What are the measles?

Measles, or rubeola, is a viral infection of the respiratory

system. Measles is a very contagious disease that can spread through contact
with infected mucus and saliva. An infected person can release the infection into
the air when they cough or sneeze. The measles virus can live on surfaces for
several hours. As the infected particles enter the air and settle on surfaces,
anyone within close proximity can become infected. Drinking from an infected
persons glass, or sharing eating utensils with an infected person, increases your
risk of infection. Measles is a leading cause of death in children. Of the 114,900
global deaths related to measles in 2014, the World Health Organization (WHO)
reported that most of the victims were under the age of 5. Contact a doctor
immediately if you suspect you have measles. If you have not received a measles
vaccine and you come into contact with an infected person, visit your doctor to
receive a measles vaccine within 72 hours of contact to prevent infection. You
can also prevent an infection with a dose of immunoglobulin taken within six days
of contact with an infected person. What are the symptoms of measles?
Symptoms of measles generally appear within 14 days of exposure to the virus.
Symptoms include: cough fever red eyes light sensitivity muscle aches
runny nose sore throat white spots inside the mouth
A widespread skin rash is a classic sign of measles. This rash can last up to
seven days and generally appears within the first three to five days of exposure to
the virus. A measles rash, which appears as red, itchy bumps, commonly
develops on the head and slowly spreads to other parts of the body. Who is at
risk for measles? The number of measles cases in the United States has
significantly dropped in recent decades due to immunizations. However, the
disease has not been completely eliminated. In fact, there were 189 cases of
measles in 2015, according to the Centers for Disease Control and Prevention
(CDC). Measles primarily occurs in unvaccinated children. Some parents choose
not to vaccinate their children for fear that vaccines will have adverse effects on
their children. Most children and adults who receive a measles vaccine do not
experience side effects. But in rare cases, the vaccine has been linked to
seizures, deafness, brain damage, and coma. It is important to note that these
serious side effects from the measles vaccine occur in less than 1 out of every
million doses of the vaccine given. Some parents believe that the measles
vaccine can cause autism in children. However, numerous studies have proven
that there is no link between autism and immunizations. A vitamin A deficiency is
also a risk factor for measles. Children with too little vitamin A in their diets have

a higher risk of catching the virus. How to treat measles There is no prescription
medication to treat measles. The virus and symptoms typically disappear within
two to three weeks. However, your doctor may recommend: acetaminophen to
relieve fever and muscle aches rest to help boost your immune system plenty
of fluids (six to eight glasses of water a day) humidifier to ease a cough and
sore throat vitamin A supplements
Complications associated with measles It is important to receive a measles
vaccine because measles can lead to life-threatening complications, such as
pneumonia and inflammation of the brain (encephalitis). Other complications
associated with measles may include: ear infection bronchitis miscarriage or
preterm labor decrease in blood platelets blindness severe diarrhea
How to prevent measles Immunizations can help prevent a measles outbreak.
The MMR vaccine is a three-in-one vaccination that can protect you and your
children from the measles, mumps, and rubella (German measles). Children can
receive their first MMR vaccination at 12 months, or sooner if traveling
internationally, and their second dose between the ages of 4 and 6. Adults who
have never received an immunization can request the vaccine from their doctor. If
you or a family member contracts the measles virus, limit interaction with others.
This includes staying home from school or work and avoiding social activities.
Mumps facts

Mumps is a highly contagious viral infection with an incubation

period of 14-18 days from exposure to onset of symptoms. The
duration of the disease is approximately 10 days.

The initial symptoms of mumps infection are nonspecific (lowgrade fever, malaise, headache, muscle aches, and loss of appetite).
The classic finding of parotid gland tenderness and swelling generally
develops the third day of illness. The diagnosis is generally made
without the need for laboratory tests.

Serious complications of mumps include meningitis, encephalitis,

deafness, and orchitis.

The MMR vaccine provides 80% effective immunity against

mumps following a two-dosage schedule (12-15 months with booster
at 4-6 years of age).

No specific therapy exists for mumps. Warm or cold packs for the
parotid gland tenderness and swelling is helpful. Pain relievers
(acetaminophen[Tylenol] and ibuprofen [Advil]) are also helpful.
What is mumps?

Mumps is a viral infection transmitted by and affecting only humans.

While the salivary glands (especially the parotid gland at the sides of
the cheeks) are well known to be involved during a mumps infection,
many other organ systems may also experience effects of the virus
infection. There is no cure for mumps, but the illness is of short
duration (seven to 10 days) and resolves spontaneously. Prior to the
introduction of mumps vaccination, the highest rate of new cases of
mumps was reported in the late winter to early spring.
What is the history of mumps?
Medical historians believe that documentation of a clinical illness
consistent with mumps dates back to Greco-Roman times. The first
effective vaccine against mumps was introduced in 1948 and used
from 1950-1978. Unfortunately, this vaccine strain had limited longterm immune memory effectiveness. The current strain used in the
United States and worldwide provides over 80% long-term immunity.
The current childhood mumps immunization schedule recommends
vaccination at 12-15 months old and a booster at 4-6 years of age. The
mumps vaccine is commonly administered as part of a combination
vaccine (MMR) also providing protection against measles and
rubella(German measles).
What causes mumps? How is mumps transmitted?
Mumps virus is a single strand of RNA housed inside a two-layered
envelope that provides the virus its characteristic immune signature.
Only one type of mumps virus has been demonstrated to exist (in
contrast to the many virus types that can cause the common cold).
Mumps is highly contagious and has a rapid spread among members
living in close quarters. The virus most commonly is spread directly
from one person to another via respiratory droplets. Less frequently,
the respiratory droplets may land on fomites (sheets, pillows, clothing)
and then be transmitted via hand-to-mouth contact after touching such
items. The incubation period from exposure to the virus and onset of
symptoms is approximately 14-18 days. Viral shedding is short lived
and a patient should be isolated from other susceptible individuals for
the first five days following the onset of swelling of the salivary
(parotid) glands.
What are risk factors for contracting mumps?
1.
Failure to be immunized completely (two separate doses) with
exposure to those with mumps
2.
Age: The highest risk of contracting mumps is to children
between 2-12 years of age
3.
Season: epidemics of mumps were most likely during the
winter/spring seasons
4.
Travel to high-risk regions of the world: Africa, general Indian
subcontinent region, and Southeast Asia. These areas have a very low
rate of vaccination.

5.
Weakening immune system: either due to diseases (for example,
HIV/AIDS, cancer) or medication (oral steroid use for more than two
weeks, chemotherapy)
6.
Born before 1956: Generally, these individuals are believed to
have experienced mumps infection in childhood. However, if they did
not, they are at risk for adult mumps disease. A blood test may be
obtained to determine immunity and is worthwhile if any doubt exists
regarding prior mumps infection.
What are the signs and symptoms of mumps in children and adults?
Nonspecific symptoms of low-grade fever, headache, muscle aches
(myalgia), reduced appetite, and malaise occur during the first 48
hours of mumps infection. Parotid gland swelling characteristically is
present on day three of illness. (The parotid gland is a salivary gland
located anterior to the ear and above the angle of the jaw -- imagine a
large set of sideburns.) The parotid gland is swollen and tender to
touch, and referred pain to the ear may also occur. Parotid gland
swelling may last up to 10 days, and adults generally experience worse
symptoms than children. Approximately 95% of individuals who
develop symptoms of mumps will experience tender inflammation of
their parotid glands.
Interestingly about 15%-20% of mumps cases have no clinical
evidence of infection, and 50% of patients will have only nonspecific
respiratory symptoms and not the characteristic description above.
Adults are more likely to experience such a subclinical or respiratoryonly constellation of symptoms while children between 2-9 years of
age are more likely to experience the classic presentation of mumps
with parotid gland swelling.
How do health-care professionals diagnose mumps?
The diagnosis of mumps is primarily one of clinical acumen. Laboratory
studies are generally done to support the clinical impression. The
purpose of these laboratory studies is to exclude other viruses that
may give a similar clinical presentation as well as to exclude very
infrequent similarly presenting parotid gland enlargement (for
examples, salivary gland cancer, Sjgren's syndrome, IgG-4 related
disease, sarcoidosis, side effects of thiazide diuretics, etc.).
What is the treatment for mumps in adults and in children?
The mainstay of therapy (regardless of age range) is to provide
comfort for this self-limited disease. Taking analgesics (acetaminophen,
ibuprofen) and applying warm or cold packs to the swollen and
inflamed salivary gland region may be helpful.
What types of doctors treat mumps?
Most cases of mumps are not complicated and thus may be managed
by a pediatrician, internist, or family practice physician. An infectiousdisease specialist may need to be consulted for unusual circumstances
or medically complicated patients.
What are complications of mumps?

There are four serious complications of mumps: meningitis(infection of

the spinal fluid which surrounds the brain and spinal cord), encephalitis
(infection of the brain substance), deafness, and orchitis (infection of
the testicle/testicles). All four complications may occur without the
patient experiencing the classic involvement of the parotid gland.
1.
Meningitis: More than half of patients with mumps will have
meningitis, which may occur during any period of the disease.
Generally patients make a full recovery without permanent side
effects.
2.
Encephalitis: Until the 1960s, mumps was the primary cause of
confirmed viral encephalitis in the United States. Since the successful
introduction of a vaccination program, the incidence of mumps
encephalitis has fallen to 0.5%. Fortunately, most patients recover
completely without permanent side effects.
3.
Deafness: Preceding the mumps vaccination program,
permanent nerve damage resulting in deafness was not unusual. While
occasionally bilateral, more commonly only one ear was affected.
4.
Orchitis: This complication was the most common side effect to
postpubertal males who contracted mumps. Severe pain (often
requiring hospitalization for pain management) was one-sided in most
cases. Some affected testes atrophied (decreased in size), and some
demonstrated impaired fertility. The "common knowledge" of sterility
was actually rare. Previous concerns regarding mumps orchitis and
later testicular cancer have not been proven. (Ovarian involvement
occurred in some postpubertal girls.)
Less frequent complications of mumps infection include arthritis,
infection of the pancreas, infection of the myocardium (heart muscle),
and neurological conditions (for example, facial palsy, Guillain-Barr
syndrome, etc.).
Is it possible to prevent mumps? Is there a vaccine for mumps?
Prior the introduction of the mumps vaccine in 1948, epidemics during
the winter/spring would commonly affect young schoolchildren with
secondary spread to other family members not yet immune. Until an
effective vaccine program was introduced, isolation of the infected
individual was the only public-health control option. The current MMR
strain used in the United States and other developed countries was
licensed in 1967. Another strain is more commonly used in developing
countries. Both strains provide approximately 80% immunity following
the two-vaccination schedule detailed below.
The Centers for Disease Control and Prevention (CDC) recommends a
combination vaccine (MMR) to children at 12 to 15 months of age with
a booster dose at 4 to 6 years of age. During periods of possible
epidemics, the booster dose may be administered after a minimum of
28 days following the initial vaccination. The MMR vaccination is
designed to prevent measles, mumps, and rubella (German measles).
Adults born after 1956 should receive at least one MMR vaccination.

Those born prior to 1956 are generally found to have acquired natural
immunity and no vaccination is necessary.
More common side effects of the MMR vaccine include stinging/burning
at the injection site, mild fever, and mild skin rash. The fever and skin
rash most commonly develop five to 12 days postvaccination and
occur more commonly after the first vaccination. Some recipients of
the vaccine will note mild enlargement and tenderness of local (for
example, neck) lymph nodes. It should be noted that these relatively
common side effects are considerably less severe than acquiring any of
the three illnesses the MMR vaccine is designed to prevent. In
extremely rare situations, more severe reactions affecting the nervous
system, gastrointestinal system, and digestive organs, the skin, and
others may occur.
A very small population should not receive the MMR vaccine. These
include those with a compromised immune system (HIV/AIDS, cancer,
those receiving more than two continuous weeks of steroids) or who
are allergic to any component of the vaccine, including gelatin or
neomycin. MMR vaccines are very unlikely to produce a severe reaction
to those who are egg white allergic. Daily use of inhaled steroids (such
as those used to control certain pulmonary diseases such as asthma,
COPD, etc.) is not a contraindication to the MMR vaccine. Patients with
a mild illness (for example, the common cold) may safely receive the
MMR vaccine. Conception should be avoided until at least 28 days
following vaccination.
Multiple international studies have not demonstrated any causative
relationship between administration of the MMR vaccine and the
development of autism, disproving previous erroneous theories.
What is the prognosis of a mumps infection?
Mumps is generally a benign self-limited disease that produces lifelong
immunity. Severe side effects are extremely rare; more common
complications (though still relatively rare) are listed above. Nonimmune women who contract mumps during the first trimester of their
pregnancy have an increased rate of miscarriage, but infants carried to
term have no higher risk for congenital malformations.
How Can I Prevent Mumps?
Vaccination can prevent mumps. Most infants and children receive a
vaccine for measles, mumps, and rubella (MMR) at the same time. The
first MMR shot is generally given between the ages of 12 and 15
months at a routine well-child visit. A second vaccination is necessary
for school-aged children between 4 and 6 years old.
Adults who were born before 1957 and havent yet contracted mumps
may wish to be vaccinated. Those who work in a high-risk environment,
such as a hospital or school, should always be vaccinated against
mumps.

However, patients who have a compromised immune system, who are

allergic to gelatin or neomycin, or who are pregnant, shouldnt receive
the MMR vaccine.
Consult your family doctor about an immunization schedule for you
and your children.