Measles In Babies - Causes, Symptoms And Treatment

Image: Shutterstock

Table of contents:

Measles leads to an unsettling rash on the baby’s body. The viral infection is highly contagious and can cause high fevers and various complications. Unfortunately, there is no treatment for the condition. So, how do you tackle the problem? MomJunction will help you with an answer to that question and also talk about the causes, symptoms, and prevention.

What Causes Measles In Babies?

Measles is a viral infection that spreads through respiratory secretions expelled by an infected person when sneezing or coughing or through infected saliva. Measles, also called rubeola, is caused by the measles virus. The infection can be fatal, but the widespread availability of the measles vaccine helps prevent the disease. Nevertheless, the virus infects about 20 million individuals a year (1), with some infants at a higher risk than others.

Back to top

Infants at higher risk of measles:

The following groups of babies are at a greater risk of contracting the virus (2):

Infant groupDescription
Unvaccinated babiesBabies that do not have a vaccine-induced immunity
Immunosuppressed infantsThose who have AIDS, cancers such as leukemia, and diseases such as tuberculosis
Poor immunityMalnourished and underweight babies; babies with vitamin A deficiency
Infants living in crowded conditionsFor instance, those in day care centers

There are up to 100,000 deaths per year wordwide documented for those below the age of five (3). The following are the symptoms in their order of appearance:

What Are The Symptoms Of Measles In Babies?

The measles virus has an incubation period of eight to 12 days after which the symptoms surface (4). Following are the symptoms in their order of appearance:

  • Flu symptoms, sore throat, and runny nose are the first symptoms to emerge at the end of the incubation period. As these symptoms are similar to those of common cold, it can be difficult to make the diagnosis at this point.
  • 2 to 3 days before the rash starts some spots can be seen in the mouth. They are normally white and can be in clusters. These spots are called Koplik’s spots.
  • Conjunctivitis, the infection of the outermost layer of the eye (conjunctiva), and fever are some other symptoms. The measles virus infects the layer causing redness and inflammation of the eyes, and moderate fever.
  • After two to three days of the first symptoms, the baby develops measles rashes, which can first appear as dull blisters, but soon turn into large blotches of tiny reddish-brown rashes. The rashes appear on the forehead and gradually spread to the arms, torso, legs, and feet.
  • The fever surges after the appearance of rashes and reaches a scorching 104°F to 105.8°F (40°C to 41°C). It is at this stage that the disease reaches its peak.

The fact that there are several other conditions with similar symptoms makes it difficult to recognize measles.

Conditions similar to measles:

  • Roseola is an infantile disease caused by the herpes virus (5). It leads to rashes all over the body, but the rashes have a lesser intensity than those caused by measles. The hallmark feature here is that there is fever typically for 3-4 days followed by the rash. Once the rash appears then typically the fever subsides.
  • Rubella or German measles is a he diseasecaused by rubella virus, but the symptoms are strikingly similar to those of measles. Unlike measles, rubella is mostly mild, with about 25-50% infected infants never displaying any symptoms (6).

The above conditions have a different prognosis than measles. The measles rash and high fever persist for five to eight days, eventually decreasing in intensity. The disease usually lasts for 14 days, and by the second week, the baby will show signs of recovery.

Back to top

How Is Measles In Infants Diagnosed?

Doctors diagnose the condition by visual inspection of the characteristic measles rash. A blood test and sometimes a urine test is conducted to assess the presence of antibodies that target the measles virus. This helps differentiate it from other conditions and makes the treatment specific and accurate..

Back to top

How Is Measles Treated?

There is no particular treatment for measles, and it cannot be treated with antibiotics since they are helpful only against bacteria. However, the following measures relieve the symptoms and bolster the immune system to clear the virus naturally.

  • Immunization: Babies older than 12 months can be administered the measles, mumps, and rubella (MMR) vaccine if measles is diagnosed within 72 hours. If the blood tests reveal the infection was contracted before 72 hours, then an injection of immunoglobulin (IG) antibodies may be given (7). Since MMR vaccine is not recommended for infants under 12 months, an IG injection is the only alternative. IG injection is also suitable for infants below six months.
  • Analgesic medication: Medicines such as paracetamol (also known as acetaminophen) are prescribed to relieve fever. These medicines are available over-the-counter, but should only be given to the baby after consulting a doctor. Analgesics such as aspirin are never given to babies since they can lead to health complications (8).
  • Vitamin supplements: The inadequacy of vitamin A is linked to an increased risk of measles. Vitamin supplements are ideal only for infants above six months as babies below six receive adequate vitamins from breastmilk alone.
  • Antibiotics: A baby’s compromised immunity leaves the body unguarded against a host of bacteria. The doctor may prescribe a precautionary antibiotic course in case of severe measles.

Like in the case of any viral infection, the patient has to be given supportive home care.

Back to top

Home care for a baby with measles:

Caring for a little one with measles is a vital part of treatment. Here is what parents can do to ensure the baby’s body fights the virus better:

  • Give plenty of fluids: If the baby is younger than six monthsone should be completely healthy b, then breastfeed the infant more frequently. Babies older than six months can be given sips of water and fresh homemade fruit purees since fruits are rich in vitamins (9). Solid foods can be difficult and painful to chew due to Koplik’s spots in the mouth. Therefore, a liquid diet of purees and blended baby cereals in milk will help the little one get the necessary nourishment.
  • Dim the room lighting: The infant should sleep in a dimly lit room. Infants with measles can find bright light uncomfortable and irritating.
  • Lots of rest: Rest always helps in viral infections as it gives the immune system adequate time to prepare itself for the attack on the virus. Pause the baby’s playtime till he is better. If the toddler goes to a preschool, then take a month off. The little one should be completely healthy before he resumes any physical activities.

The treatment and supportive care for measles are necessary to help prevent complications.

Complications Of Measles In Babies

The measles virus keeps the immune system busy leaving the body exposed to other harmful germs. An untreated measles infection may indirectly cause the following diseases in the baby:

  • Pneumonia is the most common complication of measles in infants. The measles virus increases the risk of contracting pneumonia, especially in infants with compromised immunity.
  • Bronchitis is a bacterial infection of the bronchiole tubes in the lungs and makes breathing difficult and painful for the patient.
  • Bacteria can invade the middle ear and lead to ear infections such as otitis media.
  • Upper respiratory infections, including the larynx (laryngitis) and trachea (croup), are common complications.
  • Gastroenteritis is a potentially dangerous complication that can lead to dehydration.
  • Involvement of the eyes that are not treated well can lead to vision loss.
  • Encephalitis is the most severe of all complications, but the least common – only one in 1,000 measles patients develops this condition. Encephalitis is the swelling of the brain, which causes convulsions, seizures, and coma in severe cases.

The World Health Organisation (WHO) states that most measles-related deaths are only caused by its complications (10). These complications can be prevented by prompt treatment. However, prevention is the best way to avoid the condition in the first place.

Back to top

Can You Prevent Measles Through Vaccination?

Yes, measles is preventable through the administration of the MMR vaccine, which is a single prevention measure for measles, mumps, and rubella. In most countries, MMR vaccines are part of the usual immunization checklist for an infant. According to the American Academy of Pediatrics (AAP), the vaccine has led to a 99% drop in measles cases in the US since 1963.

In some countries a maesels only vaccine is given at 6 months of age and then the MMR at one year.

Nevertheless, there are several misconceptions about the vaccine. Some unsubstantiated research has linked the vaccine to autism, but the claim has been vehemently debunked. There has been no lik esthablished between autism and any vaccine. Vaccines, as with any treatment that has an effect, has potential side-effects. These side-effects are mostly harmless eg local swelling and some pain at the site of the injection or a fine rash a few days after the vaccine. Even these minor side-effects are very rare. The vaccine has been eclared safe by the AAP, UNICEF, and even the US government (11) (12). However, a parent should keep some points in mind before going for an MMR vaccination.

Back to top

When Should My Baby Get The Measles Vaccine?

The MMR vaccine against measles is only administered to an infant after 12 months of age. In the countries where a vaccine for maesels are given before the age of 12 months it is normally a maesels only vaccine.

Some more points to know about MMR vaccination:

  • In some cases, babies between six and 11 months can be given the vaccine, especially when the little one is traveling to a measles-prevalent country. The baby will still have to undergo the two usual vaccine shots at 12-15 months and between four and six years.
  • Irrespective of their age, the vaccinated babies might have mild side effects such as low-grade fever and cold. They may also develop a moderate measles-like rash. Side effects appear six to12 days after vaccination. These effects are not dangerous and should not be a reason to evade vaccination. Also, they are seen only in about 15% of the vaccinated babies.
  • Several hospitals and clinics offer the MMRV vaccine, which immunizes the baby against the varicella virus that causes chicken pox. MMRV vaccine has a different immunization schedule. MMRV vaccine is equally safe and approved by AAP and the US Department of Health & Human Services (13).

These vaccines, however, do have some limitations and it is best to check with the doctor. The vaccine schedules of countries / regions differ depending on the risks of infections in these areas. Always consult you healthcare provider for the correct advice pertaining to your area.

Back to top

Limitations to the MMR vaccine:

An MMR vaccine may not be administered to infants in the following categories, even if the baby is older than 12 months.

  • Allergic reaction to a previous dose of the vaccine.
  • The MMR vaccine is generally not given to babies who have a compromised immunity or immunosuppressed infants such as those with AIDS or certain types of cancer.
  • If the baby is suffering from an illness, disease, or is unwell in general, then the doctor might postpone the vaccination till the baby is completely alright.

In the above cases, doctors delay vaccinations or suggest safer alternatives such as immunoglobulin injections that provide short-term immunity.

Can A Baby Get Measles Even After Vaccination?

Experts believe that it is highly unlikely for a baby to get measles after vaccination (14). The first dose of vaccine provides 90% immunity while two doses give 99% immunity against measles. However, no vaccine gives 100% protection.

Nevertheless, only 3% of immunized individuals get the disease, and the symptoms are far less intense than those that get measles without vaccination (15).

Infants who get measles even after vaccination will tolerate the infection better and are less likely to spread the virus to healthy individuals. The benefits of vaccination, thus, outweigh the risk of skipping the immunization.

In addition to vaccination, preventive care is key to protect your infant from measles.

Back to top

How Can Parents Help Prevent Measles In Babies?

Some easy and simple home prevention measures can help keep measles at bay:

  • Breastmilk protects: Studies have indicated that if a mother suffered from measles in her life, then she automatically passes her natural immunity to her baby through breastmilk (16). It is called passive immunity since the baby’s body gets readymade antibodies. This immunity is so effective that the baby has some level of protection against measles till 12 months (17). Mothers who never acquired measles, should still feed the baby since breastmilk is rich in antibodies and provides numerous scientifically-proven immunity benefits (18).
  • Avoid high-risk situations: Measles spreads easily in overcrowded environments, and is common during winter and spring seasons. Being extra cautious around this time and staying away from overcrowded places will help shield the baby.
  • Maintain hygiene: The measles virus can remain on a surface for two hours, ready to infect anyone who comes into contact with it. Cleanliness and hygiene are essential to prevent the infection. Always wash the baby’s hands after you come from outdoors, and clean his personal items and keep them in a hygienic state.

Back to top

Immunization of family members also considerably reduces the baby’s risk of contracting the virus.

A baby who has just recovered from measles will have a natural immunity against the disease, usually for the rest of their life (19). However, it is not a reason to stay away from vaccination. New data shows that some of the person’s immunity to other infections that was built up over the years are decreased following a measles infection. Simple preventive measures and vaccination are the hallmark steps to protect the little one from the clutches of measles.

The following two tabs change content below.

Dr. Wayne Hough

(MBChB, MMed, FC Paeds)
Dr. Wayne Hough is a pediatrician currently based in the Northern Suburbs of Cape Town in South Africa. He got his medical degree from the University of Stellenbosch. He then worked at the Tygerberg Children's Hospital before completing his pediatric training and qualification from the South African College of Medicine. Dr. Hough also holds a MMed degree in pediatrics from... more

Rohit Garoo

Rohit Garoo is a zoologist-botanist turned writer with over 8 years of experience in content writing, content marketing, and copywriting. He has also done an MBA in marketing and human resources and worked in the domains of market research and e-commerce. Rohit writes topics related to health, wellness and development of babies. His articles featured on several notable websites, including... more