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Measles

Nature Reviews Disease Primers volume 2, Article number: 16049 (2016) Cite this article

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Abstract

Measles is an infectious disease in humans caused by the measles virus (MeV). Before the introduction of an effective measles vaccine, virtually everyone experienced measles during childhood. Symptoms of measles include fever and maculopapular skin rash accompanied by cough, coryza and/or conjunctivitis. MeV causes immunosuppression, and severe sequelae of measles include pneumonia, gastroenteritis, blindness, measles inclusion body encephalitis and subacute sclerosing panencephalitis. Case confirmation depends on clinical presentation and results of laboratory tests, including the detection of anti-MeV IgM antibodies and/or viral RNA. All current measles vaccines contain a live attenuated strain of MeV, and great progress has been made to increase global vaccination coverage to drive down the incidence of measles. However, endemic transmission continues in many parts of the world. Measles remains a considerable cause of childhood mortality worldwide, with estimates that >100,000 fatal cases occur each year. Case fatality ratio estimates vary from <0.01% in industrialized countries to >5% in developing countries. All six WHO regions have set goals to eliminate endemic transmission of MeV by achieving and maintaining high levels of vaccination coverage accompanied by a sensitive surveillance system. Because of the availability of a highly effective and relatively inexpensive vaccine, the monotypic nature of the virus and the lack of an animal reservoir, measles is considered a candidate for eradication.

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Figure 1: History of measles virus infection and elimination programmes.
Figure 2: Global reported measles cases and estimated coverage with the first and second dose of measles-containing vaccine by year (1980–2014).
Figure 3: The number of estimated measles deaths globally by year (2000–2014).
Figure 4: Measles virus and the viral life cycle.
Figure 5: Measles virus infection and transmission.
Figure 6: Pathogenesis of measles.
Figure 7: Detection of the global distribution of measles virus genotypes and incidence in 2015.

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Acknowledgements

P.A.R. and J.L.G.: the findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention. M.T. receives funding from the Research Program on Emerging and Re-emerging Infectious Diseases, Japan Agency for Medical Research and Development (AMED).

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Authors and Affiliations

  1. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, 30329, Georgia, USA

    Paul A. Rota & James L. Goodson

  2. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA

    William J. Moss

  3. Department of Virology, National Institute of Infectious Diseases, Tokyo, Japan

    Makoto Takeda

  4. Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands

    Rik L. de Swart

  5. Kid Risk, Inc., Orlando, Florida, USA

    Kimberly M. Thompson

  6. University of Central Florida College of Medicine, Orlando, Florida, USA

    Kimberly M. Thompson

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  1. Paul A. Rota
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  4. Rik L. de Swart
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  6. James L. Goodson
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Contributions

Introduction (P.A.R.); Epidemiology (W.J.M. and J.L.G.); Mechanisms/pathophysiology (M.T. and R.L.d.S.); Diagnosis, screening and prevention (P.A.R. and R.L.d.S.); Management (K.M.T.); Quality of life (K.M.T.); Outlook (J.L.G.); Overview of Primer (P.A.R.).

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Correspondence to Paul A. Rota.

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Supplementary information

Syncytium formation by measles virus (MeV).

Vero/hSLAM cells were infected with an EGFP-expressing wild-type MeV strain (IC323-EGFP). Non-fluorescence time-lapse images are shown. Video courtesy of Y. Nakatsu, National Institute of Infectious Diseases, Tokyo, Japan. (MOV 3698 kb)

Syncytium formation by measles virus (MeV).

Vero/hSLAM cells were infected with an EGFP-expressing wild-type MeV strain (IC323-EGFP). Time-lapse images with eGFP signals are shown. Video courtesy of Y. Nakatsu, National Institute of Infectious Diseases, Tokyo, Japan. (MOV 3778 kb)

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Rota, P., Moss, W., Takeda, M. et al. Measles. Nat Rev Dis Primers 2, 16049 (2016). https://doi.org/10.1038/nrdp.2016.49

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