Symptoms of measles

The incubation period for measles is on average 8-10 days, but can extend up to 17 days.

In children who received immunoglobulin for prophylactic purposes, the incubation period is extended to 21 days. In the clinical picture of measles, three periods are distinguished: catarrhal (prodromal), rashes and pigmentation.

The onset of the disease (catarrhal period) is manifested by an increase in body temperature to 38.5-39 "C, the appearance of catarrh of the upper respiratory tract and conjunctivitis. Photophobia, conjunctival hyperemia, swelling of the eyelids, scleritis are noted, then purulent discharge appears. Often at the onset of the disease, loose stools and abdominal pain are noted. In more severe cases, symptoms of general intoxication are sharply expressed from the first days of the disease, there may be convulsions and clouding of consciousness.

The catarrhal period of measles lasts 3-4 days, sometimes extending to 5 or even 7 days. This period of measles is pathognomonic for specific changes on the mucous membrane of the cheeks near the molars, less often on the mucous membrane of the lips and gums in the form of grayish-whitish dots the size of a poppy seed, surrounded by a red rim. The mucous membrane becomes loose, rough, hyperemic, and dull. This symptom is known as Filatov-Koplik spots. They appear 1-3 days before the rash, which helps to establish the diagnosis of measles before the rash appears and differentiate catarrhal phenomena in the prodrome from catarrh of the upper respiratory tract of another etiology.

During the catarrhal period of measles, enanthem appears in the form of small pinkish-red spots on the soft and hard palate.

The appearance of the maculopapular rash begins on the 4th-5th day of the disease. The first elements of the rash appear behind the ears, on the bridge of the nose in the form of small pink spots that quickly increase in size, sometimes merge, and have an irregular shape. The number of elements of the rash increases very quickly:

• 1 day (towards the end) - the rash covers the entire face, neck, and its individual elements appear on the chest and upper back;
• 2 days - the rash completely covers the body and upper arms;
• Day 3 - the rash spreads to the legs and arms.

The staged nature of the rash is a very important diagnostic sign of measles. The rash with measles evenly covers both the outer and inner surfaces of the arms and legs and is located on an unchanged background of the skin. Sometimes the rash is hemorrhagic. It can be very abundant, confluent, or, conversely, very scanty, in the form of separate elements.

The appearance of a measles patient during the period of the rash is typical: the face is puffy, the eyelids are thickened, the nose and upper lip are swollen, the eyes are red and festering, and there is copious discharge from the nose.

The body temperature on the first day of the rash is higher than in the catarrhal period. Sometimes 1-2 days before the rash it decreases slightly, and rises again on the first day of the rash. The body temperature remains elevated throughout the entire period of the rash. In an uncomplicated course, it normalizes on the 3-4th day from the onset of the rash.

Measles pigmentation period. Measles rash very quickly begins to darken, turn brown, then takes on a brown color, the pigmentation period begins. The rash is pigmented first on the face, while on the limbs and torso it remains red, then it is pigmented on the torso and on the limbs, i.e. pigmentation occurs in the same sequence as the rash. Pigmentation usually lasts 1-1.5 weeks, sometimes longer. During this period, there may be small bran-like peeling. During the pigmentation period, body temperature normalizes. The general condition is slowly restored. Catarrhal phenomena gradually disappear. During the convalescence period of measles, asthenia and anergy (decreased immunity) persist for a long time.

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