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November 5, 2013
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MMR: Measles, Mumps, Rubella


Also known as “morbilli”, “English measles”, or “rubeola” (not to be confused with rubella). Measles is an infection of the respiratory system caused by a virus — specifically a paramyxovirus of the genus Morbillivirus. Morbilliviruses, like other paramyxoviruses, are enveloped, single-stranded, negative-sense RNA viruses. Symptoms include fever, cough, runny nose, red eyes and a generalized, maculopapular, erythematous skin rash: the symptom for which measles is best known.

Measles is spread through respiration (contact with fluids from an infected person’s nose and mouth – either directly or through aerosol transmission) and is highly contagious. 90% of people without immunity sharing living space with an infected person will catch it. An asymptomatic incubation period occurs nine to twelve days from initial exposure. The period of infectivity has not been definitively established. Some doctors say it lasts from two to four days prior, until two to five days following the onset of the rash (i.e. four to nine days infectivity in total). Others say it lasts from two to four days prior until the complete disappearance of the rash.


Mumps (epidemic parotitis) is a viral disease of the human species, caused by the mumps virus. Before the development of vaccination and the introduction of a vaccine, it was a common childhood disease worldwide. It is still a significant threat to health in developing countries, and outbreaks still occur sporadically in developed countries.

Painful swelling of the salivary glands, classically the parotid gland, is the most typical presentation. Painful testicular swelling (orchitis) and rash may also occur. The symptoms are generally not severe in children. In teenage males and men, complications such as infertility or subfertility are more common—although, still rare in absolute terms. The disease is generally self–limiting, running its course before receding. There is no specific treatment apart from controlling the symptoms with pain medication.

Fever and headache are symptoms of mumps, along with malaise and anorexia. Other symptoms of mumps can include dry mouth, sore face and/or ears, and occasionally in serious cases: loss of voice. In addition, up to 20% of persons infected with the mumps virus do not show symptoms, so it is possible to be infected and spread the virus without knowing it.

Males past puberty who develop mumps have a 15–20 percent risk of orchitis (painful inflammation of the testicles).


Rubella, also known as German measles or three-day measles, is a disease caused by the rubella virus. The name “rubella” is derived from Latin, meaning “little red”. Rubella is also known as German measles, because it was German physicians whom first described the disease in the mid-eighteenth century. This disease is often mild and attacks often pass unnoticed. The disease can last one to three days. Children recover more quickly than adults. Infection of the mother by Rubella virus during pregnancy can be serious. If the mother is infected within the first 20 weeks of pregnancy, the child may be born with congenital rubella syndrome (CRS), which entails a range of serious incurable illnesses. Spontaneous abortion occurs in up to 20% of cases.

Rubella is a common childhood infection that can sometimes be fatal usually with minimal systemic upset although transient arthropathy may occur in adults. Serious complications such as deterioration of the skin are very rare. Apart from the effects of transplacental infection on the developing fetus, rubella is a relatively trivial infection.

Acquired (i.e. not congenital) rubella is transmitted via airborne droplet emission from the upper respiratory tract of active cases (can be passed along by the breath of people sick from Rubella). The virus may also be present in the urine, feces, and on the skin. There is no carrier state: the reservoir exists entirely in active human cases. The disease has an incubation period of 2 – 3 weeks. In most people, the virus is rapidly eliminated. However, it may persist for some months postpartum, in infants surviving the CRS. These children are a significant source of infection to other infants and more importantly, to pregnant female contacts.

The name rubella is sometimes confused with rubeola, an alternative name for measles in English-speaking countries. The diseases are unrelated. In some other European languages, like Spanish, rubella and rubeola are synonyms, and rubeola is not an alternative name for measles. Thus, in Spanish, “rubeola” refers to rubella and “sarampión” refers to measles.

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