Introduction

Measles, also known as rubeola, is one of the most contagious viral diseases known to humankind. Despite the availability of safe and effective vaccines, it continues to cause outbreaks in many parts of the world. The World Health Organization (WHO) identifies measles as a major cause of child mortality, especially in areas with low immunization coverage.

Cause and Transmission

Measles is caused by the measles virus, a member of the Paramyxoviridae family and the Morbillivirus genus. The virus spreads primarily through respiratory droplets when an infected person coughs, sneezes, or even talks.

It can remain active and infectious in the air or on contaminated surfaces for up to two hours. A person with measles is contagious from about four days before the appearance of the rash to four days after it begins.

Symptoms

The disease typically begins after an incubation period of 7 to 14 days. Early symptoms resemble those of a common cold, but rapidly worsen. The main signs and symptoms include:

• High fever (often above 101°F or 38.3°C)

• Cough

• Runny nose (coryza)

• Red, watery eyes (conjunctivitis)

• Small white spots with bluish centers inside the mouth, known as Koplik spots

• A characteristic red, blotchy rash that starts on the face and spreads downward to the body and limbs

The rash usually lasts for about a week and fades gradually.

Complications

Although measles may seem like a mild childhood illness, it can lead to serious and sometimes fatal complications, especially in children under five years old and adults over twenty. Common complications include:

• Ear infections

• Diarrhea and dehydration

• Pneumonia (most common cause of measles-related death)

• Encephalitis (brain inflammation that can cause convulsions or brain damage)

• Blindness and malnutrition, particularly in developing countries

Diagnosis

Diagnosis is usually made based on the clinical symptoms and appearance of the rash. Laboratory confirmation can be done using serological tests that detect measles-specific IgM antibodies or RT-PCR tests to identify viral RNA in blood or throat samples.

Treatment

There is no specific antiviral treatment for measles. Management focuses on relieving symptoms, maintaining good hydration, and preventing complications. Supportive care includes:

• Adequate rest and fluids

• Paracetamol (acetaminophen) to reduce fever

• Vitamin A supplements, which can reduce severity and prevent eye complications

• Antibiotics if secondary bacterial infections occur

Prevention

The most effective protection against measles is vaccination. The MMR vaccine (Measles, Mumps, and Rubella) is given in two doses:

• First dose at 9–12 months of age

• Second dose at 15–18 months or at school entry

High community vaccination coverage (above 95%) is necessary to achieve herd immunity and prevent outbreaks.

Global and Local Situation

Despite major progress, measles remains a global health threat. In 2024–2025, outbreaks have been reported in several countries, including India, the United States, and parts of Africa and Europe.

In India, periodic outbreaks occur in regions with low immunization rates. The Government of India, through the Universal Immunization Programme (UIP), has been running large-scale vaccination drives to eliminate measles and rubella.

Conclusion

Measles is preventable but still dangerous. The best protection lies in maintaining high vaccination coverage, public awareness, and early detection of outbreaks. With continued global cooperation and community participation, measles elimination is not just a hope—it is an achievable goal.