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Table 5 Appendix III: Measles, Mumps, and Rubella Epidemiology16,17

Causative AgentIncubation PeriodMode of TransmissionComplicationsPeriod of CommunicabilitySigns and Symptoms
Measles Highly contagious virus that is a member of the Paramyvirus family, genus morbillivirus, and is closely related to the rinderpest and canine distemper virus.8-12 days from exposure to onset of symptoms.Spread airborne or by direct contact with small droplets from nose, throat, and mouth of a person in prodromal or early eruptive stage of disease.Complications occur in 30% of cases.

1-3 deaths per 1000 cases.

Permanent brain damage occurs in 1 per 1000 cases.

Can lead to pneumonia, encephalitis, brain damage, ear infection, and seizures.
From 2-4 days before rash appears until 2-5 days after onset.Symptoms begin with prodromal fever, coryza, cough, and conjunctivitis. Kopliks spots generally appear 2-4 days later. The characteristic rash begins 3-5 days later in front of and below the ears and on the side of the neck, as irregular macules that soon become maculopapular cutaneous rash, which spreads rapidly (within 24-48 hours) to the trunk. After 3-5 days, fever diminishes and the rash fades to a coppery-brown discoloration followed by desquamation.
Mumps A moderately contagious virus that is a member of the paramyxovirus family.12-25 days after exposure.Spread by infected droplets or direct contact with material contaminated with infected saliva.Parotitis occurs in 30% to 40% of cases.

1-3 deaths per 10,000 cases.

Hearing loss in 1 per 20,000 cases.

Orchitis (in post puberty males) 20-50% of cases.

CNS; meningitis 15% of cases, encephalitis 2 per 100,000.
From 1-6 days before the salivary glands swell.Up to 20% of mumps infections are asymptomatic. However, typically mumps begins with chills, headache, anorexia, malaise, and fever, which last for approximately 12-24 hours before the salivary gland involvement is noted.

Serious side effects are more common in adults than children.
Rubella A contagious virus classified as a toga virus that is closely related to group A arboviruses (such as Eastern and Western Equine Encephalitis).12-23 daysSpread by airborne droplets or close contact with an infected individual.Arthritis/Arthralgia occurs in up to 70% of adult women.

Encephalitis occurs 1 per 5000 cases. Hemorrhagic manifestations occur 1 per 3000 cases.

Up to 85% of infants infected in the first trimester of pregnancy will develop CRS.
From 1 week before onset of rash to 1 week after rash fades.

Typically persons are “most” contagious when the rash is first erupting.
Symptoms are often mild. 30-50% of all cases may be subclinical or inapparent.

Typically rubella begins with malaise, fever, headache, rhinitispostauricular and suboccipital lymphadeno-pathy with tender nodes. 1-2 days later a fine (pinpoint), pinkish macular rash begins to appear on the face and neck, spreading to the trunk and limbs. The rash lasts for approximately 1-3 days.

From: MMR Vaccine and Autism: No Evidence of Association

Cover of Minnesota Health Technology Assessments
Minnesota Health Technology Assessments [Internet].
Minnesota Health Technology Advisory Committee.
St. Paul (MN): Minnesota Department of Health; 1995-2001.

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