Measles
Measles may bring to mind the red, blotchy rash that often accompanies this disorder. But the rash is just an outward sign of the more worrisome changes happening inside the body. Measles is primarily a respiratory infection caused by a highly contagious virus found all over the world.
Also called rubeola, measles can be serious and even fatal for small children. Approximately 30 million to 40 million cases of measles occur worldwide each year, resulting in more than 750,000 deaths.
The measles vaccine is a highly effective way to prevent the illness. Thanks to the vaccine, less than 50 cases of measles were reported in the United States in 2002. However, vaccination programs are incomplete in much of the world, but global health organizations are working hard to address this problem. The widespread nature of the disease is why vaccination programs are still necessary in countries where few cases of measles occur. The disease can spread easily with international travelers.
Sings and Symptoms
Usually signs and symptoms of measles appear 10 to 12 days after exposure to the virus. They typically include:
- Fever
- Dry cough
- Runny nose
- Inflamed eyes (conjunctivitis)
- Sensitivity to light
- Tiny red spots with bluish-white centers on the inner lining of the cheek, called Koplik's spots
- A rash made up of large, flat blotches that often flow into one another
Measles typically begins with a mild to moderate fever, accompanied by other signs and symptoms, such as a persistent cough, runny nose, inflamed eyes (conjunctivitis) and sore throat. Two or three days later, Koplik's spots — a characteristic sign of measles — appear. Then a fever spikes, often as high as 104 or 105 F. At the same time, a red blotchy rash surfaces, usually on the face, along the hairline and behind the ears. This slightly itchy rash rapidly spreads downward to the chest and back and, finally, to the thighs and feet. After about a week, the rash fades in the same sequence that it appeared.
Causes
The cause of measles is a virus. The measles virus is so contagious that if one person has it, 90 percent of their close contacts who aren't immunized will become infected.
The virus lives in the mucus in the nose and throat of an infected child or adult. That child or adult is contagious from four days before the rash appears to four days after. When someone with measles coughs, sneezes or talks, infected droplets spray into the air, where other people can inhale them. The infected droplets may also land on a surface where they remain active and contagious for several hours. You or your child can contract the virus by putting your fingers in your mouth or nose after touching the infected surface.
Once the virus gets inside the body, it typically grows in the cells that line the back of the throat and lungs. The infection then spreads throughout the body, including the respiratory system and the skin.
Complications
Measles usually lasts about 10 to 14 days. In some parts of the world, the disease is severe, even deadly. In Western countries, that's usually not the case. People with measles may become quite ill, but most people recover completely. However, complications may include:
- Ear infection. Measles causes an ear infection in nearly one out of every 10 children.
- Encephalitis. About one in 1,000 people with measles develops encephalitis, an inflammation of the brain caused by a viral infection, which may cause vomiting, convulsions and, rarely, coma. Encephalitis can closely follow measles, or it can occur years later during adolescence as a result of a slow virus infection. The late form, called Dawson's encephalitis, is rare.
- Pneumonia. As many as one out of 20 children with measles gets pneumonia, which can be life-threatening.
- Diarrhea or vomiting. These complications are more common in infants and small children.
- Bronchitis, laryngitis or croup. Measles may lead to inflammation of your voice box (larynx) or inflammation of the inner walls that line the main air passageways of your lungs (bronchial tubes).
- Pregnancy problems. Pregnant women need to take special care to avoid measles, because the disease can cause miscarriage, premature labor or babies with low birth weights.
- Low platelet count (thrombocytopenia). Measles may lead to a decrease in platelets — the type of white blood cells that are essential for blood clotting.
Treatment
No treatment can get rid of an established measles infection. However, nonimmunized infants may be given the measles vaccination within 72 hours of exposure to the measles virus, to provide protection against the disease. Pregnant women, infants and people with weakened immune systems who are exposed to the virus may receive an injection of proteins (antibodies) that can fight off infection, called hyperimmune gamma globulin. When given within six days of exposure to the virus, these antibodies can prevent measles or make symptoms less severe.
You or your child may also take over-the-counter medications such as acetaminophen (Tylenol, others) or nonsteroidal anti-inflammatory drugs (NSAIDs) to help relieve the fever that accompanies the virus. Don't give aspirin to children because of the risk of Reye's syndrome — a rare, but potentially fatal disease.
If you develop a bacterial infection, such as pneumonia or an ear infection, your doctor may prescribe an antibiotic. Young children who are hospitalized with severe measles might also benefit from prescription doses of vitamin A.
Isolation is another element of treatment. Because measles is highly contagious from about four days before to four days after the rash breaks out, people with measles shouldn't return to activities in which they interact with other people during this period. It may also be necessary to keep nonimmunized people — siblings, for example — out of the infected person's house. Talk with your doctor about keeping someone with measles isolated.
Prevention
The measles vaccine is extremely effective. Before this vaccine, there were approximately 450,000 measles cases and 450 measles-associated deaths in the United States each year. Widespread use of the vaccine has reduced the number of measles cases in the United States by more than 99 percent. In fact, since the late 1980s — when there was a slight jump in measles cases and deaths, partly because kids weren't getting vaccines — health care professionals have stepped up immunization programs, and the number of measles cases has dropped to an all-time low.
The measles vaccine is usually given as a combined measles-mumps-rubella (MMR) inoculation, which contains the safest and most effective form of each vaccine. It's made by taking the measles virus from the throat of an infected person and adapting it to grow in chick-embryo cells in a lab. When this modified measles virus is given to a child as part of the MMR vaccine, the virus grows and causes a harmless infection before the immune system gets rid of it. This harmless infection causes 95 percent of children to develop lifetime immunity to the virus. But a second dose of the vaccine is recommended to protect the 5 percent who didn't develop immunity after the first dose and to boost immunity in the 95 percent who did.
Doctors recommend that children receive the MMR vaccine between 12 and 15 months of age, and again between 3 and 6 years of age — before entering school. Usually babies are protected from measles for four to six months after birth because of the immunity passed on from their mothers. If a child requires protection from measles before 12 months of age — for example, for certain foreign travel or in case of an outbreak — the vaccine can be given as early as 6 months of age. But it needs to be repeated after 12 months of age
Informations obtained from National Institute of Health.