What do you know about measles?
Not sure?
Well, if you are traveling out of
the US, or you often interact with people who have returned to the US from
measles-prone countries (especially underdeveloped countries), then you need to
understand what measles , what it can do to your family, and how you can deal
with it if it affects your baby or yourself.
What is measles?
Measles is an extremely contagious disease
that is characterized by a flat rash and catarrhal inflammation of the eyes and
respiratory system.
Measles normally infects children,
but it can also afflict persons of any age who have previously not been
infected by the disease.
Types of measles
Measles is classified depending on
the severity of the disease. Mild, moderate, and severe measles are
distinguished.
Besides, measles can run an
atypical course: it can be classified as abortive (rudimentary) or malignant.
The abortive measles is seen in people who are vaccinated. The symptoms are
mild; many of them are absent.
Mitigated or modified measles
occurs in children immunized prophylactically with immunoglobulin. The runny
nose period is either absent or mild.
Malignant hemorrhagic measles is
the severest form of measles. Its symptoms include high fever and bleeding. It
usually ends by death of the patient. This form is exceptionally rare now.
Measles prevalence
Measles cases are on the rise in
the United States. Although measles was eliminated in the US in 2000, outbreaks
occur when US citizens who have not been vaccinated
pick up
the infection during their travels abroad and infect Americans in
under-immunized close-knit communities.
Who is at risk?
Anybody who has not been vaccinated
is at risk of developing measles. Babies between the ages of three months and
one year who are not being breastfed are at a high risk of getting the disease.
Furthermore, pregnant women and adults who have a weak immune system also have
a high risk of contracting measles.
What organism causes measles?
Measles is caused by a medium
–sized virus of the paramyxovirus
family known as paramyxoviridae. This very small virus (about 1400 A in
diameter) induces apparent infection in only human being s and monkeys.
The virus is rapidly killed when it
is exposed to high temperatures, ultra-violet radiation (sunlight), or
disinfectants.
The journey of the virus in the
infected person
The portal of entry into a healthy
person is the lining of the upper airways. There, the virus multiplies and
causes inflammation. The virus then enters the blood to cause toxaemia (blood- poisoning) and to
affect various organs and tissues.
How measles is spread
When an infected person coughs or
sneezes, he releases the virus in droplets of mucus from his respiratory system
into the air. The virus can be carried by air to adjacent rooms and flats
within a house.
The viruses eventually settle on objects
in the environment and when an uninfected person touches the infected objects,
he gets infected.
Complications
Encephalitis (or swelling of the brain) occurs in about 1 in 1000
people who develop measles. Encephalitis occurs in mild measles, as well as
severe measles. This swelling normally appears one to 14 days after one is
infected. This complication is associated with a recurring fever, headache,
vomiting, and a stiff neck. Convulsions occasionally follow these symptoms. About
15% of people who
develop
encephalitis will die.
Symptoms of measles
When the virus enters the body, it usually
incubates for a period of between 9
and 11 days, but can last to 17 days. In people who have been immunized with
immunoglobulin,
it can incubate for as long as 21 days.
The onset of measles is usually
gradual. Initially, the infected person’s temperature rises to 38-39° C.
This is accompanied by a headache, malaise, and pain in the muscles.
Within hours, the infected person
may suffer burning pain in the eyes. Sneezing, a barking cough, and nasal
discharge are also common. Less commonly, the voice of the infected person may
become hoarse.
Tiny white spots, also known as Koplik spots, may appear in the inner
walls of the cheeks about four days after the person is infected.
Two to four days after the Koplik spots
appear, a rash follows. The rash first appears behind the ears or on the face
and spread downward to cover the trunk and, eventually, it spreads to cover the
hands and legs. The rash fades about 5 days after its onset and leaves a powdery
substance on the skin.
Measles Diagnosis
Irritability, development of a
bleary-eye, and breathing open-mouthed between sneezing and coughing are signs
that suggest that a baby has measles.
When you see these signs, as well
as the symptoms of measles enumerated above, consult your doctor immediately.
When the doctor examines the baby
and suspects measles, he will order you to do a specific diagnosis. A specific
diagnosis involves tests to isolate the measles virus from throat washings, blood,
and urine.
Measles Prognosis
Uncomplicated measles is rarely
fatal and complete recovery from the disease is the rule. Fatalities are almost
always the result of bacterial infections occurring in children below the age
of 5 who become infected after passive childhood immunity disappears around 2.5
months.
Antibiotics are effective against
the usual secondary invaders (bacteria such as Pneumococcus, Streptococcus hemolyticus, Staphylococcus aureus, and Hemophilus influenza) have reduced the
case fatality rate of measles.
Case fatality rates are high in the
elderly and people who have tuberculosis.
Congestive cardiac failure is a common cause of death in patients over
50 years old.
Measles Prevention
There are two ways of preventing
measles: getting vaccinated and observing proper hygiene.
Getting vaccinated
Highly effective vaccines, the measles-mumps-rubella
(MMR) vaccine and the measles-mumps-rubella-varicella (MMRV) vaccine,
induce
immunity in people who are vaccinated. Children should be vaccinated between
12 and 15 months, and again when they are 4 to 6 year old.
However, people taking steroid
medications, people with leukemia (cancer of the blood) and other systemic
malignant diseases, and someone with tuberculosis should not take a vaccination
shot.
Practicing good personal hygiene
Observing good hygienic practices,
such as washing your hands immediately you come home, and before you touch
anything or eat, can also help.
Furthermore, avoiding sharing items
such as sponges, spoons, cups, and toothbrushes with other people, can reduce
your risk of getting infected.
How to treat measles in babies fast
No viral infection, including
measles, can be treated. All you can do is treat the symptoms of the disease.
So for a baby who cannot be immunized (0-12 months), give him a pain killer
such as acetaminophen or ibuprofen when he develops a fever.
Furthermore, in the absence of
complications, make sure your baby gets enough bed rest in a dark room. Additionally,
give the person warm baths every other day.
Give the baby plain water and fresh
fruit juices (that contain vitamin C, a vitamin known to boost the immune
system).
Since the measles virus is unstable
in the environment, making sure the room of the baby is well aerated and
disinfecting the room should be enough to kill the virus.
The baby’s diet should be easy to
digest and assimilate and rich in vitamins, especially vitamin A to boost the
immune system.
How to stop itching from measles
Generally, the rash that develops
on the body does not itch. In a few cases, itching may occur. If the infected
person itches, put cold wet towels or cloth on the rash to reduce itching.
Applying calamine lotion can also give relief.
References
Loeb, C. (1971). Textbook of
Medicine. Thirteenth edition. W.B Saunders Company.
Volovskaya, M.L. (1990).
Epidemiology and Fundamentals of Infectious Diseases. Moscow Mir Publishers.
