Published August 16, 2024 PEDIATRICS Measles US Pharm. 2024;49(8):15-16. Highly Contagious Virus Measles (also called rubeola) is a highly contagious infectious disease that is caused by a virus. It is easily spread through the air or when a person comes in contact with the virus on surfaces. Measles typically affects children aged younger than 5 years, but adults can become infected, too. After a person is exposed to the measles virus, it can take up to 2 weeks for symptoms to appear. The respiratory symptoms of measles are not specific, so a diagnosis may not be made until a rash appears. Measles infection can have potentially serious, even fatal, complications. These are more likely to occur in young children, adults aged older than 20 years, and those who are pregnant or have weakened immune systems. Vaccinations Prevent Large Outbreaks Before a measles vaccine became available, millions of people were infected every year in the United States. Now, with the vaccine and immunization programs, measles is seldom seen. Unfortunately, measles is still common in many countries without these programs and initiatives. Additionally, small outbreaks of measles still occur in the U.S. when travelers with measles enter the country and infect people who have not been vaccinated. Measles Symptoms and Transmission It can take 7 to 14 days for a person to start experiencing symptoms. Early symptoms include fever, fatigue, runny nose, sore throat, red and watery eyes, and cough. A rash begins on the face and upper neck 3 to 5 days later. It then spreads down the arms, chest, and back and eventually reaches the thighs, hands, and feet. The fever can worsen at this time. After several more days, the fever usually improves and the rash begins to slowly fade. Some people might develop Koplik spots, which are small red spots with blue-white centers, in the mouth before the rash appears. The infection can be spread from 4 days before and up to 4 days after the rash appears. It spreads between people when they breathe air droplets from coughing or sneezing or contact surfaces that are contaminated with the virus. Infected individuals can decrease the risk of spreading the infection if they stay away from group or community activities. Diagnosis and Treatment Measles is diagnosed through a physical examination, including the rash, since other infections can manifest in the way that measles does. Laboratory tests may be used to detect the measles virus in the blood, nose, throat, or urine. Only supportive treatment is available for measles because antibiotics are not effective against viruses. Acetaminophen or ibuprofen may be used to reduce fever. Aspirin should not be given to a child or adolescent due to the risk of Reye’s syndrome, which can be life-threatening. Make sure to ask the pharmacist or physician whether the medications are appropriate to use and, if so, the correct doses. It is important to stay hydrated to replenish fluids that are lost from sweating from a high or prolonged fever. Complications and Prevention Complications from measles can be serious. Common complications include ear infections and diarrhea. However, vomiting, laryngitis, bronchitis, pneumonia, and encephalitis (swelling of the brain) can also happen. Additionally, the virus can cause low birth weight, premature labor, or fetal death in pregnant women. Approximately 90% of unvaccinated people or those who have not gotten measles will become infected if they are exposed. Therefore, the best way to prevent infection and transmission is through vaccination. The measles vaccine is given as part of a measles, mumps, and rubella (MMR) vaccine in infants aged 12 to 15 months and again at age 4 to 6 years. The MMR and varicella (MMRV) vaccine is also available. For children, adolescents, and adults who are not immune, the vaccine should be given immediately and again 28 days later. When traveling internationally, children aged 6 to 11 months should receive a dose of the vaccine, but they will still need the two-dose series after their first birthday. The vaccine contains a weakened live measles virus that stimulates a healthy immune system to generate immunity without developing an infection. This immunity lasts throughout the vaccinated person’s lifetime. Unfortunately, pregnant women or women who think they may be pregnant and those with weakened immune systems cannot receive the vaccine. The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.To comment on this article, contact rdavidson@uspharmacist.com.