Measles is an acute viral infectious disease normally resulting in rash and fever, with cough, conjunctivitis, and coryza. Other symptoms of measles include anorexia, diarrhea, and generalized lymphadenopathy. Measles transmission is primarily person to person via large respiratory droplets.
Reported cases of measles have declined rapidly after the resurgence in 1989-1991. Since 1993, fewer than 500 cases have been reported annually in the U.S., and fewer than 200 cases have been reported since 1997. In recent years, almost all cases of measles reported in the U.S. can be traced directly or indirectly to foreign travel or contact with foreign visitors. All confirmed cases of measles in Indiana since 1994 have been the result of importation from a foreign country. This reinforces the need for all international travelers to be immune to measles prior to leaving the United States.
Because of the low incidence of measles, an IgM measles-specific serologic analysis must be conducted on all reported cases. The specimen should be drawn at least three days following onset of rash. Although incidence of measles disease is low, health care providers should consider measles diagnosis and serological analysis when patients have a generalized rash, with a fever of 101 degrees Fahrenheit or greater and at least one of the prodromal symptoms of cough, conjunctivitis, or coryza.
There were no reported measles cases in Indiana during 2003. Only 8 cases of measles were reported in Indiana during the five-year period 1999-2003 (Figure 1).