Measles is a vaccine-preventable disease, and a safe, effective and inexpensive vaccine is widely available. The fact that MeV is contagious before the onset of recognizable disease can hinder the effectiveness of quarantine measures, although isolation of susceptible contacts is recommended. ![]() People with measles are considered infectious from 4 days before to 4 days after the onset of rash, when the levels of MeV in the respiratory tract are highest 1. The clustered white lesions that can be seen on the buccal mucosa lining the cheeks - Koplik spots - are considered pathognomonic for measles. The clinical signs of measles are a generalized maculopapular (non-vesicular) skin rash and fever above 38.3 ☌ (101 ☏) accompanied by cough, coryza (or rhinitis) and/or conjunctivitis. The incubation period is approximately 10 days to the onset of fever and 14 days to the onset of rash. The prodromal phase of measles involves sneezing and coughing, which enhance the transmission of the virus. The virus can also be transmitted through direct contact with infected secretions, but MeV does not survive long on fomites (that is, any object that can carry pathogens, for example, skin, hair, clothing and bedding) as it is inactivated by heat and UV radiation within a few hours. MeV is an airborne pathogen that is transmitted by inhalation of respiratory droplets that disperse within minutes and smaller aerosols that can remain suspended for several hours 2, 3. The measles virus (MeV) is a single-stranded, negative-sense RNA virus in the genus Morbillivirus of the family Paramyxoviridae 1. Because of the availability of a highly effective and relatively inexpensive vaccine, the monotypic nature of the virus and the lack of an animal reservoir, measles is considered a candidate for eradication. All six WHO regions have set goals to eliminate endemic transmission of MeV by achieving and maintaining high levels of vaccination coverage accompanied by a sensitive surveillance system. Case fatality ratio estimates vary from 5% in developing countries. Measles remains a considerable cause of childhood mortality worldwide, with estimates that >100,000 fatal cases occur each year. However, endemic transmission continues in many parts of the world. All current measles vaccines contain a live attenuated strain of MeV, and great progress has been made to increase global vaccination coverage to drive down the incidence of measles. Case confirmation depends on clinical presentation and results of laboratory tests, including the detection of anti-MeV IgM antibodies and/or viral RNA. ![]() MeV causes immunosuppression, and severe sequelae of measles include pneumonia, gastroenteritis, blindness, measles inclusion body encephalitis and subacute sclerosing panencephalitis. Symptoms of measles include fever and maculopapular skin rash accompanied by cough, coryza and/or conjunctivitis. ![]() Before the introduction of an effective measles vaccine, virtually everyone experienced measles during childhood. Measles is an infectious disease in humans caused by the measles virus (MeV).
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