Measles

Measles (or rubeola), is a highly contagious viral
infection characterized by a fever, cough, spots on the
gums, and a red rash that usually begins at the head and
neck and slowly moves down to cover the entire body. The
measles virus, Morbillivirus, is spread by inhalation of
airborne droplets of infected nasal discharge.
 
Measles and chicken pox appear to be the most readily
transmitted of all infections diseases. In urban areas,
measles is largely a disease of preschool and young school
children. Mothers who have had measles give their infants a
transplacental passive immunity for most of the first year
of life. Thereafter, susceptibility is high, as evidenced
by the fact that about 98% of the population has had frank
measles at some time, usually during early childhood.
Before widespread active immunization, epidemics of measles
occurred every two or three years with small localized
outbreaks during intervening years. 

After an incubation period of seven to fourteen days,
prodromal symptoms of fever, hacking cough, and
conjunctivitis appear. Within 24 to 48 hours, Koplik's
spots may be seen in the mouth. The characteristic rash
appears 3 to five days after onset of symptoms and often 2
to 3 days after the appearance of Koplik's spots, beginning
in front of and below the ears and on the side of the neck.
Severity of symptoms varies from epidemic to epidemic. When
the disease is at its height, the temperature may be over
104F., with swelling of the face (particularly about the
eyes), conjunctivitis, a hacking cough, extensive rash, and
mild itching. About the 4th day, the fever falls, the
patient feels more comfortable, and the rash fades rapidly,
leaving a coppery brown discoloration. 

In some instances, however, complications and secondary
infections may prolong the illness. These include ear and
chest infections, diarrhea, vomiting, and abdominal pain.
Encephalitis, or inflammation of the brain, occurs in about
one in 1,000 measles cases. A progressive brain disorder,
subacute sclerosing panencephalitis, occurs in about one in
one million cases. Treatment usually includes bed rest,
drinking plenty of fluids, taking acetaminophen to reduce
the fever, and application of lotions to relieve the
itching 
 
German Measles (Rubella)
 
The disease is caused by a myxovirus spread by droplets
from the nose and throat, airborne or by close contact.
Rubella is less contagious than measles,which is probably
why children often do not contract the disease whereas it
is frequent in young adults. A considerable percentage of
cases are mistakenly diagnosed or are symptomatically so
mild as to escape notice. The incubation period is 14 to 21
days. 

The early symptoms--fever, malaise, sore muscles, headache,
eye irritation, and sensitivity to light--occur about 11
days after infection. Nasal discharge, sneezing, and
coughing develop rapidly. Two to four days after the first
symptom, a characteristic skin rash appears which fades
after a few days. 

Diagnosis should consider measles, scarlet fever, secondary
syphilis, drug rashes, and infectious mononucleosis.
Rubella is differentiated from measles by the absence of
Koplik's spots, and cough. The patient with rubeola is
sicker, and the illness lasts longer. On the 2nd day, the
rubella eruption may resemble that of scarlet fever;
however, even mild scarlet fever has more constitutional
symptoms, including more severe redness and soreness of the
throat. 

Uncomplicated German measles requires little or no
treatment. If itching is present, a lotion or powder may be
applied.