Measles Before the Rash: What Comes First?

May 22, 2014

It's been a while since "the measles" was a household term in the United States, but 13 states so far this year have seen outbreaks. Have you seen a case lately? Would you recognize the virus prodrome?

s of April 18th, the CDC reported that 13 states have had 129 cases of measles in 13 separate outbreaks, with California and Ohio leading the way with 80 cases between them. Most of cases were in persons who chose not to be immunized or who were too young to receive the vaccine.

 

It’s unfortunate, but most of our vaccine preventable diseases in the US are just a plane ride away. For example, one of the outbreaks in Ohio began with an unimmunized person who had been exposed to the virus during a visit to the Philippines and became sick after returning to the US. The incubation time for measles is about 8 to 12 days from exposure to onset of symptoms.

The reappearance of measles is disheartening-the endemic disease was eliminated in the US in 2000. It also makes some of us a little nervous because many young practicing US clinicians have never seen a case of the measles.  Does that include you? Would you recognize it if it showed up in your office? 

See if you can put the following groups of signs and/or symptoms in the correct order of appearance in a classic case of the measles:

   - Fever and malaise          

   - Facial rash                          

   - Body rash                           

   - Koplik’s spots on the buccal mucosa       

   - Coryza, conjunctivitis, and cough       

- See more at: http://www.consultantlive.com/vaccines/measles-key-5-signs-and-symptoms#sthash.Jyr0eKP0.dpuf

s of April 18th, the CDC reported that 13 states have had 129 cases of measles in 13 separate outbreaks, with California and Ohio leading the way with 80 cases between them. Most of cases were in persons who chose not to be immunized or who were too young to receive the vaccine.

 

It’s unfortunate, but most of our vaccine preventable diseases in the US are just a plane ride away. For example, one of the outbreaks in Ohio began with an unimmunized person who had been exposed to the virus during a visit to the Philippines and became sick after returning to the US. The incubation time for measles is about 8 to 12 days from exposure to onset of symptoms.

The reappearance of measles is disheartening-the endemic disease was eliminated in the US in 2000. It also makes some of us a little nervous because many young practicing US clinicians have never seen a case of the measles.  Does that include you? Would you recognize it if it showed up in your office? 

See if you can put the following groups of signs and/or symptoms in the correct order of appearance in a classic case of the measles:

   - Fever and malaise          

   - Facial rash                          

   - Body rash                           

   - Koplik’s spots on the buccal mucosa       

   - Coryza, conjunctivitis, and cough       

- See more at: http://www.consultantlive.com/vaccines/measles-key-5-signs-and-symptoms#sthash.Jyr0eKP0.dpuf

As of April 18, the CDC reported that 13 states have had 129 cases of measles in 13 separate outbreaks, with California and Ohio leading the way with 80 cases between them. Most of cases were in persons who chose not to be immunized or who were too young to receive the vaccine.

It’s unfortunate, but most of our vaccine-preventable diseases in the US are just a plane ride away. For example, one of the outbreaks in Ohio began with an unimmunized person who had been exposed to the virus during a visit to the Philippines and became sick after returning to the US. The incubation time for measles is about 8 to 12 days from exposure to onset of symptoms.

The reappearance of measles is disheartening-the endemic disease was eliminated in the US in 2000. It also makes some of us a little nervous because many young practicing US clinicians have never seen a case of the measles. Does that include you? Would you recognize it if it showed up in your office?

See if you can put the following signs and/or symptoms in the correct order of appearance in a classic case of measles:

   - Fever and malaise          

   - Facial rash                          

   - Body rash                           

   - Koplik spots on the buccal mucosa       

   - Coryza, conjunctivitis, and cough 
      

Please leave your thoughts below; for the correct order and short discusison, CLICK HERE.