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Measles, Suspected Exposure or Infection — Measles — Clinical Pathway

Suspected Measles Exposure or Infection Clinical Pathway — ED, Outpatient Specialty and Primary Care

Measles

Symptoms
  • Fever with the 4 C’s:
    • Conjunctivitis
    • Coryza (inflammation of mucous membrane of nose usually with discharge)
    • Cough
    • Koplik Spots
Rash
  • Onset 2-4 days after symptoms start
  • Starts on face, head, behind the ears
  • Then cephalocaudal spread to torso
  • Papules coalesce to larger patches
  • Can be itchy
  • Resolves after 1 wk
Incubation
  • 5-21 days
  • Most become symptomatic 10-14 days after exposure
Contagious
  • From start of respiratory symptoms, which start
  • 4 days before onset of rash until 4 days after rash appears
Complications
  • > 30% cases have a complication
  • Most common in age < 5 yrs and adults
  • Diarrhea, AOM, PNA
  • Encephalitis
  • Subacute sclerosing panencephalitis
  • Death
Days of Fever and Symptoms Graph

Source: Iowa DOH

 

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