Measles (Rubeola)

Measles is caused by an enveloped RNA virus in the Paramyxoviridae family. It spreads through airborne respiratory particles and is extraordinarily contagious; a susceptible person can be exposed simply by sharing air with an infectious patient. The average incubation period is about 10 days, with a usual range of 7 to 18 days. A patient can transmit the virus beginning 4 days before the rash appears and remains infectious until 4 days after rash onset. The absence of a rash therefore does not make measles safe to ignore. The bedside pattern is a high fever followed by the “3 Cs”: - Cough - Coryza, meaning a runny nose or nasal inflammation - Conjunctivitis, usually non-purulent and associated with photophobia Koplik spots are small white or blue-white lesions on an erythematous base, usually on the buccal mucosa opposite the molars. They often appear 2 to 3 days before the skin eruption and are highly characteristic of measles. The rash is maculopapular, begins at the hairline and face, and spreads downward to the trunk and extremities over several days. An experienced nurse...