Infectious diseases specialists diagnose and treat infections from bacteria, viruses, fungi, and parasites, focusing on fevers, antibiotics, and vaccines.
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Measles symptoms appear in a clear, step-by-step pattern as the virus spreads through the body. Unlike many other viral illnesses, measles has a predictable timeline. Recognizing these symptoms early is important for quick diagnosis and isolation, which help stop the spread. Measles spreads extremely efficiently through the air, infecting almost everyone who is not immune.
Following the virus’s entry into the respiratory mucosa, a silent period known as the incubation phase ensues. This typically lasts from 10 to 14 days. During this time, the patient is asymptomatic and unaware of the infection. Biologically, however, the virus is replicating intensely within the local lymphatic tissue and disseminating into the bloodstream (primary viremia). It is towards the very end of this phase, approximately 4 days before the rash appears, that the patient becomes infectious to others, shedding virus from the nasopharynx before knowing they are ill.
To understand infectious diseases, one must understand the agents that cause them. They are biologically distinct and require different treatments.
A unique sign of measles appears 2 to 3 days before the skin rash: Koplik spots. These look like tiny white or bluish-white spots on a red background inside the cheeks, usually near the back teeth. They are often described as “grains of salt on a red background.” Finding these spots lets doctors diagnose measles before the rash appears, giving an important chance to isolate the patient.
The characteristic measles rash, or exanthem, typically emerges 3 to 5 days after the onset of symptoms.
Morphology: The rash consists of erythematous macules (flat red spots) and papules (raised bumps). Initially, the lesions are discrete (separate), but as the rash spreads downwards, those on the face and trunk tend to become confThe rash is made up of flat red spots and raised bumps. At first, the spots are separate, but as the rash spreads, the spots on the face and body often join together, forming large red patches.dermal capillaries and the epidermis.
Measles is an airborne pathogen, meaning it is transmitted via respiratory droplets and aerosolized particles.
Infectivity Period: Patients are contagious from 4 days before the rash appears to 4 days after the rash appears. This pre-rash window is particularly dangerous for public health, as individuals shed large amounts of virus while appearing to have only a common cold.
Measles has an attack rate of over 90% among people who are not immune. If 10 unprotected people are in a room with someone who has measles, at least 9 will get infected. The virus spreads through the air, so no direct contact is needed. Because it spreads so easily, Liv Hospital uses strict isolation measures, such as negative-pressure rooms and airborne precautions.
The symptoms of measles are not limited to the surface. The virus causes a systemic vasculitis and inflammation.
Neurological: Acute encephalitis (inflammation of the brain) occurs in approximately 1 in 1,000 cases, often resulting in permanent brain damage or deafness.
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A person with measles is contagious for 8 days, starting 4 days before the rash appears and ending 4 days after it appears. The most infectious period is usually the prodromal phase (before the rash), when the person is coughing and has a runny nose, as they spread the virus into the air without knowing they have measles.
Koplik spots look like tiny white or bluish-white specks, often described as resembling grains of salt or sand. They appear on the bright red lining of the inside of the cheeks, usually near the back teeth (molars). They are a unique early warning sign of measles that appears a few days before the main skin rash.
The measles virus infects the mucous membranes, including the conjunctiva (the lining of the eye). This causes conjunctivitis, or “pink eye,” leading to inflammation, redness, and swelling. The sensitivity to light (photophobia) occurs because the inflammation irritates the nerve endings in the eye, making normal light levels painful.
While measles is primarily an airborne virus, it can survive on surfaces and objects for up to 2 hours. If an infected person coughs or sneezes on a surface, or touches it with contaminated hands, and you touch that surface and then touch your nose, mouth, or eyes within that two-hour window, transmission is possible.
The measles rash is generally not intensely itchy, unlike the rash of chickenpox. However, some patients may experience mild itching as the rash begins to heal and the skin starts to peel (desquamate). The rash is typically more uncomfortable due to the associated high fever and feeling of heat in the skin rather than itchiness.
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