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Chickenpox     Measles     Pertussis     Rubella

Measles	[Top of page]
	Red, watery, puffy eyes seen in the prodromal (early) stage of measles during which the child develops a flu-like illness with fever, runny nose, conjunctivitis, cough and malaise. The prodromal stage starts about 10 to 12 days after exposure to the virus and lasts about 2 to 4 days. The measles rash is just slightly apparent as a fine granular eruption on the forehead and hairline of this child.
	During the early flu-like stage of measles, white or greyish spots called Koplik spots, appear on the inner lining of the mouth. These spots look like small grains of sand with a reddish base and they are peculiar to measles. Typically, they appear about 1 to 2 days before the rash and fade rapidly, usually within a day.
	The measles rash starts about 14 days after exposure to the virus as a fine, flat or slightly raised (macular or maculopapular) rash behind the ears, on the face and neck and spreads over a 3 to 4 day period. The rash becomes confluent as it progresses and initially blanches with pressure but later changes to a brownish, non-blanching appearance. As seen in this child, the rash starts to fade on the face even as it continues to spread to the upper body and abdomen. The early-onset signs of a flu-like illness are still evident in this child. Photo by courtesy of Dr. J.H. Victor Marchessault
	Children with measles are often ill-looking, miserable and irritable. The typical red blotchy rash seen at the peak of measles infection is seen in this child. About 14 days after exposure to the virus, the measles rash starts as a fine, flat or slightly raised (macular or maculopapular) rash behind the ears, on the face and neck and spreads to the upper body and abdomen over a 3 to 4 day period. The rash becomes confluent as it progresses; in severe cases, the rash is more confluent and extensive.
	Typical red blotchy appearance of measles rash at its peak. Children with measles are often ill-looking and miserable. The early signs of measles start approximately 10-12 days after exposure to the virus and consist of a runny nose with fever, red and puffy eyes (indicating inflammation of the conjunctiva), cough and malaise. During this early stage, white or greyish spots, which look like small grains of sand with a reddish base also develop on the inner lining of the mouth; these Koplik spots are peculiar to measles.
	Generalized measles rash which is starting to clear on the face. The rash typically clears in the order of appearance, starting from the head (face, neck, behind the ears) and progressing to the body and limbs. At this late stage, the child still looks ill and miserable with inflamed, puffy eyes.
	Brown, dusky appearance of measles rash at late stage of illness. As the rash clears, there is usually a slight desquamation or peeling of the skin. The rash typically clears in the order of appearance, starting from the head (face, neck, behind the ears) and progressing to the body and limbs.
	Appearance of measles rash in a dark-skinned child. The red, blotchy appearance of a measles rash is not apparent in darker people but the skin looks granular in the early stage. The slight desquamation or peeling of the skin which occurs as the rash clears can be seen on the face and upper body of this child. Photo by courtesy of Dr. Adwoa Bentsi-Enchill.
	Appearance of measles rash in a dark-skinned child; the rash can only be seen as a fine granular eruption. In darker people the red blotchy appearance of the measles rash is not seen. The early signs appear the same, including Koplik spots which appear as granular white or greyish spots with a reddish base on the inner lining of the mouth during the early stage. Photo by courtesy of Dr. Adwoa Bentsi-Enchill.
	Measles is generally more severe in adults and infants than in older children. In Canada, persons born before 1957 (when the measles vaccine was introduced) are usually considered to have had measles in childhood and therefore, to be protected from further clinical measles. This case was recorded during the investigation of a measles outbreak in the Baffin Region of the North West Territories in 1991 (For report of outbreak investigation, see CCDR 1991;17(42):225-228).
	Dusky, brown rash as seen in late stage of measles, already clearing from the upper body and abdomen. The rash typically clears in the order of appearance, starting from the head (face, neck, behind the ears) and progressing to the body and limbs, and may be followed by some desquamation or peeling of the skin.
	Like most children who have measles, this child looks ill and miserable. The rash starts about 14 days after exposure to the virus as a fine, flat or slightly raised (macular or maculopapular) rash and becomes confluent as it progresses, giving it this red, blotchy appearance at its peak. In mild cases the rash tends not to be confluent while in severe cases the rash is more confluent and the skin may be completely covered.
	Measles rash in an adolescent Courtesy of the Centers for Disease Control and Prevention, Atlanta, Georgia, U.S.A.
	Promotional material supplied by Health Canada for the 1996 Supplementary Measles Catch-Up campaigns and the implementation of routine two-dose measles vaccination. As the poster states, "It takes two doses of red measles vaccine to be better protected." Parents are advised to let their children "Get that second dose!"

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