Smarter Decisions,
Better Care

UpToDate synthesizes the most recent medical information into evidence-based practical recommendations clinicians trust to make the right point-of-care decisions.

  • Rigorous editorial process: Evidence-based treatment recommendations
  • World-Renowned physician authors: over 5,100 physician authors and editors around the globe
  • Innovative technology: integrates into the workflow; access from EMRs

Choose from the list below to learn more about subscriptions for a:


Subscribers log in here


Clinical presentation and diagnosis of measles

INTRODUCTION

Measles virus (rubeola) is a member of the family Paramyxoviridae, genus Morbillivirus. Measles virus infection can cause a variety of clinical syndromes, including [1]:

Classic measles infection in immunocompetent patients

Modified measles in patients with preexisting but incompletely protective anti-measles antibody

Atypical measles in patients immunized with the killed virus vaccine

Neurologic syndromes following measles infection, including acute disseminated encephalomyelitis (ADEM) and subacute sclerosing panencephalitis (SSPE)

                          

Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: Oct 2014. | This topic last updated: Jun 10, 2014.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2014 UpToDate, Inc.
References
Top
  1. Moss WJ, Griffin DE. Measles. Lancet 2012; 379:153.
  2. Sugerman DE, Barskey AE, Delea MG, et al. Measles outbreak in a highly vaccinated population, San Diego, 2008: role of the intentionally undervaccinated. Pediatrics 2010; 125:747.
  3. Centers for Disease Control and Prevention (CDC). Update: measles--United States, January-July 2008. MMWR Morb Mortal Wkly Rep 2008; 57:893.
  4. Perry RT, Halsey NA. The clinical significance of measles: a review. J Infect Dis 2004; 189 Suppl 1:S4.
  5. BABBOTT FL Jr, GORDON JE. Modern measles. Am J Med Sci 1954; 228:334.
  6. Cherry JD. Measles virus. In: Textbook of Pediatric Infectious Diseases, 6th ed, Feigin RD, Cherry JD, Demmler-Harrison GJ, et al (Eds), Saunders, Philadelphia 2009. p.2427.
  7. Bernstein DI, Schiff GM. Measles. In: Infectious Diseases, Gorbach SL, Bartlett JG, Blacklow NR (Eds), WB Saunders, Philadelphia 1998. p.1296.
  8. Griffin DE, Bellini WJ. Measles virus. In: Fields' Virology, Fields BN, Knipe DM, Howley PM (Eds), Lippincott-Raven, Philadelphia 1996. p.1267.
  9. HUDSON JB, WEINSTEIN L, CHANG TW. Thrombocytopenic purpura in measles. J Pediatr 1956; 48:48.
  10. Abramson O, Dagan R, Tal A, Sofer S. Severe complications of measles requiring intensive care in infants and young children. Arch Pediatr Adolesc Med 1995; 149:1237.
  11. Suringa DW, Bank LJ, Ackerman AB. Role of measles virus in skin lesions and Koplik's spots. N Engl J Med 1970; 283:1139.
  12. Schaffner W, Schluederberg AE, Byrne EB. Clinical epidemiology of sporadic measles in a highly immunized population. N Engl J Med 1968; 279:783.
  13. Cherry JD, Feigin RD, Lobes LA Jr, et al. Urban measles in the vaccine era: a clinical, epidemiologic, and serologic study. J Pediatr 1972; 81:217.
  14. Sissons JG, Borysiewicz LK. Viruses. In: Clinical Aspects of Immunology, Lachmann PJ, Peters K, Rosen FS, et al. (Eds), Blackwell Scientific, Boston 1993. p.1497.
  15. Gershon AA. Measles virus (rubeola). In: Mandell, Douglas and Bennett's Principles and Practice of Infectious Diseases, Mandell GL, Bennett JE, Dolin R (Eds), Churchill Livingstone, New York City 1995. p.1519.
  16. Darmstadt GL, Lane A. Disorders of the mucous membranes. In: Nelson Textbook of Pediatrics, 15th ed, WB Saunders, Philadelphia 1996. p.1888.
  17. Laboratory diagnosis of measles infection and monitoring of measles immunization: memorandum from a WHO meeting. Bull World Health Organ 1994; 72:207.
  18. Nandy R, Handzel T, Zaneidou M, et al. Case-fatality rate during a measles outbreak in eastern Niger in 2003. Clin Infect Dis 2006; 42:322.
  19. Kaplan LJ, Daum RS, Smaron M, McCarthy CA. Severe measles in immunocompromised patients. JAMA 1992; 267:1237.
  20. CHRISTENSEN PE, SCHMIDT H, BANG HO, et al. An epidemic of measles in southern Greenland, 1951; measles in virgin soil. III. Measles and tuberculosis. Acta Med Scand 1953; 144:450.
  21. Arya LS, Taana I, Tahiri C, et al. Spectrum of complications of measles in Afghanistan: a study of 784 cases. J Trop Med Hyg 1987; 90:117.
  22. Beckford AP, Kaschula RO, Stephen C. Factors associated with fatal cases of measles. A retrospective autopsy study. S Afr Med J 1985; 68:858.
  23. Quiambao BP, Gatchalian SR, Halonen P, et al. Coinfection is common in measles-associated pneumonia. Pediatr Infect Dis J 1998; 17:89.
  24. Garly ML, Balé C, Martins CL, et al. Prophylactic antibiotics to prevent pneumonia and other complications after measles: community based randomised double blind placebo controlled trial in Guinea-Bissau. BMJ 2006; 333:1245.
  25. Kabra SK, Lodha R, Hilton DJ. Antibiotics for preventing complications in children with measles. Cochrane Database Syst Rev 2008; :CD001477.
  26. Johnson RT, Griffin DE, Hirsch RL, et al. Measles encephalomyelitis--clinical and immunologic studies. N Engl J Med 1984; 310:137.
  27. Adams RD, Victor M, Ropper AH. Multiple sclerosis and allied demyelinative diseases. In: Principles of Neurology, McGraw-Hill (Ed), New York City 1997. p.921.
  28. Dyken PR. Viral diseases of the central nervous system. In: Pediatric Neurology: Principles and Practice, Mosby, St. Louis 1994. p.670.
  29. Centers for Disease Control (CDC). Subacute sclerosing panencephalitis surveillance - United States. MMWR Morb Mortal Wkly Rep 1982; 31:585.
  30. Bellini WJ, Rota JS, Lowe LE, et al. Subacute sclerosing panencephalitis: more cases of this fatal disease are prevented by measles immunization than was previously recognized. J Infect Dis 2005; 192:1686.
  31. Bernstein DI, Reuman PD, Schiff GM. Rubeola (measles) and subacute sclerosing panencephalitis virus. In: Infectious Diseases, Gorbach SL, Bartlett JG, Blacklow NR (Eds), WB Saunders, Philadelphia 1998. p.2135.
  32. Garg RK. Subacute sclerosing panencephalitis. J Neurol 2008; 255:1861.
  33. Sun X, Burns JB, Howell JM, Fujinami RS. Suppression of antigen-specific T cell proliferation by measles virus infection: role of a soluble factor in suppression. Virology 1998; 246:24.
  34. Adams RD, Victor M, Ropper AH. Viral infections of the central nervous system. In: Principles of Neurology, McGraw-Hill, New York City 1997. p.767.
  35. Fisch BJ. Periodic complexes. In: Spehlmann's EEG Primer, Fisch BJ (Ed), Elsevier Science, Amsterdam 1991. p.376.
  36. Seo YS, Kim HS, Jung DE. 18F-FDG PET and MRS of the early stages of subacute sclerosing panencephalitis in a child with a normal initial MRI. Pediatr Radiol 2010; 40:1822.
  37. Kagame K, Schwab L. Childhood blindness: dateline Africa. Ophthalmic Surg 1989; 20:128.
  38. Ross LA, Kim KS, Mason WH Jr, Gomperts E. Successful treatment of disseminated measles in a patient with acquired immunodeficiency syndrome: consideration of antiviral and passive immunotherapy. Am J Med 1990; 88:313.
  39. Oldstone MB. Virus-lymphoid cell interactions. Proc Natl Acad Sci U S A 1996; 93:12756.
  40. Bhardwaj N. Interactions of viruses with dendritic cells: a double-edged sword. J Exp Med 1997; 186:795.
  41. Kannangara S, DeSimone JA, Pomerantz RJ. Attenuation of HIV-1 infection by other microbial agents. J Infect Dis 2005; 192:1003.
  42. Moss WJ, Monze M, Ryon JJ, et al. Prospective study of measles in hospitalized, human immunodeficiency virus (HIV)-infected and HIV-uninfected children in Zambia. Clin Infect Dis 2002; 35:189.
  43. Moss WJ, Ryon JJ, Monze M, et al. Suppression of human immunodeficiency virus replication during acute measles. J Infect Dis 2002; 185:1035.
  44. Grivel J, Garca M, Moss W, et al. Chemokine/cytokine modulation by measles virus induces HIV-1 suppression in human lymphoid tissue ex vivo [abstract TuOrA1185]. In: EJournal of the International AIDS Society, XV International AIDS Conference (Bangkok). Geneva: International AIDS Society, 2004.
  45. Embree JE, Datta P, Stackiw W, et al. Increased risk of early measles in infants of human immunodeficiency virus type 1-seropositive mothers. J Infect Dis 1992; 165:262.
  46. Scott S, Cumberland P, Shulman CE, et al. Neonatal measles immunity in rural Kenya: the influence of HIV and placental malaria infections on placental transfer of antibodies and levels of antibody in maternal and cord serum samples. J Infect Dis 2005; 191:1854.
  47. de Moraes-Pinto MI, Verhoeff F, Chimsuku L, et al. Placental antibody transfer: influence of maternal HIV infection and placental malaria. Arch Dis Child Fetal Neonatal Ed 1998; 79:F202.
  48. Atmar RL, Englund JA, Hammill H. Complications of measles during pregnancy. Clin Infect Dis 1992; 14:217.
  49. Siegel M, Fuerst HT. Low birth weight and maternal virus diseases. A prospective study of rubella, measles, mumps, chickenpox, and hepatitis. JAMA 1966; 197:680.
  50. Gershon AA. Chickenpox, measles and mumps. In: Infectious Diseases of the Fetus and Newborn Infant, 6th ed, Remington JS, Klein JO, Wilson CB, et al (Eds), Elsevier Saunders, Philadelphia 2006. p.693.
  51. Siegel M, Fuerst HT, Peress NS. Comparative fetal mortality in maternal virus diseases. A prospective study on rubella, measles, mumps, chicken pox and hepatitis. N Engl J Med 1966; 274:768.
  52. Ogbuanu IU, Zeko S, Chu SY, et al. Maternal, fetal, and neonatal outcomes associated with measles during pregnancy: Namibia, 2009-2010. Clin Infect Dis 2014; 58:1086.
  53. Bellini WJ, Helfand RF. The challenges and strategies for laboratory diagnosis of measles in an international setting. J Infect Dis 2003; 187 Suppl 1:S283.
  54. Mason EO. Use of the serology laboratory. In: Textbook of Pediatric Infectious Diseases, 5th ed, Feigin RD, Cherry JD, Demmler GJ, et al (Eds), WB Saunders, Philadelphia 2004. p.3318.
  55. Featherstone D, Brown D, Sanders R. Development of the Global Measles Laboratory Network. J Infect Dis 2003; 187 Suppl 1:S264.
  56. Jenkerson SA, Beller M, Middaugh JP, Erdman DD. False positive rubeola IgM tests. N Engl J Med 1995; 332:1103.
  57. Measles. In: Red Book: 2012 Report of the Committee on Infectious Diseases, 29th ed, Pickering LK (Ed), American Academy of Pediatrics, Elk Grove Village, Illinois 2012. p.444.