The key difference between measles and shingles is that the primary infection with the virus causes measles but shingles occur due to the reactivation of the virus that remains dormant after the primary infection. Measles is an acute and contagious disease caused by a virus and characterized by the outbreak of small red spots on the skin whereas shingles is a disease caused by the varicella-zoster virus, especially by reactivated virus, characterized by skin eruptions and pain along the course of involved sensory nerves.
Measles and shingles are viral infections that are typically manifested as skin rashes along with other constitutional symptoms.
CONTENTS
1. Overview and Key Difference
2. What is Measles
3. What is Shingles
4. Similarities Between Measles and Shingles
5. Side by Side Comparison – Measles vs Shingles in Tabular Form
6. Summary
What is Measles?
Measles is a highly contagious disease whose spread has seen a rapid decline within the last decade following the aggressive immunization launched worldwide.
Clinical Features
Clinical features appear after an incubation period of 8-14 days. There are two main distinct phases of disease progression:
Pre-eruptive and Catarrhal Phase
It is possible to identify the virus in the blood during this stage. Characteristic koplik’s spots appear in most of the patients, typically in the oral mucosa opposite the second molar tooth during this stage. In addition, other constitutional symptoms such as fever, malaise, cough, rhinorrhea and conjunctival suffusion are also present.
Figure 01: Measles
Eruptive and Exanthematous Phase
The occurrence of a maculopapular rash marks the onset of this stage. It initially appears in the face and later spreads to the other parts of the body.
Acute measles encephalitis is the most dreaded complication of this disease. Bacterial pneumonitis, bronchitis, otitis media, hepatitis, and myocarditis are the other less severe complications that can occur with measles. Malnourished children and patient’s with other comorbidities are at a higher risk of getting the aforementioned complications. If the patient gets measles before the age of 18 years they can get subacute sclerosing panencephalitis. Maternal measles does not cause fetal abnormalities.
Diagnosis
In doubtful circumstances, clinicians look for measles-specific IgM antibodies in blood and oral mucosa.
Treatment
Supportive treatment is carried out and antibiotics are given only when there are concomitant bacterial infections.
What is Shingles?
After the initial infection, varicella zoster virus can remain dormant in the dorsal root ganglia of sensory nerves and get reactivated whenever the person’s immunity weakens. Shingles refer to the reactivation of the varicella zoster virus in this manner.
Clinical Features
- Usually, there is a burning sensation or a pain in the affected dermatome. A rash characterized by the presence of vesicles often appears in this region with distant chicken pox-like lesions.
- Paresthesia may exist without any associated dermatological manifestations
- Multi dermatomal involvement, severe disease and prolonged duration of the symptoms suggest underlying immune deficiencies such as HIV.
Usually, the thoracic dermatomes are the regions that are commonly affected by the reactivation of the virus. Vesicles can appear in the cornea when there is a reactivation of the virus in the ophthalmic division of the trigeminal nerve. These vesicles can rupture, giving rise to corneal ulcerations, which require the immediate attention of an ophthalmologist to avoid blindness.
Figure 02: Shingles
When the viruses in the geniculate ganglion get reactivated, it causes the Ramsay Hunt syndrome, which has the following hallmark features.
- Facial palsy
- Ipsilateral loss of taste
- Buccal ulceration
- A rash in the external auditory canal
Bladder and bowel dysfunction are due to the involvement of sacral nerve roots.
Other Rare Manifestations of Shingles
- Cranial nerve palsies
- Myelitis
- Encephalitis
- Granulomatous cerebral angiitis
There can be postherpetic neuralgia in some patients for about six months after the reactivation. The incidence of postherpetic neuralgia increases with advanced age.
Management
- Treatment with acyclovir can be useful in minimizing the pain
- Administering strong analgesic agents and other drugs such as amitriptylin to relieve the pain due to postherpetic
What are the Similarities Between Measles and Shingles?
- Measles and shingles are infectious diseases
- Both measles and shingles cause rashes
- They are caused by viruses.
What is the Difference Between Measles and Shingles?
Measles is an acute and contagious disease caused by a virus and characterized by the outbreak of small red spots on the skin. Shingles, on the other hand, is a disease caused by the varicella-zoster virus, especially by reactivated virus, characterized by skin eruptions and pain along the course of involved sensory nerves.
Measles is due to the primary infection with the virus whereas shingles are due to the reactivation of the virus that remains dormant after the primary infection. This is the main difference between measles and shingles. Moreover, measles is a highly contagious disease while shingles are not contagious.
Summary – Measles vs Shingles
Both shingles and measles are viral infections that can have fatal outcomes. Primary infection with the virus is the cause of measles but shingles is due to the reactivation of the virus that remains dormant after the initial infection. This is the basic difference between measles and shingles.
Reference:
1. Kumar, Parveen J., and Michael L. Clark. Kumar & Clark clinical medicine. Edinburgh: W.B. Saunders, 2009.
Image Courtesy:
1. “Measles enanthema” By de:User:Steffen Bernard – de.wikipedia (Public Domain) via Commons Wikimedia
2. “Shingles Lesions (Varicella Zoster, Trigeminal/Mandibular)” by brownpau (CC BY 2.0) via Flickr