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Measles

Measles is a highly contagious viral infection, appearing in epidemics. The virus, which is inhaled, multiplies in the respiratory tract. The incubation period varies from ten to fourteen days.

Symptoms

The early signs of measles are very similar to those of a common cold. There is a harsh cough, a runny nose, red eyes and sore throat; and exposure to bright light is often uncomfortable (photophobia). There may be headache, hoarseness and diarrhoea with a rise in temperature. A diagnosis of measles can usually be made by the early appearance inside the cheek of small white spots called Koplik's spots. The disease is at its most infectious at this early stage.

After the initial fever the temperature will often return to normal, and then rise again to about 40°C (104°F) on the evening before the skin rash appears. At first the rash is composed of distinct pink spots, but as it spreads to cover the whole body the colour intensifies to a reddish-purple and the spots become raised and pimple-like (papules). These papules become so numerous that they tend to join together at their edges, giving the impression of large, irregular blotches on the skin. After forty-eight to seventy-two hours, the temperature gradually returns to normal and the rash begins to fade, leaving a brownish stain which lasts about seven to ten days, after which time the affected skin peels off.

The danger of measles lies in the possibility of its complications such as bronchopneumonia, ear infection or otitis media and inflammation of the brain, or encephalomyelitis.

Treatment

There is no specific treatment except to make the patient comfortable in bed; the illness has to take its course. Conjunctivitis can be eased by bathing the eyes with warm boracic acid or sodium bicarbonate solution several times a day, and if there is photophobia the amount of light entering the room must be reduced. If the tongue is furred the mouth can be cleaned by rinsing with a mouthwash. Anti­biotics may be prescribed if there is a secondary bacterial infection.

Vaccination against measles is recommended for all children. It is usually administered at about fifteen months of age.

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