Measles virus

Measles is a dangerous and potentially fatal illness caused by the highly contagious respiratory virus known as the measles virus (Morbillivirus).

Fig: Measles Virus

Characteristics of Measles virus

Contagiousness: Nine out of ten non-immune individuals will contract it if they come into contact with an infected person, making it one of the most contagious diseases known.

Transmission: Respiratory droplets from coughing or sneezing carry the virus, which is airborne. After an infected person has left, it can remain in the air or on surfaces for up to two hours.

Infectious Period: From four days prior to the rash's appearance until four days following it, people are contagious.

Measles virus cases worldwide in 2025-2026

Country	Number of Cases
Indonesia	14,406
Yemen	9,277
Mongolia	8,483
Pakistan	8,310
India	8,184
Angola	5,823
Nigeria	4,676
Mexico	3,164
Russian Federation	2,939
Laos People's Democratic Republic	2,859
Nepal	690 (2023-2024)

Source: WHO, Measles and Rubella global report, 2026

Modes of Transmission

·         Airborne Spread: When an infected person breathes, talks, coughs, or sneezes, the virus is expelled into the air in small particles.

·         Environmental Persistence: The measles virus can remain active and contagious in the air or on surfaces for up to two hours after an infected person has left the area.

·         Direct Contact: Transmission can occur through direct contact with infected nasal or throat secretions (e.g., kissing, sharing drinks) or by touching a contaminated surface and then touching your own eyes, nose, or mouth.

·         Vertical Transmission: Though rare, a pregnant woman can transmit the virus to her fetus during pregnancy or to the baby during delivery.

Fig: Transmission of measles

Symptoms

1.      First Stage (3–5 Days) 

The illness often starts with cold-like symptoms: 

·         High Fever: up to 104°F (40°C).

·         Cough: Usually dry or "barky".

·         (Runny Nose): Sneezing and nasal congestion.

·         Conjunctivitis: Red, watery, or sore eyes, often with sensitivity to light (photophobia).

·         Koplik Spots: Tiny white or bluish-white spots on a red background inside the mouth or cheeks. 

2.      

Second Stage or Rash Stage

A red, blotchy rash typically appears a few days after the initial symptoms: 

·         Progression: It starts at the hairline or behind the ears and spreads downward to the face, neck, trunk, arms, and eventually the feet.

·         Appearance: Small, flat red spots that may be joined together by raised bumps, forming large blotchy patches.

D     Duration: The rash usually lasts 5 to 7 days before fading in the same order it appeared

 

Fig: Koplik Spots of Face and body of child

Treatment

There is no specific antiviral treatment or cure for measles

Home Care and Symptom Relief

Most people recover at home within 7 to 10 days by managing the following: 

·         Hydration: Drink plenty of fluids (water, broth, or oral rehydration solutions) to prevent dehydration caused by fever or diarrhea.

·         Fever and Pain Management: Use over-the-counter medications like paracetamol (acetaminophen) or ibuprofen to reduce high fever and body aches.

o    Warning: Do not give aspirin to children or teenagers due to the risk of Reye’s syndrome, a rare but life-threatening condition.

·         Eye Care: If eyes are sensitive to light, stay in a darkened room. Use a damp cloth or cooled, boiled water with cotton wool to gently clean crusty or sticky eyes.

·         Rest: Ensure plenty of rest to help the body recover. 

Medical and Specialized Treatments

In more severe cases:

·         Vitamin A Supplements: All children diagnosed with measles should be given two doses of vitamin A supplements given 24 hours apart. This helps prevent eye damage and can reduce the risk of death by up to 50%.

·         Antibiotics: While antibiotics do not treat the measles virus itself, they are prescribed if secondary bacterial infections develop, such as pneumonia or ear infections.

o    Prevention and control

Vaccination (Primary Prevention): The most effective way to prevent measles is through the MMR (measles, mumps, and rubella) or MMRV (includes varicella) vaccine.

Source:MoHP Nepal, 2025.

A joyful mother with her child after the child received the measles-rubella vaccine.

Source: WHO Nepal/S.G.Amatya