Duration of the symptoms of measles

Measles disease is divided into two phases. The first phase, the prodromal stage, lasts about three to seven days. The second phase, the exanthema stage, lasts about four to seven days. The symptoms thus last for one to two weeks, with coughing, rhinitis, fever and fatigue dominating in the first phase and rashes in the second phase.

Incubation period

The word comes from the Latin incubare, which means to incubate. The incubation period is therefore understood to be the time between the penetration of the pathogen into the body and the onset of the first symptoms. This period of time is due to the fact that only a few pathogens enter the body and cannot have a great effect on their own.

This means that they first multiply locally at their point of entry before they attack the target organs via the bloodstream. There they continue to multiply and the disease breaks out visibly until the immune system can effectively fight the intruder. The incubation period is characteristic for different pathogens and can vary greatly from a few hours to many years. For measles, the incubation period is 8-10 days to the precursor stage and 14 days to the outbreak of the exanthema.

Course of the disease

Most cases of measles occur without complications and in two phases. The first phase is called the intial/prodromal or precursor stage. At the onset of this phase, one is usually already infected with the pathogen for 10 to 14 days.

Typical for prodromal stages is that the symptoms that occur are quite uncharacteristic for a particular disease. Measles, for example, is characterized by flu-like symptoms such as fatigue, exhaustion, headaches and sore throats, nausea and high fever. Typical for measles, however, are inflammations of the mucous membranes (conjunctiva of the eyes, oral cavity and upper respiratory tract).

Towards the end of the stage, the fever drops back to normal values. The main or exanthema stage announces itself with a renewed sharp rise in fever and the typical rash that starts behind the ears and spreads to the rest of the body. In uncomplicated cases the rash subsides after a few days and a rapid recovery follows.

One is now immune to the measles pathogen for life. But not all courses of the disease follow this typical pattern. In patients with immunodeficiency, untypical courses are not uncommon, for example, the skin rash may be absent, in which case one speaks of white measles.

Since the immune system does not function properly in these patients (due to HIV, congenital immune defects, tumors or medication), the courses of the disease are often more severe, more protracted and more often associated with complications.However, atypical courses can also occur in other situations, for example in infants who receive maternal antibodies (borrowed immunity) or patients who receive antibody preparations from outside. The course of the disease is then attenuated. In addition to the typical and atypical course of the disease, complications can occur, especially in very young or adult patients.

There are relatively frequent complications such as inflammation of the middle ear or lungs (approx. 6-7%) and relatively rare ones such as meningoencephalitis (approx. 0.1%) and subacute sclerosing panencephalitis (SSPE; <0.1%).

According to the Robert Koch Institute, the mortality (lethality) of measles is 1:1000, with pneumonia being the most common cause of death. It manifests itself mainly in the form of a respiratory disorder up to respiratory distress. Meningoencephalitis is an inflammation of the brain and meninges.

It begins about three to eleven days after the onset of exanthema with fever, headache, neck stiffness, vomiting and loss of consciousness. In 15-20% of cases it is fatal and in 20-40% of cases permanent damage remains. SSPE is a late complication and can occur up to 10 years after the disease.

It occurs in three stages, a phase characterized by mental disorders and dementia. It is followed by a stage with muscle spasms and epileptic seizures and finally severe damage to the cerebrum. This complication is fatal in 95% of cases.