Rubeola (Measles)

What is rubeola?

Rubeola, also called 10-day measles, red measles, or measles, is a viral illness that results in a viral exanthem. Exanthem is another name for a rash or skin eruption. Rubeola has a distinct rash that helps aid in the diagnosis. Measles is spread from one child to another through direct contact with discharge from the nose and throat. Sometimes, it is spread through airborne droplets from an infected child. This is a very contagious disease that usually consists of a fever, and cough, followed by a generalized rash. 

What causes the measles?

Measles virus, the cause of measles, is classified as a Morbillivirus. It is mostly seen in the winter and spring. Rubeola is preventable by proper immunization with the measles vaccine.

What are the symptoms of the measles?

It may take between seven to 14 days for a child to develop symptoms of rubeola after being exposed to the disease. It is important to know that a child is contagious four days before the onset of signs and symptoms and four days after the rash develops. Therefore, children may be contagious before they even know they have the disease.

During the early phase of the disease (which lasts between one and four days), symptoms usually resemble those of an upper respiratory infection. The following are the common symptoms of rubeola. However, each child may experience symptoms differently. Symptoms may include:

  • Runny nose

  • Hacking cough

  • Conjunctivitis (pink eye) 

  • Fever

  • Small spots with white centers (Koplik's spots) appear on the inside of the cheek (usually occur two or three days after symptoms begin )

  • Rash. Deep, red, flat rash that starts on the face and spreads down to the trunk, arms, legs and feet. The rash starts as small distinct lesions, which then combines as one big rash. After three to seven days, the rash will begin to clear leaving a brownish discoloration and peeling skin.

  • Severe diarrhea 

The most serious complications from rubeola include the following:

  • Ear infections

  • Pneumonia

  • Croup

  • Encephalitis (inflammation of the brain)

  • Blindness

The symptoms of rubeola may resemble other skin conditions or medical problems. Always consult your child's doctor for a diagnosis.

How is rubeola diagnosed?

Rubeola is usually diagnosed based on a complete medical history and physical examination of your child. The lesions of rubeola are unique and usually allow for a diagnosis simply on physical examination. In addition, your child's doctor may order blood or urine tests to confirm the diagnosis.

What is the treatment for rubeola?

Specific treatment for rubeola will be determined by your doctor based on:

  • Your child's age, overall health, and medical history

  • Extent of the disease

  • Your child's tolerance for specific medications, procedures or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

The goal of treatment for rubeola is to help decrease the severity of the symptoms. Since it is a viral infection, antibiotics are ineffective. Treatment may include:

  • Increased fluid intake

  • Acetaminophen for fever (DO NOT GIVE ASPIRIN)

  • Vitamin A. Two doses are recommended for all children in developing countries who get measles, to help prevent eye damage and blindness, and decrease the number of deaths from the disease. Always consult your child's doctor for advice.

If your child was exposed and has not been immunized, your child's doctor may give the MMR vaccine to the child within 72 hours or immune globin (IG) within six days of measles exposure to help prevent the disease.

How is rubeola prevented?

Since the use of the rubeola (or measles) vaccine, the incidence of measles has decreased substantially. A small percentage of measles are due to vaccine failure. The measles vaccine is usually given in combination with the mumps and rubella vaccine. It is called the MMR. It is usually given when the child is age 12 months to 15 months and then again between age 4 and 6. Other ways to prevent the spread of rubeola include:

  • Children should not attend school or day care for four days after the rash appears. Always contact your child's doctor for advice.

  • Assure all of your child's contacts have been properly immunized.

Learn more about measles and the MMR vaccine at CHOP's Vaccine Education Center.

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