13 March 2024: Review Articles
A Review of the Resurgence of Measles, a Vaccine-Preventable Disease, as Current Concerns Contrast with Past Hopes for Measles Elimination
Dinah V. Parums BCDEF*DOI: 10.12659/MSM.944436
Med Sci Monit 2024; 30:e944436
Background
The History of Measles Virus Infection
Clinical Presentation, Diagnosis, and Differential Diagnoses
Complications of Measles
Subacute Sclerosing Panencephalitis (SSPE)
Presumptive (Presumed) Measles Virus Immunity
Elimination of Measles
The History of Measles Vaccination and the MMR Vaccine
Protective Immune Responses from Infection and Vaccination
Measles in the United States (US)
Measles Vaccination, Elimination, and Resurgence in the US
Measles in Europe
Measles in the United Kingdom (UK)
The COVID-19 Pandemic and Measles Resurgence
Global Responses
Conclusions
References
Table 1 Childhood diseases in the differential diagnosis of measles [10].
| Childhood disease | Clinical diagnosis |
|---|---|
| Dengue fever | Dengue has a similar presentation to prodromal and post-rash measles. Relevant epidemiology and serologic testing can diagnose dengue |
| Childhood respiratory viruses, including rhinoviruses, parainfluenza, influenza, adenovirus, and respiratory syncytial virus (RSV) | Fever due to measles infection is usually more severe than for other childhood respiratory viruses, diagnosed from nasal swab using polymerase chain reaction (PCR) |
| Childhood viral infections with skin rash include varicella, human herpesvirus 6 (roseola infection), parvovirus B19 (erythema infectiosum), and rubella | Measles has a distinctive clinical progression of the rash, which can be brown, blanches on pressure, and is associated with coryza and conjunctivitis. Serology can diagnose other childhood virus infections |
| Group A infections, including scarlet fever and toxic shock syndrome | Scarlet fever presents with an erythematous skin rash and pharyngitis. Toxic shock syndrome results in hypotension and organ system dysfunction. Isolation of group A Streptococcus is diagnostic |
| Meningococcemia can include a petechial rash, fever, vomiting, headache, and sepsis | infection is confirmed by bacterial culture |
| Rocky Mountain spotted fever can include a maculopapular rash | Rocky Mountain spotted fever is associated with tick exposure and diagnostic serology or skin biopsy |
| respiratory tract infection can present with an erythematous maculopapular or vesicular rash | The diagnosis of may be difficult, but pneumonia is the main feature |
| Infectious mononucleosis can result in a generalized maculopapular, urticarial, or petechial rash | Infectious mononucleosis includes fever, fatigue, pharyngitis, and lymphadenopathy and is diagnosed by serology and virology |
| Exanthematous drug eruption can resemble a measles rash | A history of recent drug exposure, with resolution of the rash after drug withdrawal |
| Fordyce spots (small yellow/white granules on the buccal mucosa) are benign ectopic sebaceous glands. In early measles infection | Fordyce spots can be confused with Koplik spots in early measles infection |
| Multisystem inflammatory syndrome in children (MIS-C) from SARS-CoV-2 includes fever, abdominal pain, conjunctivitis, and rash | The diagnosis of MIS-C can be confirmed by RT-PCR testing for SARS-CoV-2 |