.com/en/conditions/acute-otitis-media/) - [Conjunctivitis](https://durgical.com/en/conditions/conjunctivitis/) - [Kawasaki disease](https://durgical.com/en/conditions/kawasaki-disease/) - [Varicella (chickenpox)](https://durgical.com/en/conditions/varicella/) - [Dengue](https://durgical.com/en/conditions/dengue/) - [Dehydration in children (acute diarrhoeal disease)](https://durgical.com/en/conditions/dehydration-in-children/) - [Febrile seizures](https://durgical.com/en/conditions/febrile-seizures/) Educational information, not medical advice. For any symptom, see a health professional. Sources: [Measles](https://www.who.int/news-room/fact-sheets/detail/measles) (World Health Organization, 2026); [Measles - PAHO/WHO | Pan American Health Organization](https://www.paho.org/en/topics/measles) (Pan American Health Organization, 2026). [← All conditions](https://durgical.com/en/conditions/) ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/conditions/measles/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/conditions/measles/