Measles

Measles is characterized by fever, cough, coryza, conjunctivitis, an exanthem composed of erythematous macules and papules, and Koplik spots. In young children, the disease often is complicated by otitis media, pneumonia, croup, and diarrhea. Acute encephalitis, which occurs in 1 in 1,000 cases, may lead to permanent brain injury. In the United States, death occurs in 1 to 3 per 1,000 cases and usually is the result of respiratory or neurologic complications.

Measles is transmitted by direct contact with infectious droplets or, less commonly, by airborne spread. In the prevaccine era, this was an epidemic disease that affected primarily young school-age children. Since vaccine licensure in 1963 and the introduction of immunization programs, there has been a 99% reduction in disease incidence in the United States. Children who have measles are contagious from 4 to 5 days before the onset of the rash (1 to 2 days before the onset of symptoms) to 4 days after the appearance of the rash. The incubation period is 8 to 12 days from exposure until the onset of symptoms.

References:
American Academy of Pediatrics. Measles. In: Pickering LK, ed. 2000 Red Book: Report of the Committee on Infectious Diseases. 25th ed. Elk Grove Village, Ill: American Academy of Pediatrics; 2000:385-386
American Academy of Pediatrics. Passive immunization: immune globulin intravenous. In: Pickering LK, ed. 2000 Red Book: Report of the Committee on Infectious Diseases. 25th ed. Elk Grove Village, Ill: American Academy of Pediatrics; 2000:44-47