Measles

Symptoms

• High fever (40°C [104°F] or more) that subsides on the third day after the rash appears
• Blotchy rash with round, red, raised areas that are smooth to the touch; the rash begins to appear on the face about 3 to 5 days after the onset of fever, and then spreads over the body, moving from top to bottom
• Red, watery eyes and light sensitivity
• Cold-like symptoms (fever, cough, runny nose) a few days before other symptoms appear

If your child has a high fever, talk speak to your doctor as soon as possible, especially if your child won’t eat or drink and is experiencing vomiting and headaches. Don’t wait to see if a rash appears before contacting your doctor. They can check for other causes of the fever (e.g., a urinary tract infection, pneumonia, or meningitis).

Complications

If your child already has the measles and has any of the following symptoms, see below for what to do.

• Their ears or throat hurt: In some cases, a sore throat may indicate a complication that requires antibiotics, such as laryngitis or laryngotracheitis.
• They’re having diarrhea.

Before you arrive, notify the clinic or hospital that your child has the measles. The staff will tell you what to do to avoid spreading the illness.

• Has a headache
• Seems confused or sleepy
• Starts vomiting
• Has trouble breathing
• Has a seizure

Complications are rare. Complications may include otitis, pneumonia, bronchitis, febrile seizure, and for smaller children, diarrhea and vomiting. In very rare cases, measles can lead to encephalitis.

What is measles?

Measles is an infection caused by a virus that has become increasingly rare in Quebec, thanks to vaccination. However, this disease is highly contagious for unvaccinated people.

Treatment

There is no specific treatment for measles. As long as there are no complications, no treatment other than fever control is needed. No antiviral treatment currently exists to treat measles complications.

Sometimes doctors prescribe an antibiotic to treat complications (e.g., otitis, pneumonia).

In some cases, if medically recommended, vitamin A supplements may be given to help reduce the severity of measles symptoms and avoid the risk of certain complications.

Care and practical advice

• Encourage quiet activities. You don’t have to keep your child in bed all day, but they do need rest.
• Give your child small amounts of fluids, frequently. You can offer water, milk, or apple or grape juice (no more than 120 ml of juice a day). Avoid overly acidic juices (e.g., orange juice, lemonade).
• To relieve their fever, give them acetaminophen (Tylenol^® or Tempra^®) or ibuprofen (Advil^®, Motrin^®, etc.) as indicated and according to the recommended dose for your child’s weight. Don’t give ibuprofen to babies under 6 months, and never give Aspirin^® (acetylsalicylic acid) to a child or teenager.
• Disinfect the bathtub after bathing your child. Launder their washcloth and towel after each use, too.
• Watch for signs of complications: earache, sore throat, headache, vomiting, diarrhea, breathing problems, or seizure.

Prevention

Vaccination is the best way to protect your child from the measles.

The Quebec vaccination schedule calls for two doses of the MMR (measles, mumps, rubella) vaccine. The first dose is given at 12 months, the second at 18 months. This vaccine provides over 85% protection after one dose and over 95% after two doses. For information about the other recommended vaccines, consult the full vaccination schedule.

Vaccination is recommended before the age of 12 months for children travelling to regions where measles tends to be more common or regions with a measles epidemic.

Recently reported cases of measles are considered local outbreaks. These are usually caused by people who carry the measles virus after contracting it in another country. Outbreaks can also occur in the event of contact with local communities where children are unvaccinated.

Unvaccinated infant exposure to measles

Mothers who have been vaccinated or who have already had the measles will pass on their antibodies to their babies, protecting them until the age of 6 months. In case of doubt about maternal antibodies, infants less than one year old should receive an antibody injection.

Children aged 6 months and over who are not protected against measles can be given a postexposure vaccine in the 72 hours after their first exposure to the illness. They must also receive their regularly scheduled measles vaccinations at 12 and 18 months.

Scientific review: Dr. Anne-Claude Bernard-Bonnin, pediatrician Research and copywriting:The Naître et grandir team Updated: January 2024

Photo: AdobeStock/Luci