Measles is a highly contagious viral illness that can lead to serious complications, especially in young children, les femmes enceintes, and the immunocompromised. Although safe and effective vaccines have drastically reduced global cases, outbreaks still occur when vaccination rates fall. This guide explains symptoms, transmission, complications, diagnostic (including serologic testing and RT-PCR), traitement, and prevention.
What is Measles?
Measles is a highly contagious viral infection caused by the measles virus (MeV), a member of the Paramyxoviridae family. It primarily affects children but can occur at any age in unvaccinated individuals. The virus spreads through respiratory droplets from coughs or sneezes of infected people.
Early symptoms include high fever, la toux, nez qui coule, mal de gorge, and red, watery eyes. Dans quelques jours, a red rash appears, typically starting on the face and spreading to the rest of the body.
Key Symptoms and Timeline
- Incubation: 7–14 days after exposure, usually without symptoms.
- Prodrome (2–4 days): High fever, la toux, coryza (nez qui coule), conjunctivitis (red eyes), and Koplik spots (tiny white lesions) on the buccal mucosa.
- Rash: A maculopapular rash starts on the face/hairline, spreads downward to the trunk and limbs, and may coalesce. Fever often peaks with rash onset.
- Recovery: Symptoms improve within a week, though cough and fatigue can linger.
Seek urgent care for breathing difficulty, persistent high fever, confusion, severe dehydration, or if the patient is an infant, pregnant, or immunocompromised.
How Measles Spreads
- Respiratory droplets and aerosols from coughing or sneezing
- Direct contact with nasal or throat secretions
- Measles is so contagious that up to 90% of susceptible close contacts may become infected
Instructions for test types
Serologic Testing
- Detect measles-specific IgM antibodies in a serum specimen collected as soon as possible after rash onset (ideally within the first few days). A second sample may be needed if the initial test is negative but suspicion remains high.
- IgG serology (acute and convalescent) can document seroconversion or a fourfold rise, supporting diagnosis or evidence of immunity.
RT-PCR for Viral Detection
- Real-time reverse transcription polymerase chain reaction (RT-PCR) detects viral RNA and is highly specific.
- Collect a throat swab, écouvillonnage nasopharyngé, or urine for RT-PCR, preferably within the first 3–7 days after rash onset. RT-PCR can also genotype the virus for epidemiologic tracking.
Optimal Specimen Collection
- Respiratory: A flocked throat swab or nasopharyngeal swab placed in viral transport medium.
- Urine: At least 10–50 mL of freshly voided urine in a sterile container (centrifuged if available) can increase detection.
- Échantillon de sérum: For IgM/IgG serology; follow local guidelines on timing and storage.
- Always coordinate with your local public health laboratory for proper collection, stockage (chaîne du froid), and shipping.
Treatment and Supportive Care
There is no specific antiviral therapy for measles. Management is supportive:
- Hydration, antipyretics, and monitoring for complications
- Treat bacterial superinfections (Par exemple, pneumonie, otitis media) as indicated
- Vitamin A supplementation for children with acute measles, per WHO/CDC guidance, reduces morbidity and mortality
Mesures préventives
Vaccination is the most reliable way to prevent measles. Public health organizations recommend that all children receive two doses of the MMR vaccine. Maintaining high vaccination coverage helps prevent outbreaks and protects communities through herd immunity.
Other preventive measures include:
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Avoiding close contact with infected individuals
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Practicing good hand hygiene
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Covering mouth and nose when coughing or sneezing
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