Measles (rubeola) is a highly contagious viral
infection—so contagious that 90% of people exposed to
it, who are not immune, will develop the disease. Since vaccinations were
introduced in 1963, measles has become rare in developed countries, including
the United States. However, there are still an estimated 30 million cases of
measles worldwide each year, resulting in 888,000 deaths.
Signs and Symptoms
Measles is associated with the following signs and symptoms:
Moderate to high fever
Conjunctivitis (red, irritated eyes)
Sore throat; hoarseness
Red spots with bluish-white centers, called Koplik's spots, on the
inside of the mouth
Red blotchy rash, which begins on the face and then spreads
Enlarged lymph nodes
Rarely (1 in 1000 cases), extreme drowsiness, seizure, or coma,
suggesting involvement of the central nervous
What Causes It?
Measles is caused by a virus (paramyxovirus) that is spread through the air
or by contact with infectious droplets from the nose, mouth, or throat. The
disease is so contagious that it's possible to contract it by merely being in
the same room as an infected person. Most people get measles because they were
never immunized. Once someone has had measles, that person is immunized for
Who's Most At Risk?
People with the following conditions or characteristics are at risk for
Impaired immunity caused by a congenital immunodeficiency, the human
immunodeficiency virus (HIV), or certain drugs that suppress the immune system
(for example, cancer chemotherapy medicines)
Infants less than 1 year of age (too young to be immunized)
Other children and adults who have not been immunized or who have been
insufficiently immunized (single immunization prior to 1989, when two doses
Diminished immunity from vaccination in childhood (occurs rarely but
with increasing frequency as adults get older)
What to Expect at Your Provider's Office
Anyone with a fever and unexplained rash should see a healthcare provider. He
or she will do a physical examination, checking for Koplik's spots or the rash
that usually appears several days after the spots have disappeared. Due to the
success of immunizations, most young providers have never seen a case of
measles. To help confirm the diagnosis, they will frequently order a blood test
to detect the presence of antibodies against the measles virus. They may also
use other blood tests to help diagnose a bacterial infection that may develop in
addition to the original viral infection.
Vaccination is the key to preventing measles. Since the 1980s, the live,
weakened measles vaccine, available as the combination vaccine of
measles-mumps-rubella (MMR), is administered in two
doses—one at age 12 to 15 months and the second at age
5 to 12 years. Of those who receive the vaccine, greater than 95% have lifelong
immunity. Note: People allergic to eggs (the vaccine virus is grown in
chick embryos), and those allergic to neomycin (a type of antibiotic frequently
found in topical preparations for cuts and burns) should consult with their
healthcare provider before receiving the vaccine.
Rest, drinking plenty of fluids, and treatment to relieve symptoms are
adequate if there are no complications.
The following medications may be used in the management of
Antipyretics (for example, acetaminophen) for high fevers
Antibiotics for bacterial complications such as pneumonia and ear
Ribavirin for antiviral treatment (not FDA-approved for this
Immune globulin followed by measles vaccination 5 to 6 months
Complementary and Alternative
People who are deficient in vitamin A are more likely to get infections,
including measles, and their cases are more likely to be severe, even fatal. In
areas of the world where vitamin A deficiency is widespread or where at least 1%
of those with measles die, experts (including the World Health Organization)
recommend giving high doses of vitamin A supplements to children with the
Flavonoids, plant compounds with potent biologic activity, are believed to
help fight viruses. Of those tested in vitro (in a lab), the following has
demonstrated slight benefit against measles:
Wax tree (Rhus succedanea L.); rhusflavanone is the active
ingredient in the case of measles.
Calendula flower (Calendula officinalis) has shown antiviral
activity in vitro and is thought to enhance the immune system, although it has
not been studied against measles specifically.
Spicebush (Linderabenzoin) is a remedy used by Native
Americans of the Cherokee nation for measles; not studied
Thirty out of 142 extracts of traditional herbal remedies studied in vitro
(in test tubes) showed antimeasles activity. The most active included:
Mugwort (Artemisia princeps)
Kosam seed (Brucea javanica)
Sappan wood (Caesalpinia sappan)
Goldthread (Coptis chinensis)
Forsythia (Forsythia suspensa)
Amur corktree (Phellodendron amurense)
Pomegranate (Punica granatum)
Japanese sumac (Rhus javanica)
Chinese Skullcap (Scutellaria baicalensis)
Fire-flame bush (Woodfordia
Test tube studies do not necessarily translate to effectiveness or safety in
people; more research is needed to know the value of these herbs in clinical
There have been few studies examining the effectiveness of specific
homeopathic remedies. A professional homeopath, however, may recommend one or
more of the following treatments for measles based on his or her knowledge and
clinical experience. Before prescribing a remedy, homeopaths take into account a
person's constitutional type. In homeopathic terms, a person's constitution is
his or her physical, emotional, and intellectual makeup. An experienced
homeopath assesses all of these factors when determining the most appropriate
remedy for a particular individual.
Aconitum — for symptoms that come on
suddenly including fever, conjunctivitis, dry cough, and restlessness; best used
very early in the course of the disease
Apis mellifica — for individuals with
swollen lips and eyes and a rash that is not fully developed; warmth increases
itchiness as well as swelling
Belladonna — can be used either during
early stages of measles or after the rash has erupted; useful for those who have
difficulty sleeping and symptoms that include fever, headache, and drowsiness
Bryonia — for individuals with a
delayed rash who have a dry, painful cough, headaches, and muscle pain that
worsens with movement and warmth; this remedy is most appropriate for
individuals with a rash primarily on the chest, a dry mouth, and a desire for
Euphrasia — for nasal discharge, red
eyes, and tears associated with measles; this remedy is most appropriate for
individuals who have a strong sensitivity to light
Gelsemium — for the early stages of
measles when there is a slow onset of fever and chilliness, cough, headache,
weakness, and a watery nasal discharge that burns the upper lip; the individual
for whom this remedy is most appropriate may be tired, apathetic and have little
or no thirst
Pulsatilla — can be used at any stage
of the measles but often used after fever has resolved; the individual for whom
this remedy is appropriate may have thick, yellow nasal discharge, a dry cough
at night, a productive cough in the daytime, and mild ear pain; symptoms are
Sulphur — for measles in which the
skin has a purplish appearance; the individual for whom this remedy is
appropriate may have red mucus membranes with a cough and diarrhea that is worse
in the mornings
Measles is most often an uncomplicated childhood illness. However, infants
and adults, especially those who are malnourished or whose immune system is
weak, may develop complications that involve the respiratory system, central
nervous system, or digestive system, in which case hospitalization is required.
A small percentage of people who contract measles will die as a result. The
measles mortality rate is 0.3% in industrialized countries, and 1% to 10% in
Measles in a pregnant woman can result in premature birth, miscarriage,
stillbirth, or low-birth-weight babies. Infants of mothers with active measles
should be given immune globulin at birth. Pregnant women should not be
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Review Date: December 2000
Reviewed By: Participants in the review process include: Richard Glickman-Simon, MD,
Department of Family Medicine, New England Medical Center, Tufts University,
Boston, MA; Jacqueline A. Hart, MD, Department of Internal Medicine,
Newton-Wellesley Hospital, Harvard University and Senior Medical Editor
Integrative Medicine, Boston, MA; Dahlia Hirsch, MD, Center for Holistic
Healing, BelAir, MD.
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of any of the information contained herein, including any injury and/or damage
to any person or property as a matter of product liability, negligence, or
otherwise. No warranty, expressed or implied, is made in regard to the contents
of this material. No claims or endorsements are made for any drugs or compounds
currently marketed or in investigative use. This material is not intended as a
guide to self-medication. The reader is advised to discuss the information
provided here with a doctor, pharmacist, nurse, or other authorized healthcare
practitioner and to check product information (including package inserts)
regarding dosage, precautions, warnings, interactions, and contraindications
before administering any drug, herb, or supplement discussed