SYMPTOMS: The diagnosis of measles is suspected in a
child who has not received the measles vaccine and who, after coming in contact with a case of measles, develops
fever, dry cough, running of the nose, and watering of the eyes.
The symptoms worsen as the days pass. After 3 to 4 days
(a day before the rash appears), the child gets white
spots, like grains of salt on a red surface (koplick spots) inside
the cheek opposite the first and second upper molar teeth. The
rash appears the next day, first on the hairline and then
spreading downward, starting as fine, slightly raised spots, which
may join together to give a patchy appearance. The fever
shoots up to around 104°F.
The child looks quite ill and loses his appetite. He may
not even want to have water. If he is breastfed, he may
demand feeds more often. The fever continues for about 3 days
after the appearance of the rash, which lasts for 5 to 8 days.
After the rash fades, the skin may tend to peel off.
How To Differentiate Measles From Other Similar Illnesses
When a mother tells me that her child got a second
attack of measles or he had measles after having received the
measles vaccine, it is often a case of mistaken diagnosis. The
child probably had or is now having a measles-like illness and
not measles. One such illness is exanthem subitum or roseola infanturn. This is also a viral infection in which the
child gets high fever as in measles, but does not look too sick.
There is hardly any cold or cough. After 3 days, the fever
suddenly returns to normal to be followed the next day by a light
red rash that is not raised from the skin. It spreads from the
trunk or the face and then to the limbs and fades within a day. It
may be noticed that in measles, the temperature rises as the
rash appears and the fever continues for a few days more
along with the rash. But in exanthem subitum, the fever returns to
normal.
TREATMENT: There is no specific treatment. For cough, a homemade syrup of 2 parts of
honey, one part of lime
juice and tulsi (or ginger)
juice is helpful. (Also see Cough).
A child can be given 1 to 2 teaspoons of this mixture 4
to 5 times a day.
Children with measles prefer to stay in the dark as
bright light causes discomfort to the eyes.
For fever, sponging with slightly warm water can be done or paracetamol may be given. Daily
sponging of the whole body is advisable. A bath with slightly warm water is
also allowed.
Give the child the food he asks for; no food
restrictions are necessary. Make sure he drinks enough fluids including
juice, coconut water and plain water. Consult your doctor to
rule out complications if your child refuses all foods and
liquids and if he has fast breathing, earache, persistent headache, drowsiness or vomiting, or if the fever and cough
persist after about 10 days.
Your child with measles is infectious to others from 1
to 2 days before the onset of illness to about 4 days after
the rash appears. Keep him home from school and away from
your other children. If the patient’s brother or sister has
not had measles before, they should not be sent to school or any crowded place for 10 days. This is to prevent them
infecting people they come in contact with.
