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measles
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{{pp-semi|small=yes}}{{short description|Viral disease affecting humans}}







factoids
Measles is a highly contagious infectious disease caused by the measles virus.WEB, Measles, Merck Manual Professional, Merck Sharp & Dohme Corp., September 2013, 23 March 2014,weblink Caserta, MT, live,weblink" title="web.archive.org/web/20140323104756weblink">weblink 23 March 2014, WEB, Measles (Red Measles, Rubeola),weblink Dept of Health, Saskatchewan, 10 February 2015, dead,weblink" title="web.archive.org/web/20150210111358weblink">weblink 10 February 2015, Symptoms usually develop 10–12 days after exposure to an infected person and last 7–10 days.WEB,weblink Measles Fact sheet N°286, November 2014, who.int,weblink" title="web.archive.org/web/20150203144905weblink">weblink 3 February 2015, live, 4 February 2015, BOOK, Conn's Current Therapy 2015, 2014, Elsevier Health Sciences, 9780323319560, 153,weblink live,weblink 2017-09-08, Initial symptoms typically include fever, often greater than {{convert|40|C|F|0}}, cough, runny nose, and inflamed eyes. Small white spots known as Koplik's spots may form inside the mouth two or three days after the start of symptoms. A red, flat rash which usually starts on the face and then spreads to the rest of the body typically begins three to five days after the start of symptoms.WEB, Measles (Rubeola) Signs and Symptoms,weblink cdc.gov, 5 February 2015, November 3, 2014, live,weblink" title="web.archive.org/web/20150202192809weblink">weblink 2 February 2015, Common complications include diarrhea (in 8% of cases), middle ear infection (7%), and pneumonia (6%). These occur in part due to measles-induced immunosuppression.JOURNAL, Rota, PA, Moss, WJ, Takeda, M, de Swart, RL, Thompson, KM, Goodson, JL, Measles., Nature Reviews. Disease Primers, 14 July 2016, 2, 16049, 10.1038/nrdp.2016.49, 27411684, Less commonly seizures, blindness, or inflammation of the brain may occur. Other names include morbilli, rubeola, red measles, and English measles.BOOK, Milner, Danny A., Diagnostic Pathology: Infectious Diseases E-Book, 2015, Elsevier Health Sciences, 9780323400374, 24,weblink en, live,weblink 2017-09-08, BOOK, Stanley, Jacqueline, Essentials of Immunology & Serology, 2002, Cengage Learning, 978-0766810648, 323,weblink en, live,weblink 2017-09-08, Both rubella, also known as "German measles", and roseola are different diseases caused by unrelated viruses.BOOK, Marx, John A., Rosen's emergency medicine: concepts and clinical practice, 2010, Mosby/Elsevier, Philadelphia, 9780323054720, 1541, 7th,weblink live,weblink 2017-09-08, Measles is an airborne disease which spreads easily through the coughs and sneezes of infected people. It may also be spread through direct contact with mouth or nasal secretions. Nine out of ten people who are not immune and share living space with an infected person will be infected. People are infectious to others from four days before to four days after the start of the rash.BOOK, Atkinson, William, Epidemiology and Prevention of Vaccine-Preventable Diseases, 2011, Public Health Foundation, 9780983263135, 301–23, 12,weblink 5 February 2015, live,weblink" title="web.archive.org/web/20150207061223weblink">weblink 7 February 2015, Most people do not get the disease more than once. Testing for the measles virus in suspected cases is important for public health efforts.The measles vaccine is effective at preventing the disease, and is often delivered in combination with other vaccines. Vaccination resulted in a 80% decrease in deaths from measles between 2000 and 2017, with about 85% of children worldwide having received their first dose as of 2017.WEB,weblink Measles, www.who.int, en, 2019-05-20, Once a person has become infected, no specific treatment is available, although supportive care may improve outcomes. Such care may include oral rehydration solution (slightly sweet and salty fluids), healthy food, and medications to control the fever. Antibiotics should be prescribed if secondary bacterial infections such as ear infections or pneumonia occur. Vitamin A supplementation is also recommended for children.Measles affects about 20 million people a year, primarily in the developing areas of Africa and Asia. While often regarded as a childhood illness, it can affect people of any age.REPORT, Chen S.S.P., February 22, 2018, Measles,weblink Medscape, live,weblink" title="web.archive.org/web/20110925023230weblink">weblink September 25, 2011, It is one of the leading vaccine-preventable disease causes of death.JOURNAL, Kabra SK, Lodha R, Antibiotics for preventing complications in children with measles, The Cochrane Database of Systematic Reviews, 8, 8, CD001477, August 2013, 23943263, 10.1002/14651858.CD001477.pub4, WEB, Despite the availability of a safe, effective and inexpensive vaccine for more than 40 years, measles remains a leading vaccine-preventable cause of childhood deaths.,weblink 16 February 2019, In 1980, 2.6 million people died of it, and in 1990, 545,000 died; by 2014, global vaccination programs had reduced the number of deaths from measles to 73,000.JOURNAL, Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015, Lancet, 388, 10053, 1459–1544, October 2016, 27733281, 5388903, 10.1016/S0140-6736(16)31012-1, Wang, Haidong, Naghavi, Mohsen, Allen, Christine, Barber, Ryan M., Bhutta, Zulfiqar A., Carter, Austin, Casey, Daniel C., Charlson, Fiona J., Chen, Alan Zian, Coates, Matthew M., Coggeshall, Megan, Dandona, Lalit, Dicker, Daniel J., Erskine, Holly E., Ferrari, Alize J., Fitzmaurice, Christina, Foreman, Kyle, Forouzanfar, Mohammad H., Fraser, Maya S., Fullman, Nancy, Gething, Peter W., Goldberg, Ellen M., Graetz, Nicholas, Haagsma, Juanita A., Hay, Simon I., Huynh, Chantal, Johnson, Catherine O., Kassebaum, Nicholas J., Kinfu, Yohannes, Kulikoff, Xie Rachel, 29, JOURNAL, Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013, Lancet, 385, 9963, 117–71, January 2015, 25530442, 4340604, 10.1016/S0140-6736(14)61682-2, GBD 2013 Mortality Causes of Death Collaborators, Despite these trends, rates of disease and deaths increased from 2017 to 2019 due to a decrease in immunization.WEB, Measles cases spike globally due to gaps in vaccination coverage,weblink WHO, 21 December 2018, en, 29 November 2018, NEWS, U.S. measles cases surge nearly 20 percent in early April, CDC says,weblink 16 April 2019, Reuters, 16 April 2019, en, WEB, Measles – European Region,weblink WHO, 8 May 2019, The risk of death among those infected is about 0.2%, but may be up to 10% in people with malnutrition. Most of those who die from the infection are less than five years old. Measles is not known to occur in other animals. File:Wikipedia-VideoWiki-Measles.webm|thumb|thumbtime=1:30|upright=1.4|Video summary (script)]]{{TOC limit}}

Signs and symptoms

(File:Morbillivirus measles infection.jpg|thumb|upright=1.3|Maculopapular rash on the abdomen after 3 days of measles infection)Symptoms typically begin 10–14 days after exposure. The classic symptoms include a four-day fever (the 4 D's) and the three C's—cough, coryza (head cold, fever, sneezing), and conjunctivitis (red eyes)—along with a maculopapular rash.JOURNAL, Biesbroeck L, Sidbury R, Viral exanthems: an update, Dermatologic Therapy, 26, 6, 433–8, November 2013, 24552405, 10.1111/dth.12107, Fever is common and typically lasts for about one week; the fever seen with measles is often as high as {{convert|40|C}}.Koplik's spots seen inside the mouth are diagnostic for measles, but are temporary and therefore rarely seen. Koplik spots are small white spots that are commonly seen on the inside of the cheeks opposite the molars. They appear as "grains of salt on a reddish background."JOURNAL, Steichen O, Dautheville S, Koplik spots in early measles, CMAJ, 180, 5, 583, March 2009, 19255085, 2645467, 10.1503/cmaj.080724, Recognizing these spots before a person reaches their maximum infectiousness can help reduce the spread of the disease.JOURNAL, Baxby D, The diagnosis of the invasion of measles from a study of the exanthema as it appears on the buccal mucous membrane by Henry Koplik, M.D. Reproduced from Arch. Paed. 13, 918-922 (1886), Reviews in Medical Virology, 7, 2, 71–74, July 1997, 10398471, 10.1002/(SICI)1099-1654(199707)7:23.0.CO;2-S, The characteristic measles rash is classically described as a generalized red maculopapular rash that begins several days after the fever starts. It starts on the back of the ears and, after a few hours, spreads to the head and neck before spreading to cover most of the body, often causing itching. The measles rash appears two to four days after the initial symptoms and lasts for up to eight days. The rash is said to "stain", changing color from red to dark brown, before disappearing.NHS UK: Symptoms of measles. Last reviewed: 26/01/2010 {{webarchive|url=https://web.archive.org/web/20110131164435weblink |date=2011-01-31 }}. Overall, measles usually resolves after about three weeks.File:Measles baby.jpg|A baby with measlesImage:Koplik spots, measles 6111 lores.jpg| Koplik's spots on the third pre-eruptive dayImage:Koplik spots, measles 2019.jpg|Koplik's spots on the day of measles rash.

Complications

Complications of measles are relatively common, ranging from mild ones such as diarrhea to serious ones such as pneumonia (either direct viral pneumonia or secondary bacterial pneumonia), laryngotracheobronchitis (croup) (either direct viral laryngotracheobronchitis or secondary bacterial bronchitis), otitis media,JOURNAL, Gardiner, W. T., Otitis Media in Measles, The Journal of Laryngology & Otology, 39, 11, 614–17, 2007, 10.1017/S0022215100026712, acute brain inflammationJOURNAL, Fisher DL, Defres S, Solomon T, Measles-induced encephalitis, QJM, 108, 3, 177–82, March 2015, 24865261, 10.1093/qjmed/hcu113, (and very rarely subacute sclerosing panencephalitis),BOOK, Anlar B, Pediatric Neurology Part II, 112, 1183–89, 2013, 23622327, 10.1016/B978-0-444-52910-7.00039-8, Handbook of Clinical Neurology, 9780444529107, Subacute sclerosing panencephalitis and chronic viral encephalitis, and corneal ulceration (leading to corneal scarring).JOURNAL, Semba RD, Bloem MW, Measles blindness, Survey of Ophthalmology, 49, 2, 243–55, March 2004, 14998696, 10.1016/j.survophthal.2003.12.005, In addition, measles can suppress the immune system for weeks to months, and this can contribute to bacterial superinfections such as otitis media and bacterial pneumonia.BOOK, Gupta, Piyush, Menon, P. S. N., Ramji, Siddarth, Lodha, Rakesh, PG Textbook of Pediatrics: Volume 2: Infections and Systemic Disorders, 2015, JP Medical Ltd, 9789351529552, 1158,weblink en, JOURNAL, Griffin DE, Measles virus-induced suppression of immune responses, Immunological Reviews, 236, 176–89, July 2010, 20636817, 2908915, 10.1111/j.1600-065X.2010.00925.x, JOURNAL, Rota PA, Moss WJ, Takeda M, de Swart RL, Thompson KM, Goodson JL, Measles, Nature Reviews. Disease Primers, 2, 16049, July 2016, 27411684, 10.1038/nrdp.2016.49, The death rate in the 1920s was around 30% for measles pneumonia.JOURNAL, Ellison JB, Pneumonia in Measles, Archives of Disease in Childhood, 6, 31, 37–52, February 1931, 21031836, 1975146, 10.1136/adc.6.31.37, People who are at high risk for complications are infants and children aged less than 5 years; adults aged over 20 years; pregnant women; people with compromised immune systems, such as from leukemia, HIV infection or innate immunodeficiency;WEB, Measles {{!, For Healthcare Professionals|url=https://www.cdc.gov/measles/hcp/index.html|website=www.cdc.gov|access-date=22 October 2016|url-status=live|archive-url=https://web.archive.org/web/20161023051702weblink|archive-date=23 October 2016|df=}} and those who are malnourished or have Vitamin A deficiency.WEB,weblink Vitamin A, National Institutes of Health Office of Dietary Supplements, 2013, U.S. Department of Health & Human Services, 11 March 2015, live,weblink" title="web.archive.org/web/20150311000932weblink">weblink 11 March 2015, Complications are usually more severe in adults who catch the virus.JOURNAL, Sabella C, Measles: not just a childhood rash, Cleveland Clinic Journal of Medicine, 77, 3, 207–13, March 2010, 20200172, 10.3949/ccjm.77a.09123, Between 1987 and 2000, the case fatality rate across the United States was three deaths per 1,000 cases attributable to measles, or 0.3%.JOURNAL, Perry RT, Halsey NA, The clinical significance of measles: a review, The Journal of Infectious Diseases, 189 Suppl 1, S1, S4-16, May 2004, 15106083, 10.1086/377712, In underdeveloped nations with high rates of malnutrition and poor healthcare, fatality rates have been as high as 28%. In immunocompromised persons (e.g., people with AIDS) the fatality rate is approximately 30%.JOURNAL, Sension MG, Quinn TC, Markowitz LE, Linnan MJ, Jones TS, Francis HL, Nzilambi N, Duma MN, Ryder RW, Measles in hospitalized African children with human immunodeficiency virus, American Journal of Diseases of Children, 142, 12, 1271–2, December 1988, 3195521, 10.1001/archpedi.1988.02150120025021, Even in previously healthy children, measles can cause serious illness requiring hospitalization. One out of every 1,000 measles cases progresses to acute encephalitis, which often results in permanent brain damage. One or two out of every 1,000 children who become infected with measles will die from respiratory and neurological complications.

Cause

(File:Measles virus.JPG|thumb|upright=1.3|An electron micrograph of the measles virus)Measles is caused by the measles virus, a single-stranded, negative-sense, enveloped RNA virus of the genus Morbillivirus within the family Paramyxoviridae.The virus is highly contagious and is spread by coughing and sneezing via close personal contact or direct contact with secretions. It can live for up to two hours in that airspace or nearby surfaces.WEB, Measles,weblink CDC, 6 May 2018, en-us, 2 April 2018, Measles is so contagious that if one person has it, 90% of nearby non-immune people will also become infected. Humans are the only natural hosts of the virus, and no other animal reservoirs are known to exist.Risk factors for measles virus infection include immunodeficiency caused by HIV or AIDS,JOURNAL, Gowda VK, Sukanya V, Acquired immunodeficiency syndrome with subacute sclerosing panencephalitis, Pediatric Neurology, 47, 5, 379–81, November 2012, 23044024, 10.1016/j.pediatrneurol.2012.06.020, immunosuppression following receipt of an organ or a stem cell transplant,JOURNAL, Waggoner JJ, Soda EA, Deresinski S, Rare and emerging viral infections in transplant recipients, Clinical Infectious Diseases, 57, 8, 1182–8, October 2013, 23839998, 10.1093/cid/cit456,weblink alkylating agents, or corticosteroid therapy, regardless of immunization status; travel to areas where measles commonly occurs or contact with travelers from such an area; and the loss of passive, inherited antibodies before the age of routine immunization.

Pathophysiology

(File:MeaslesOsmosisPic5.jpg|thumb|upright=1.4|Drawing of the measles virus attaching to the lining of the trachea)Once the measles virus gets onto the mucosa, it infects the epithelial cells in the trachea or bronchi.JOURNAL, Moss WJ, Griffin DE, Measles, Lancet, 379, 9811, 153–64, January 2012, 21855993, 10.1016/S0140-6736(10)62352-5, BOOK, Textbook of Microbiology & Immunology, 2009, Elsevier India, 9788131221631, 535,weblink en, Measles virus uses a protein on its surface called hemagglutinin (H protein), to bind to a target receptor on the host cell, which could be CD46, which is expressed on all nucleated human cells, CD150, aka signaling lymphocyte activation molecule or SLAM, which is found on immune cells like B or T cells, and antigen-presenting cells, or nectin-4, a cellular adhesion molecule.BOOK, Kaslow, Richard A., Stanberry, Lawrence R., Duc, James W. Le, Viral Infections of Humans: Epidemiology and Control, 2014, Springer, 9781489974488, 540,weblink en, Once bound, the fusion, or F protein helps the virus fuse with the membrane and ultimately get inside the cell. The virus is a single-stranded negative-sense RNA virus meaning it first has to be transcribed by RNA polymerase into a positive-sense mRNA strand.After that it is ready to be translated into viral proteins, wrapped in the cell's lipid envelope, and sent out of the cell as a newly made virus.BOOK, Schaechter's Mechanisms of Microbial Disease, 2012, Lippincott Williams & Wilkins, 9780781787444, 357,weblink en, Within days, the measles virus spreads through local tissue and is picked up by dendritic cells and alveolar macrophages, and carried from that local tissue in the lungs to the local lymph nodes. From there it continues to spread, eventually getting into the blood and spreading to more lung tissue, as well as other organs like the intestines and the brain.WEB, Pinkbook Measles Epidemiology of Vaccine Preventable Diseases,weblink CDC, 6 May 2018, en-us, 15 November 2016, Functional impairment of the infected dendritic cells by the measles virus is thought to contribute to measles-induced immunosuppression.

Diagnosis

Clinical diagnosis of measles requires a history of fever of at least three days, with at least one of the following symptoms: cough, coryza, or conjunctivitis. Observation of Koplik's spots is also diagnostic. Laboratory confirmation is however strongly recommended.WEB, Measles,weblink www.cdc.gov, 8 May 2018, en-us, 2 April 2018,

Laboratory testing

Laboratory diagnosis of measles can be done with confirmation of positive measles IgM antibodies or isolation of measles virus RNA from respiratory specimens.JOURNAL, Durrheim DN, Kelly H, Ferson MJ, Featherstone D, Remaining measles challenges in Australia, The Medical Journal of Australia, 187, 3, 181–4, August 2007, 17680748,weblink live,weblink 2015-04-02, For people unable to have their blood drawn, saliva can be collected for salivary measles-specific IgA testing.JOURNAL, Friedman M, Hadari I, Goldstein V, Sarov I, Virus-specific secretory IgA antibodies as a means of rapid diagnosis of measles and mumps infection, Israel Journal of Medical Sciences, 19, 10, 881–4, October 1983, 6662670, Positive contact with other people known to have measles adds evidence to the diagnosis.

Prevention

{{further|Measles vaccine|MMR vaccine|MMRV vaccine}}(File:Measles vaccination coverage world.svg|thumb|upright=1.4|Rates of measles vaccination worldwide)Mothers who are immune to measles pass antibodies to their children while they are still in the womb, especially if the mother acquired immunity through infection rather than vaccination.JOURNAL, Leuridan E, Sabbe M, Van Damme P, Measles outbreak in Europe: susceptibility of infants too young to be immunized, Vaccine, 30, 41, 5905–13, September 2012, 22841972, 10.1016/j.vaccine.2012.07.035, Such antibodies will usually give newborn infants some immunity against measles, but these antibodies are gradually lost over the course of the first nine months of life.WEB, Measles,weblink Merck Manuals Professional Edition, 6 May 2018, January 2018, Infants under one year of age whose maternal anti-measles antibodies have disappeared become susceptible to infection with the measles virus.In developed countries, it is recommended that children be immunized against measles at 12 months, generally as part of a three-part MMR vaccine (measles, mumps, and rubella). The vaccine is generally not given before this age because such infants respond inadequately to the vaccine due to an immature immune system. A second dose of the vaccine is usually given to children between the ages of four and five, to increase rates of immunity. Vaccination rates have been high enough to make measles relatively uncommon. Adverse reactions to vaccination are rare, with fever and pain at the injection site being the most common. Life-threatening adverse reactions occur in less than one per million vaccinations ( Some groups, like young children and the severely malnourished, are also given vitamin A, which act as an immunomodulator that boosts the antibody responses to measles and decreases the risk of serious complications.JOURNAL, Measles vaccines: WHO position paper – April 2017, Releve Epidemiologique Hebdomadaire, 92, 17, 205–27, April 2017, 28459148,weblink

Medications

Treatment is supportive, with ibuprofen or paracetamol (acetaminophen) to reduce fever and pain and, if required, a fast-acting medication to dilate the airways for cough.NEWS, Rezaie, Salim R., Measles: The Sequel,weblink 7 June 2019, Emergency Physicians Monthly, As for aspirin, some research has suggested a correlation between children who take aspirin and the development of Reye syndrome.JOURNAL, Casteels-Van Daele M, Van Geet C, Wouters C, Eggermont E, Reye syndrome revisited: a descriptive term covering a group of heterogeneous disorders, European Journal of Pediatrics, 159, 9, 641–8, September 2000, 11014461, 10.1007/PL00008399, Reye syndrome is a non-specific descriptive term covering a group of heterogeneous disorders. Moreover, not only the use of acetylsalicylic acid but also of antiemetics is statistically significant in Reye syndrome cases. Both facts weaken the validity of the epidemiological surveys suggesting a link with acetylsalicylic acid., JOURNAL, Schrör K, Aspirin and Reye syndrome: a review of the evidence, Paediatric Drugs, 9, 3, 195–204, 2007, 17523700, 10.2165/00148581-200709030-00008,weblink The suggestion of a defined cause-effect relationship between aspirin intake and Reye syndrome in children is not supported by sufficient facts. Clearly, no drug treatment is without side effects. Thus, a balanced view of whether treatment with a certain drug is justified in terms of the benefit/risk ratio is always necessary. Aspirin is no exception., live,weblink" title="web.archive.org/web/20110629193955weblink">weblink 2011-06-29, JOURNAL, Macdonald S, Aspirin use to be banned in under 16 year olds, BMJ, 325, 7371, 988c–988, November 2002, 12411346, 1169585, 10.1136/bmj.325.7371.988/c, Professor Alasdair Breckenridge, said, "There are plenty of analgesic products containing paracetamol and ibuprofen for this age group not associated with Reye's syndrome. There is simply no need to expose those under 16 to the risk—however small.", WEB,weblink Aspirin and Reye's Syndrome, 2011-03-17, October 2003, MHRA, dead,weblink" title="web.archive.org/web/20120319232017weblink">weblink 2012-03-19, JOURNAL, Surgeon General's advisory on the use of salicylates and Reye syndrome, MMWR. Morbidity and Mortality Weekly Report, 31, 22, 289–90, June 1982, 6810083,weblink live,weblink" title="web.archive.org/web/20110629161116weblink">weblink 2011-06-29, Centers for Disease Control (CDC), {{NINDS|Reyes-Syndrome|Reye's Syndrome}} "Epidemiologic evidence indicates that aspirin (salicylate) is the major preventable risk factor for Reye's syndrome. The mechanism by which aspirin and other salicylates trigger Reye's syndrome is not completely understood."The use of vitamin A during treatment is recommended to decrease the risk of blindness;JOURNAL, Measles vaccines: WHO position paper, Releve Epidemiologique Hebdomadaire, 84, 35, 349–60, August 2009, 19714924,weblink live,weblink" title="web.archive.org/web/20150219004315weblink">weblink 19 February 2015, however, it does not prevent or cure the disease.WEB,weblink Frequently Asked Questions about Measles, Washington State Department of Health, [Vitamin A] cannot prevent or cure the measles, February 10, 2019, A systematic review of trials into its use found no reduction in overall mortality, but it did reduce mortality in children aged under two years.JOURNAL, Huiming Y, Chaomin W, Meng M, Vitamin A for treating measles in children, The Cochrane Database of Systematic Reviews, 4, CD001479, October 2005, 16235283, 10.1002/14651858.CD001479.pub3, Yang, Huiming, It is unclear if zinc supplementation in children with measles affects outcomes as it has not been sufficiently studied.JOURNAL, Awotiwon AA, Oduwole O, Sinha A, Okwundu CI, Zinc supplementation for the treatment of measles in children, The Cochrane Database of Systematic Reviews, 6, CD011177, June 2017, 28631310, 6481361, 10.1002/14651858.CD011177.pub3,

Prognosis

Most people survive measles, though in some cases, complications may occur. About 1 in 4 individuals will be hospitalized and 1-2 in 1000 will die. Complications are more likely in children under age 5 and adults over age 20.WEB, Measles Complications,weblink www.cdc.gov, 14 May 2019, en-us, 25 February 2019, Possible consequences of measles virus infection include laryngotracheobronchitis, sensorineural hearing loss,JOURNAL, Cohen BE, Durstenfeld A, Roehm PC, Viral causes of hearing loss: a review for hearing health professionals, Trends in Hearing, 18, 2331216514541361, July 2014, 25080364, 4222184, 10.1177/2331216514541361, and—in about 1 in 10,000 to 1 in 300,000 casesJOURNAL, Noyce RS, Richardson CD, Nectin 4 is the epithelial cell receptor for measles virus, Trends in Microbiology, 20, 9, 429–39, September 2012, 22721863, 10.1016/j.tim.2012.05.006, —panencephalitis, which is usually fatal.WEB,weblink NINDS Subacute Sclerosing Panencephalitis Information Page, 2018-03-26, live,weblink" title="web.archive.org/web/20141017073411weblink">weblink 2014-10-17, "NINDS Subacute Sclerosing Panencephalitis Information Page" Acute measles encephalitis is another serious risk of measles virus infection. It typically occurs two days to one week after the measles rash breaks out and begins with very high fever, severe headache, convulsions and altered mentation. A person with measles encephalitis may become comatose, and death or brain injury may occur.{{MerckManual|14|193|b|}}For people having had measles, it is rare to ever have a symptomatic reinfection.WEB,weblink Recommendation of the Immunization Practices Advisory Committee (ACIP) Measles Prevention, Centers for Disease Control and Prevention, This page last reviewed 5/2/01

Epidemiology

(File:Measles world map-Deaths per million persons-WHO2012.svg|thumb|upright=1.4|Deaths from measles per million persons in 2012 {{legend|#ffff20|0}}{{legend|#ff9a20|1–8}}{{legend|#f08015|9–26}}{{legend|#e06815|27–38}}{{legend|#d85010|39–73}}{{legend|#d02010|74–850}})File:Measles world map - DALY - WHO2004.svg|thumb|upright=1.4|#b3b3b3|no data}}{{legend|#ffff65|≤ 10}}{{legend|#fff200|10–25}}{{legend|#ffdc00|25–50}}{{legend|#ffc600|50–75}}{{legend|#ffb000|75–100}}{{legend|#ff9a00|100–250}}{{legend|#ff8400|250–500}}{{legend|#ff6e00|500–750}}{{legend|#ff5800|750–1000}}{{legend|#ff4200|1000–1500}}{{legend|#ff2c00|1500–2000}}{{legend|#cb0000|≥ 2000}}Measles is extremely infectious and its continued circulation in a community depends on the generation of susceptible hosts by birth of children. In communities that generate insufficient new hosts the disease will die out. This concept was first recognized in measles by Bartlett in 1957, who referred to the minimum number supporting measles as the critical community size (CCS).JOURNAL, Bartlett, M.S., Measles periodicity and community size, J. R. Stat. Soc., 1957, Ser. A, 120, 48–70, Analysis of outbreaks in island communities suggested that the CCS for measles is around 250,000.JOURNAL, Black FL, Measles endemicity in insular populations: critical community size and its evolutionary implication, Journal of Theoretical Biology, 11, 2, 207–11, July 1966, 5965486, 10.1016/0022-5193(66)90161-5, To achieve herd immunity, more than 95% of the community must be vaccinated due to the ease with which measles is transmitted from person to person.In 2011, the WHO estimated that 158,000 deaths were caused by measles. This is down from 630,000 deaths in 1990.JOURNAL, Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al., Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010, Lancet, 380, 9859, 2095–128, December 2012, 23245604, 10.1016/S0140-6736(12)61728-0, 10536/DRO/DU:30050819, As of 2018, measles remains a leading cause of vaccine-preventable deaths in the world.WEB, Measles Data and Statistics,weblink 15 August 2019, In developed countries the mortality rate is lower, for example in England and Wales from 2007-2017 death occurred between two to three cases out of 10,000.WEB, Measles notifications and deaths in England and Wales: 1940 to 2017,weblink GOV.UK, 1 October 2019, en, In children one to two cases out of every 1,000 die in the United States (0.1–0.2%).WEB,weblink Complications of measles, November 3, 2014, CDC, November 7, 2014, live,weblink" title="web.archive.org/web/20150103130249weblink">weblink January 3, 2015, In populations with high levels of malnutrition and a lack of adequate healthcare, mortality can be as high as 10%. In cases with complications, the rate may rise to 20–30%.Measles {{webarchive|url=https://web.archive.org/web/20150203144905weblink |date=2015-02-03 }}, World Health Organization Fact sheet N°286. Retrieved June 28, 2012. Updated February 2014 In 2012, the number of deaths due to measles was 78% lower than in 2000 due to increased rates of immunization among UN member states.{| class="wikitable" style="text-align:right; font-size:88%; float:right; clear:right; margin-left:1em" Reported casesWHO: Global summary on measles {{webarchive|url=https://web.archive.org/web/20130814150053weblink |date=2013-08-14 }}, 2006Measles Surveillance Data after WHO {{webarchive|url=https://web.archive.org/web/20150703130205weblink |date=2015-07-03 }}, last updated 2014-3-6Measles reported cases by WHO in 2014 {{webarchive|url=https://web.archive.org/web/20150703194912weblink |date=2015-07-03 }}Số người chết và mắc bệnh theo quốc gia {{webarchive|url=https://web.archive.org/web/20150703015216weblink |date=2015-07-03 }}, last update 2014-4-7 by WHOWEB,weblink Measles—United States, 2005, December 22, 2006, Centers for Disease Control and Prevention, 30 March 2015, live,weblink" title="web.archive.org/web/20150313120119weblink">weblink 13 March 2015, Reported Measles Cases by WHO region 2014, 2015, as of 07 July 201 {{webarchive|url=https://web.archive.org/web/20150703022211weblink |date=2015-07-03 }}, WHO! WHO-Region! 1980! 1990! 2000! 2005! 2014 African Region 1,240,993 481,204 520,102 316,224 71,574 Region of the Americas 257,790 218,579 1,755 66 19,898 Eastern Mediterranean Region 341,624 59,058 38,592 15,069 28,031 European Region 851,849 234,827 37,421 37,332 16,899 South-East Asia Region 199,535 224,925 61,975 83,627 112,418 Western Pacific Region 1,319,640 155,490 176,493 128,016 213,366 Worldwide 4,211,431 1,374,083 836,338 580,287 462,186Even in countries where vaccination has been introduced, rates may remain high. Measles is a leading cause of vaccine-preventable childhood mortality. Worldwide, the fatality rate has been significantly reduced by a vaccination campaign led by partners in the Measles Initiative: the American Red Cross, the United States CDC, the United Nations Foundation, UNICEF and the WHO. Globally, measles fell 60% from an estimated 873,000 deaths in 1999 to 345,000 in 2005.UNICEF Joint Press Release {{webarchive|url=https://web.archive.org/web/20150204152400weblink |date=2015-02-04 }} Estimates for 2008 indicate deaths fell further to 164,000 globally, with 77% of the remaining measles deaths in 2008 occurring within the Southeast Asian region.WHO Weekly Epidemiology Record, 4th December 2009 WHO.int {{webarchive|url=https://web.archive.org/web/20131026035711weblink |date=2013-10-26 }}Cases reported in the first three months of 2019 were 300% higher than in the first three months of 2018, with outbreaks in every region of the world, even in countries with high overall vaccination coverage where it spread among clusters of unvaccinated people.NEWS, New measles surveillance data for 2019,weblink 4 June 2019, WHO, 15 April 2019,

Europe

In 2013–14, there were almost 10,000 cases in 30 European countries. Most cases occurred in unvaccinated individuals and over 90% of cases occurred in Germany, Italy, Netherlands, Romania, and United Kingdom. Between October 2014 and March 2015, a measles outbreak in the German capital of Berlin resulted in at least 782 cases.WEB,weblink Who Is Stefan Lanka? Court Orders German Measles Denier To Pay 100,000 Euros, Elizabeth Whitman, International Business Times, 2015-03-13, 2015-03-31, live,weblink" title="web.archive.org/web/20150402182617weblink">weblink 2015-04-02, In 2017, numbers continued to increase in Europe to 21,315 cases, with 35 deaths.WEB, Europe observes a 4-fold increase in measles cases in 2017 compared to previous year,weblink www.euro.who.int, 22 February 2018, en, 19 February 2018, In preliminary figures for 2018, reported cases in the region increased 3-fold to 82,596 in 47 countries, with 72 deaths; Ukraine had the most cases (53,218), with the highest incidence rates being in Ukraine (1209 cases per million), Serbia (579), Georgia (564) and Albania (500).WEB,weblink WHO EpiData, WHO, February 2019, 27 March 2019, WEB,weblink Measles in Europe: record number of both sick and immunized, WHO, 7 February 2019, 27 March 2019, The previous year (2017) saw an estimated measles vaccine coverage of 95% for the first dose and 90% for the second dose in the region, the latter figure being the highest-ever estimated second-dose coverage.In 2019 the United Kingdom, Albania, Czechia, and Greece lost their measles free status due to ongoing and prolonged spread of the disease in these countries.WEB, European Region loses ground in effort to eliminate measles,weblink www.euro.who.int, 31 August 2019, en, 29 August 2019, In the first 6 months of 2019 90,000 cases occurred in Europe.

Americas

As a result of widespread vaccination, the disease was declared eliminated from the Americas in 2016.WEB, Region of the Americas is declared free of measles,weblink PAHO, 30 September 2016, 29 September 2016, live,weblink" title="web.archive.org/web/20160930044745weblink">weblink 30 September 2016, However, there were cases again in 2017, 2018 and 2019 in this region.NEWS, Measles spreads again in the Americas,weblink 4 July 2018, MercoPress, 28 March 2018,

United States

{{see also|Measles resurgence in the United States}}In the United States, measles affected approximately 3,000 people per million in the 1960s before the vaccine was available. With consistent widespread childhood vaccination, this figure fell to 13 cases per million by the 1980s, and to about 1 case per million by the year 2000.JOURNAL, Orenstein WA, Papania MJ, Wharton ME, Measles elimination in the United States, The Journal of Infectious Diseases, 189 Suppl 1, Supplement 1, May 2004, 15106120, 10.1086/377693, Figure 1, Before immunization in the United States, between three and four million cases occurred each year. The United States was declared free of circulating measles in 2000, with 911 cases from 2001 to 2011. In 2014 the CDC said endemic measles, rubella, and congenital rubella syndrome had not returned to the United States.JOURNAL, Papania MJ, Wallace GS, Rota PA, Icenogle JP, Fiebelkorn AP, Armstrong GL, Reef SE, Redd SB, Abernathy ES, Barskey AE, Hao L, McLean HQ, Rota JS, Bellini WJ, Seward JF, Elimination of endemic measles, rubella, and congenital rubella syndrome from the Western hemisphere: the US experience, JAMA Pediatrics, 168, 2, 148–55, February 2014, 24311021, 10.1001/jamapediatrics.2013.4342, Occasional measles outbreaks persist, however, because of cases imported from abroad, of which more than half are the result of unvaccinated U.S. residents who are infected abroad and infect others upon return to the United States. The CDC continues to recommend measles vaccination throughout the population to prevent outbreaks like these.JOURNAL, Multistate Measles Outbreak Associated with an International Youth Sporting Event – Pennsylvania, Michigan, and Texas, August–September 2007, Www.cdc.gov,weblink 2 February 2018, In 2014, an outbreak was initiated in Ohio when two unvaccinated Amish men harboring asymptomatic measles returned to the United States from missionary work in the Philippines.JOURNAL, Gastañaduy PA, Budd J, Fisher N, Redd SB, Fletcher J, Miller J, McFadden DJ, Rota J, Rota PA, Hickman C, Fowler B, Tatham L, Wallace GS, de Fijter S, Parker Fiebelkorn A, DiOrio M, A Measles Outbreak in an Underimmunized Amish Community in Ohio, The New England Journal of Medicine, 375, 14, 1343–1354, October 2016, 27705270, 10.1056/NEJMoa1602295, Their return to a community with low vaccination rates led to an outbreak that rose to include a total of 383 cases across nine counties. Of the 383 cases, 340 (89%) occurred in unvaccinated individuals.From January 4 to April 2, 2015, there were 159 cases of measles reported to the CDC. Of those 159 cases, 111 (70%) were determined to have come from an earlier exposure in late December 2014. This outbreak was believed to have originated from the Disneyland theme park in California. The Disneyland outbreak was held responsible for the infection of 147 people in seven U.S. states as well as Mexico and Canada, the majority of which were either unvaccinated or had unknown vaccination status.WEB,weblink Year in Review: Measles Linked to Disneyland, 2017-05-26, live,weblink 2017-05-19, Of the cases 48% were unvaccinated and 38% were unsure of their vaccination status.WEB,weblink Measles – United States, January 4 – April 2, 2015, Clemmons, Nakia, cdc.gov, The initial exposure to the virus was never identified.In 2015, a U.S. woman in Washington state died of pneumonia, as a result of measles. She was the first fatality in the US from measles since 2003.NEWS, Measles kills first patient in 12 years,weblink 2 July 2015, USA Today, 2 July 2015, live,weblink" title="web.archive.org/web/20150702200945weblink">weblink 2 July 2015, The woman had been vaccinated for measles and was taking immunosuppressive drug for another condition. The drugs suppressed the woman's immunity to measles, and the woman became infected with measles; she did not develop a rash, but contracted pneumonia, which caused her death.WEB, First Measles Death in US Since 2003 Highlights the Unknown Vulnerables – Phenomena: Germination,weblink 2015-07-03, live,weblink" title="web.archive.org/web/20150703035924weblink">weblink 2015-07-03, 2015-07-02, WEB, First Measles Death In 12 Years Renews Vaccination Concerns, NPR.org, July 6, 2015,weblink April 23, 2019, In June 2017, the Maine Health and Environmental Testing Laboratory confirmed a case of measles in Franklin County. This instance marks the first case of measles in 20 years for the state of Maine.WEB, Maine confirms its first case of measles in 20 years,weblink CBC News, 28 June 2017, live,weblink" title="web.archive.org/web/20170628021043weblink">weblink 28 June 2017, In 2018 one case occurred in Portland, Oregon, with 500 people exposed; 40 of them lacked immunity to the virus and were being monitored by county health officials as of July 2, 2018.NEWS,weblink Measles case confirmed in Portland, about 500 people possibly exposed, News, KATU, KATU, 2018-07-03, en-US, There were 273 cases of measles reported throughout the United States in 2018,WEB,weblink TABLE 1. Weekly cases* of selected infrequently reported notifiable diseases (, wonder.cdc.gov, 2019-01-12, including an outbreak in Brooklyn with more than 200 reported cases from October 2018 to February 2019. The outbreak was tied with population density of the Orthodox Jewish community, with the initial exposure from an unvaccinated child that caught measles while visiting Israel.NEWS,weblink New York tackles 'largest measles outbreak' in state's recent history as cases spike globally, Howard, Jacqueline, January 9, 2019, CNN, January 12, 2019, A resurgence of measles occurred during 2019, which has been generally tied to parents choosing not to have their children vaccinated as most of the reported cases have occurred in people 19 years old or younger.WEB,weblink Washington state is averaging more than one measles case per day in 2019, NBC News, 5 February 2019, WEB,weblink Amid Measles Outbreak, Anti-Vaxx Parents Have Put Others' Babies At Risk, MSN, 5 February 2019, WEB,weblink Washington declared a public health emergency over measles. Thank vaccine-refusing parents., Julia, Belluz, 27 January 2019, Vox, 5 February 2019, WEB,weblink "Dangerous" anti-vaxx warning issued by Washington officials as cases in measles outbreak continue to rise, kashmiragander, 28 January 2019, Newsweek, 5 February 2019, Cases were first reported in Washington state in January, with an outbreak of at least 58 confirmed cases most within Clark County, which has a higher rate of vaccination exemptions compared to the rest of the state; nearly one in four kindergartners in Clark did not receive vaccinations, according to state data.WEB,weblink A quarter of all kindergartners in Washington county aren't immunized. Now there's a measles crisis, Ken, Alltucker, February 11, 2019, February 11, 2019, USA Today, This led state governor Jay Inslee to declare a state of emergency, and the state's congress to introduce legislation to disallow vaccination exemption for personal or philosophical reasons.WEB,weblink Amid measles outbreak, legislation proposed to ban vaccine exemptions, Jake, Goldstein-Street, January 28, 2019, January 28, 2019, The Seattle Times, In April 2019 Bill de Blasio declared a public health emergency because of “a huge spike” in cases of measles in New York where there were 285 cases centred on the Orthodox Jewish areas of Brooklyn in 2018, while there were only two cases in 2017. There were 168 more in neighboring Rockland County.NEWS, New York City mayor declares measles public health emergency,weblink 10 April 2019, British Medical Journal, 10 April 2019, Other outbreaks have included Santa Cruz County and Butte County in California, and the states of New Jersey and Michigan.WEB,weblink US measles outbreak is largest since disease was declared eliminated in 2000, Jacqueline, Howard, Debra, Goldschmidt, April 24, 2019, April 24, 2019, CNN, As of April 2019, there have been 695 cases of measles have been reported in 22 states. This is the highest number of measles cases since it was declared eradicated in 2000.WEB, CDC Media Statement: Measles cases in the U.S. are highest since measles was eliminated in 2000,weblink CDC.gov, Centers for Disease Control and Prevention, 2019-04-26,

Brazil

The spread of measles had been interrupted in Brazil as of 2016, with the last known case twelve months earlier.WEB, Redação do G1,weblink Sarampo está eliminado do Brasil, segundo comitê internacional, G1 (website), G1, 26 July 2016, 26 July 2016, This last case was in the state of Ceará.ARTICLE, 2016-07-26, Sarampo está eliminado do Brasil, segundo comitê internacional,weblink Bem Estar, pt-BR, Brazil won a measles elimination certificate by the Pan American Health Organization in 2016, but the Ministry of Health has proclaimed that the country has struggled to keep this certificate, since two outbreaks had already been identified in 2018, one in the state of Amazonas and another one in Roraima, in addition to cases in other states (Rio de Janeiro, Rio Grande do Sul, Pará, São Paulo and Rondônia), totaling 1053 confirmed cases until August 1, 2018.ARTICLE, Brasil já tem mais de mil casos de sarampo em 2018, segundo Ministério da Saúde,weblink G1 (website), G1, pt-BR, WEB,weblink Ministério da Saúde atualiza casos de sarampo, 2018-08-02, portalms.saude.gov.br, Saúde, Ministério da, pt-br, In these outbreaks, and in most other cases, the contagion was related to the importation of the virus, especially from Venezuela. This was confirmed by the genotype of the virus (D8) that was identified, which is the same that circulates in Venezuela.

Southeast Asia

In the Vietnamese measles epidemic in spring of 2014, an estimated 8,500 measles cases were reported as of April 19, with 114 fatalities;WEB,weblink Vietnam minister calls for calm in face of 8,500 measles cases, 114 fatalities, Lien Chau, Thanh Niên, 18 April 2014, 19 April 2014,weblink" title="web.archive.org/web/20140418220953weblink">weblink 18 April 2014, live, as of May 30, 21,639 suspected measles cases had been reported, with 142 measles-related fatalities.WEB,weblink Bộ Y tế: "VN đã phản ứng rất nhanh đối với dịch sởi", Ministry of Health: "Vietnam has responded very quickly to measles", Quốc Thanh, Vietnamese, Tuổi Trẻ, 30 May 2014, 19 April 2014,weblink" title="web.archive.org/web/20140531233458weblink">weblink 31 May 2014, live, In the Naga Self-Administered Zone in a remote northern region of Myanmar, at least 40 children died during a measles outbreak in August 2016 that was probably caused by lack of vaccination in an area of poor health infrastructure.WEB,weblink WHO doctors in Myanmar's Naga areas identify 'mystery disease', Eastern Mirror Nagaland, 6 August 2016, 8 August 2016,weblink" title="web.archive.org/web/20170819065303weblink">weblink 19 August 2017, live, WEB,weblink Myanmar (02): (SA) fatal, measles confirmed, www.promedmail.org (Archive Number: 20160806.4398118), International Society for Infectious Diseases, 8 August 2016,weblink" title="web.archive.org/web/20160820090754weblink">weblink 20 August 2016, live, Following the 2019 Philippines measles outbreak, 23,563 measles cases have been reported in the country with 338 fatalities.WEB,weblink Philippines measles update: Nearly 600 cases in 2 days, Outbreak News Today, 26 March 2019, 30 August 2019,weblink" title="web.archive.org/web/20190830010007weblink">weblink 30 August 2019, live, A measles outbreak also happened among the Malaysian Orang Asli sub-group of Batek people in the state of Kelantan from May 2019, causing the deaths of 15 from the tribe.WEB,weblink A Measles Outbreak Is The Cause of 15 Orang Asli Deaths In Kelantan, Alyssa J. Oon, Says.com, 17 June 2019, 30 August 2019,weblink 27 August 2019, live, WEB,weblink The mysterious illness that caused 15 deaths in a Malaysian tribe has been linked to a measles outbreak, Rachel Tay, Business Insider Malaysia, 18 June 2019, 30 August 2019,weblink 30 August 2019, live,

History

{{See also|Timeline of measles}}File:Measles Aztec drawing.jpg|left|thumb|16th-century AztecAztecEstimates based on modern molecular biology place the emergence of measles as a human disease sometime after 500 AD (the former speculation that the Antonine Plague of 165–180 AD was caused by measles is now discounted). The first systematic description of measles, and its distinction from smallpox and chickenpox, is credited to the Persian physician Rhazes (860–932), who published The Book of Smallpox and Measles.JOURNAL, Cohen SG, Measles and immunomodulation, The Journal of Allergy and Clinical Immunology, 121, 2, 543–4, February 2008, 18269930, 10.1016/j.jaci.2007.12.1152,weblink Given what is now known about the evolution of measles, Rhazes' account is remarkably timely, as recent work that examined the mutation rate of the virus indicates the measles virus emerged from rinderpest (cattle plague) as a zoonotic disease between 1100 and 1200 AD, a period that may have been preceded by limited outbreaks involving a virus not yet fully acclimated to humans.JOURNAL, Furuse Y, Suzuki A, Oshitani H, Origin of measles virus: divergence from rinderpest virus between the 11th and 12th centuries, Virology Journal, 7, 52, March 2010, 20202190, 2838858, 10.1186/1743-422X-7-52, This agrees with the observation that measles requires a susceptible population of >500,000 to sustain an epidemic, a situation that occurred in historic times following the growth of medieval European cities.File:Hilleman-Walter-Reed.jpeg|thumb|upright=1|(Maurice Hilleman]]'s measles vaccine is estimated to prevent 1 million deaths per year."Maurice R. Hilleman Dies; Created Vaccines {{webarchive|url=https://web.archive.org/web/20121020102622weblink |date=2012-10-20 }}". The Washington Post. April 13, 2005.)Measles is an endemic disease, meaning it has been continually present in a community, and many people develop resistance. In populations not exposed to measles, exposure to the new disease can be devastating. In 1529, a measles outbreak in Cuba killed two-thirds of those natives who had previously survived smallpox. Two years later, measles was responsible for the deaths of half the population of Honduras, and it had ravaged Mexico, Central America, and the Inca civilization.BOOK, Joseph Patrick, Byrne, Encyclopedia of Pestilence, Pandemics, and Plagues: A–M,weblink ABC-CLIO, 2008, 413, 978-0-313-34102-1, live,weblink" title="web.archive.org/web/20131113180934weblink">weblink 2013-11-13, Between roughly 1855 and 2005, measles has been estimated to have killed about 200 million people worldwide.Torrey EF and Yolken RH. 2005. Their bugs are worse than their bite. Washington Post, April 3, p. B01. {{webarchive|url=https://web.archive.org/web/20091002053856weblink |date=2009-10-02 }} Measles killed 20 percent of Hawaii's population in the 1850s.weblink" title="web.archive.org/web/20090101183418weblink">Migration and Disease. Digital History. In 1875, measles killed over 40,000 Fijians, approximately one-third of the population.Fiji School of Medicine {{webarchive|url=https://web.archive.org/web/20150410002823weblink |date=2015-04-10 }} In the 19th century, the disease killed 50% of the Andamanese population.Measles hits rare Andaman tribe {{webarchive|url=https://web.archive.org/web/20110823054811weblink |date=2011-08-23 }}. BBC News. May 16, 2006. Seven to eight million children are thought to have died from measles each year before the vaccine was introduced.JOURNAL, Ludlow M, McQuaid S, Milner D, de Swart RL, Duprex WP, Pathological consequences of systemic measles virus infection, The Journal of Pathology, 235, 2, 253–65, January 2015, 25294240, 10.1002/path.4457, In 1954, the virus causing the disease was isolated from a 13-year-old boy from the United States, David Edmonston, and adapted and propagated on chick embryo tissue culture.JOURNAL, Live attenuated measles vaccine, EPI Newsletter, 2, 1, 6, February 1980, 12314356, To date, 21 strains of the measles virus have been identified.JOURNAL, Rima BK, Earle JA, Yeo RP, Herlihy L, Baczko K, ter Meulen V, Carabaña J, Caballero M, Celma ML, Fernandez-Muñoz R, Temporal and geographical distribution of measles virus genotypes, The Journal of General Virology, 76 ( Pt 5), 5, 1173–80, May 1995, 7730801, 10.1099/0022-1317-76-5-1173,weblink While at Merck, Maurice Hilleman developed the first successful vaccine.BOOK, Offit PA, Vaccinated: One Man's Quest to Defeat the World's Deadliest Diseases, Washington, DC, Smithsonian, 978-0-06-122796-7, 2007, Licensed vaccines to prevent the disease became available in 1963."Measles Prevention: Recommendations of the Immunization Practices Advisory Committee (ACIP) {{webarchive|url=https://web.archive.org/web/20120515055632weblink |date=2012-05-15 }}". Centers for Disease Control and Prevention (CDC). An improved measles vaccine became available in 1968.Measles: Questions and Answers, {{webarchive|url=https://web.archive.org/web/20130124052237weblink |date=2013-01-24 }} Immunization Action Coalition {{webarchive|url=https://web.archive.org/web/20080827113501weblink |date=2008-08-27 }}. Measles as an endemic disease was eliminated from the United States in 2000, but continues to be reintroduced by international travelers.WEB, Measles Frequently Asked Questions about Measles in U.S,weblink www.cdc.gov, en-us, 28 August 2018,

Society and culture

German anti-vaccination campaigner and HIV/AIDS denialistWEB,weblink HIV; Reality or artefact?, Stefan Lanka, Virusmyth.com, April 1995, 2015-03-31, live,weblink" title="web.archive.org/web/20150326075413weblink">weblink 2015-03-26, :de:Stefan Lanka, Stefan Lanka posed a challenge on his website in 2011, offering a sum of €100,000 for anyone who could scientifically prove that measles is caused by a virus and determine the diameter of the virus.WEB,weblink Das Masern-Virus 100.000 € Belohnung! WANTeD Der Durchmesser, German, 2011-11-24, 2015-03-31, live,weblink" title="web.archive.org/web/20150402163126weblink">weblink 2015-04-02, He posits that the illness is psychosomatic and that the measles virus does not exist. When provided with overwhelming scientific evidence from various medical studies by German physician David Bardens, Lanka did not accept the findings, forcing Bardens to appeal in court. The legal case ended with the ruling that Lanka was to pay the prize.NEWS,weblink Germany court orders measles sceptic to pay 100,000 euros, BBC News Online, 2015-03-12, 2015-03-31, live,weblink" title="web.archive.org/web/20150331020314weblink">weblink 2015-03-31, BBC News, The case received wide international coverage that prompted many to comment on it, including neurologist, well-known skeptic and science-based medicine advocate Steven Novella, who called Lanka "a crank".WEB,weblink Yes, Dr. Lanka, Measles is Real, Steven Novella, NeuroLogica Blog, 2015-03-13, 2015-03-31, live,weblink" title="web.archive.org/web/20150331035815weblink">weblink 2015-03-31, Steven Novella, As outbreaks easily occur in under-vaccinated populations, the disease is seen as a test of sufficient vaccination within a population.BOOK, Abramson, Brian, Vaccine, vaccination, and immunization law, 2018, Bloomberg Law, 9781682675830, 10–30,

Alternative names

Other names include morbilli, rubeola, red measles, and English measles.

Research

In May 2015, the journal Science published a report in which researchers found that the measles infection can leave a population at increased risk for mortality from other diseases for two to three years.WEB, Bakalar, Nicholas, Measles May Increase Susceptibility to Other Infections,weblink The New York Times, The New York Times Company, 7 June 2015, live,weblink" title="web.archive.org/web/20150510032648weblink">weblink 10 May 2015, 2015-05-07, JOURNAL, Mina MJ, Metcalf CJ, de Swart RL, Osterhaus AD, Grenfell BT, Long-term measles-induced immunomodulation increases overall childhood infectious disease mortality, Science, 348, 6235, 694–9, May 2015, 25954009, 4823017, 10.1126/science.aaa3662, live, 2015Sci...348..694M,weblink" title="web.archive.org/web/20150510235121weblink">weblink 10 May 2015, A specific drug treatment for measles, ERDRP-0519, has shown promising results in animal studies, but has not yet been tested in humans.JOURNAL, White LK, Yoon JJ, Lee JK, Sun A, Du Y, Fu H, Snyder JP, Plemper RK, Nonnucleoside inhibitor of measles virus RNA-dependent RNA polymerase complex activity, Antimicrobial Agents and Chemotherapy, 51, 7, 2293–303, July 2007, 17470652, 1913224, 10.1128/AAC.00289-07, JOURNAL, Krumm SA, Yan D, Hovingh ES, Evers TJ, Enkirch T, Reddy GP, Sun A, Saindane MT, Arrendale RF, Painter G, Liotta DC, Natchus MG, von Messling V, Plemper RK, An orally available, small-molecule polymerase inhibitor shows efficacy against a lethal morbillivirus infection in a large animal model, Science Translational Medicine, 6, 232, 232ra52, April 2014, 24739760, 4080709, 10.1126/scitranslmed.3008517, WEB, The measles virus is highly infectious, but rarely deadly,weblink NewScientist.com, 5 February 2017, live,weblink 5 February 2017,

References

{{Reflist}}

External links

{{Medical condition classification and resourcesB00}}055}}| DiseasesDB = 7890| MedlinePlus = 001569| eMedicineSubj = derm| eMedicineTopic = 259emergped|1388}}| MeshID = D008457}}{{Commons category|Measles}} {{Viral cutaneous conditions}}{{Diseases of Poverty}}{{Numbered Diseases of Childhood}}{{Eradication_of_infectious_disease}}{{Authority control}}

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