Measles is an acute viral infection that is highly contagious, especially in children. Measles infection is characterized by fever, runny nose, cough, red eyes, and weakness, followed by a skin rash. Measles itself progresses through several phases, each with its own distinct symptoms. By understanding each phase of measles, parents can recognize the signs and symptoms of infection, prevent the spread of the virus to others, and know when to seek further medical attention.
Measles and How the Virus Attacks the Body
Measles is a disease caused by the measles morbillivirus. This virus spreads through respiratory droplets from an infected person coughing, sneezing, or talking. Transmission can also occur through close contact with an infected person or objects contaminated with the virus.
The virus can even survive in the air and on surfaces for several hours. Therefore, someone who is not yet immune to measles is at high risk of contracting it if they are in the same environment as an infected person.
Understanding the Measles Phases from Initial Infection to Recovery
Measles generally progresses through several phases. Each phase has distinct characteristics and symptoms. The stages of measles infection include the incubation period, prodromal stage, eruption stage, and convalescence (healing).
1. Incubation Period: The virus enters without causing symptoms
The incubation period is the initial stage after someone is exposed to the measles virus. Generally, this phase lasts 6-21 days, with a median of 13 days. It begins when the virus enters the respiratory tract or eyes, then multiplies locally and spreads through the circulatory system.
During the incubation period, there are no obvious symptoms, so many people don't realize they've been infected. The contagious period is estimated to last from five days before the rash appears to four days afterward.
2. Prodromal Phase: Measles Often Mistaken for Flu
At this stage, measles symptoms often resemble those of a respiratory infection or the common cold, so they often go unrecognized early. Symptoms last 2-4 days, but can persist for up to 8 days.
Some common symptoms that appear include:
- High fever
- The body feels weak
- Decreased appetite
- Cough
- Have a cold
- Red and watery eyes
- Sensitive to light
One of the hallmark signs of this phase of measles is the appearance of Koplik spots , which are small, grayish-white spots on the inside of the cheeks (enanthema), which can spread to the mucous membranes of the lips. These spots usually appear 2–3 days before the red rash appears on the skin and persist for 12–72 hours, which is an important clue in diagnosing measles.
3. Rash Phase: Measles Symptoms Begin to Become Clear
The rash phase is the most easily recognized. The measles rash usually appears about 2-4 days after the fever. The rash is reddish, raised, and resembles a rash. In severe cases, the rash may contain blood. The rash begins on the face and then spreads to the neck, chest, back, and limbs.
At this stage the child complains of:
- Fever is usually still high
- Sufferers may feel very weak
- Cough and cold may still persist
- Appetite often decreases
- The risk of transmission is still high
The measles rash usually lasts for several days before starting to fade. Even after the rash appears, the person can still transmit the virus to others up to four days after the rash appears.
4. Recovery/Convalescent Phase and Body Condition After Measles
The final stage of measles is the recovery period. During this phase, the fever begins to subside and other symptoms gradually improve, although the cough may persist for 1-2 weeks.
The previously red rash will turn darker (hyperpigmentation) or brownish before finally disappearing completely.
Even if the primary symptoms have subsided, the body still needs time to restore its immune system after fighting off the viral infection. Therefore, sufferers are still advised to get adequate rest and maintain a healthy nutritional intake during the recovery period.
How to Care for Measles Patients at Home
Most cases of measles can be managed with home care. Treatment for children with measles is supportive to help the body reduce discomfort caused by the symptoms. Some steps that can be taken include:
1. Make sure the patient gets enough rest.
Rest helps the body focus energy on fighting infection and speeds up the recovery process.
2. Meet your fluid needs
Fever can increase the risk of dehydration. Offer water, soup, or other fluids as needed to maintain fluid balance.
3. Use fever-reducing medication as directed by your doctor.
Fever-reducing medication can help improve patient comfort when body temperature rises.
4. Avoid Close Contact with Other People
Measles is highly contagious, so sufferers should reduce interaction with other people, especially babies, the elderly, pregnant women, and individuals with weak immune systems.
5. Consume nutritious food
Eating foods rich in vitamins, minerals, protein, and calories can help support the immune system during the healing process.
6. Beware of Danger Signs
Seek immediate medical attention if the sufferer experiences symptoms that indicate complications, such as shortness of breath or seizures.
When Should Measles Be Checked by a Doctor Immediately?
Although most cases of measles resolve with proper treatment, the condition can still cause serious complications in some people. See a doctor immediately if you experience:
- High fever for more than three days.
- Shortness of breath or rapid breathing
- Seizures
- Persistent vomiting or difficulty in intake
- Loss of consciousness
- Fever after 3-4 days of rash
A medical examination is necessary to confirm the diagnosis and detect potential complications early, such as diarrhea (30%), pneumonia, ear infections (5-10%), or brain inflammation ( encephalitis ). Family members with immunodeficiency conditions, pregnant women, vitamin A deficiency, and malnutrition are at risk for complications.
Article written by Dr. Messia Paramita, Sp.A, M.Sc (Pediatrician at EMC Sentul Hospital).