Measles (or rubeola), is a highly contagious viral infection characterized by a fever, cough, spots on the gums, and a red rash that usually begins at the head and neck and slowly moves down to cover the entire body. The measles virus, Morbillivirus, is spread by inhalation of airborne droplets of infected nasal discharge. Measles and chicken pox appear to be the most readily transmitted of all infections diseases. In urban areas, measles is largely a disease of preschool and young school children. Mothers who have had measles give their infants a transplacental passive immunity for most of the first year of life. Thereafter, susceptibility is high, as evidenced by the fact that about 98% of the population has had frank measles at some time, usually during early childhood. Before widespread active immunization, epidemics of measles occurred every two or three years with small localized outbreaks during intervening years. After an incubation period of seven to fourteen days, prodromal symptoms of fever, hacking cough, and conjunctivitis appear. Within 24 to 48 hours, Koplik's spots may be seen in the mouth. The characteristic rash appears 3 to five days after onset of symptoms and often 2 to 3 days after the appearance of Koplik's spots, beginning in front of and below the ears and on the side of the neck. Severity of symptoms varies from epidemic to epidemic. When the disease is at its height, the temperature may be over 104F., with swelling of the face (particularly about the eyes), conjunctivitis, a hacking cough, extensive rash, and mild itching. About the 4th day, the fever falls, the patient feels more comfortable, and the rash fades rapidly, leaving a coppery brown discoloration. In some instances, however, complications and secondary infections may prolong the illness. These include ear and chest infections, diarrhea, vomiting, and abdominal pain. Encephalitis, or inflammation of the brain, occurs in about one in 1,000 measles cases. A progressive brain disorder, subacute sclerosing panencephalitis, occurs in about one in one million cases. Treatment usually includes bed rest, drinking plenty of fluids, taking acetaminophen to reduce the fever, and application of lotions to relieve the itching German Measles (Rubella) The disease is caused by a myxovirus spread by droplets from the nose and throat, airborne or by close contact. Rubella is less contagious than measles,which is probably why children often do not contract the disease whereas it is frequent in young adults. A considerable percentage of cases are mistakenly diagnosed or are symptomatically so mild as to escape notice. The incubation period is 14 to 21 days. The early symptoms--fever, malaise, sore muscles, headache, eye irritation, and sensitivity to light--occur about 11 days after infection. Nasal discharge, sneezing, and coughing develop rapidly. Two to four days after the first symptom, a characteristic skin rash appears which fades after a few days. Diagnosis should consider measles, scarlet fever, secondary syphilis, drug rashes, and infectious mononucleosis. Rubella is differentiated from measles by the absence of Koplik's spots, and cough. The patient with rubeola is sicker, and the illness lasts longer. On the 2nd day, the rubella eruption may resemble that of scarlet fever; however, even mild scarlet fever has more constitutional symptoms, including more severe redness and soreness of the throat. Uncomplicated German measles requires little or no treatment. If itching is present, a lotion or powder may be applied.