Recognition
- Prodrome: High fever (often >104F), cough, coryza (runny nose), conjunctivitis (the "three C's")
- Koplik spots: Pathognomonic white spots on the buccal mucosa appearing 1-2 days before the rash — if present, diagnosis is confirmed
- Rash: Maculopapular rash beginning at the hairline and spreading cephalocaudally (head to toe) over 3-4 days. Rash lasts 7-10 days
- Incubation: 10-14 days from exposure to prodrome onset
- Contagious period: From 4 days before to 4 days after rash onset
- Reportable disease in Ontario. Suspected cases require immediate public health reporting
MT Relevance
- Systemic contraindication: Acute measles systemically contraindicates massage — the client is febrile, systemically unwell, and highly infectious
- Contagion risk: The virus remains airborne in a room for up to 2 hours. Standard PPE is insufficient without airborne precautions
- Immunocompromised clients: Be alert when treating immunosuppressed clients. They are at risk for severe complications from exposure
- Return to treatment: Massage may resume once the client is afebrile, the rash has fully resolved, and the client is cleared by a physician
Required Actions
- Refer to a physician immediately if measles is suspected — reportable disease
- Do not treat during active infection
- Notify clinic management if a client with suspected measles was present in the treatment space (airborne exposure risk for 2 hours)
Key Takeaways
- Measles is caused by Morbillivirus. Airborne transmission. Incubation 10-14 days. R0 of 12-18.
- Classic prodrome: high fever + three C's (cough, coryza, conjunctivitis). Koplik spots are pathognomonic.
- Maculopapular rash spreads cephalocaudally, beginning at the hairline.
- Measles is a reportable disease in Ontario. Suspected cases require immediate physician referral.
- Acute measles is a systemic contraindication. The virus remains airborne and infectious for up to 2 hours.