Measles in Children: Understanding Risks and Prevention

There is no "adult measles" distinct from childhood measles. Measles (rubeola) is caused by a single virus (MeV, genus Morbillivirus). The disease is the same regardless of age, but severity and complications differ.

Key Facts

• Transmission: Airborne (aerosols); R₀ 12–18 (most contagious human pathogen). Infectious 4 days before to 4 days after rash onset.
• Incubation: 10–14 days (avg 11–12).
• Prodrome: Fever, cough, coryza, conjunctivitis (3 "C"s), Koplik spots (pathognomonic).
• Rash: Maculopapular, starts face/hairline → spreads downward; lasts 5–6 days.

Age‑Related Severity

Prevention

• MMR vaccine: 2 doses (12–15 mo, 4–6 yr) – 97% effective.
• Herd immunity: Requires ≥95% 2‑dose coverage.
• Post‑exposure prophylaxis: MMR within 72 hrs or IG within 6 days for susceptible contacts.

Global Context

Measles eliminated in Americas (2016) but resurgent due to vaccination gaps. 136,000 deaths globally (2022), mostly unvaccinated children.

Measles is one disease; age modifies outcome. Vaccination is the only reliable prevention.

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Group	Risk
Children <5 years	High complication rate: pneumonia, otitis, diarrhea, encephalitis (1/1000), death (1–3/1000)
Adults ≥20 years	Higher pneumonia, hospitalization, encephalitis risk; pregnancy → miscarriage, preterm birth
Immunocompromised	Severe, prolonged, atypical (no rash); high mortality