Measles - Symptoms

The first signs of measles are a fever, runny nose, red and runny eyes, and a cough. A few days later, a rash appears in the mouth. The rash consists of tiny white dots on a reddish bump. This rash is called Koplik's spots. They are important in diagnosing measles because they do not occur with other diseases. Koplik's spots are accompanied by a red, sore, swollen throat.

About two days after Koplik's spots appear, the measles rash begins. It first shows up on the head, face, and neck. It then travels to the abdomen and, finally, to the arms and legs. At first, the rash consists of flat, red patches. Eventually, bumps appear. The rash may or may not be itchy. As the rash develops, the patient's temperature begins to rise and may so as high as 105°F (40.5°C). Other symptoms include nausea, vomiting, diarrhea, and swollen lymph nodes. The patient usually feels very ill.

The rash normally lasts about five days. As it fades, it becomes more brownish in color. The affected skin becomes dry and flaky.

A bout of measles leads to other infections in 5 percent to 15 percent of patients. Some of these infections are caused by bacteria. These include ear infections, sinus infections, and pneumonia (see pneumonia entry). Other infections are caused by viruses. Some common viral infections are croup, bronchitis (see bronchitis entry), laryngitis (see laryngitis entry), and viral pneumonia. Inflammation of the liver, appendix, intestines, and lymph nodes are other problems that may develop as a result of a measles infection. Less common complications include inflammation of the heart or kidney, loss of blood platelets (the blood cells that help blood clot; pronounced PLATE-lits), and recurrence of old tuberculosis (see tuberculosis entry) infections.

Probably the most serious complication of a measles infection is encephalitis (see encephalitis entry). Encephalitis is a brain infection that results in a very high fever and swelling of the brain. Symptoms of encephalitis include fever, headaches, sleepiness, seizures, and coma. People with encephalitis may suffer serious, long-term brain damage. Encephalitis occurs in about 1 out of every 1,000 cases of measles. About 10 percent to 15 percent of those who develop the disease die from it.

A very rare complication of measles is called subacute sclerosing panencephalitis. This disease can occur up to ten years after infection by the measles virus. It develops slowly over a period of years and causes massive destruction of the brain. It eventually results in death.