Measles: What is it?
Measles is a highly contagious airborne disease produced by a virus. It can lead to massive infections and deaths in developing continents, especially in Africa and Asia.
Measles is not just a light rash, this disease can be serious, especially in children. 1 out of 5 people infected with the virus need to be hospitalized and 1-3 out of 1000 will die even after being hospitalized.
People infected with measles can spread the disease for about eight days. Infection period starts 4 days before the rash appears. Transmission may occur by coughing, sneezing and through any direct contact with nasal or throat secretions of people who carry the virus. 90% of the people who are not immune and share the same space will get infected. They may get infected 2 hours after the initial host left.
Even if you show no symptoms, you can still spread the virus. This can happen due to the fact that symptoms start to show after the infection period started.
Measles: Signs and Symptoms
The first symptoms begin after incubating the disease for around two weeks. These symptoms may include:
- Fever: it may increase with each day. It can reach up to 40ºC (104ºF).
- Dry Cough and sore throat.
- Conjunctivitis: inflammation and red eyes.
- Koplik’s Spots: tiny white spots on a reddish background found inside the mouth on the inside of the cheeks. If it is spotted on time, some measures to prevent it from spreading to the rest of your body may be implemented.
- Rash: 2 to 3 days after incubating measles, a rash may appear, forming clusters of slightly raised red spots. It usually starts on the face more specifically close to the back of the ear. But after a few days the rash spreads to the rest of the body.
These symptoms can be milder if the infected person is vaccinated against measles but have not developed complete immunity.
Risk Factors and Complications
Approximately 30% of measles cases can lead to one or more complications which can include:
- Diarrhea: this leads to dehydration due to fluid loss.
- Ear Infections.
- Pneumonia: causes fever, breathing difficulties, chest pain and dry cough.
- Bronchitis, Laryngitis.
- Blindness produced by corneal ulcer.
- Encephalitis: causes mild symptoms such as headache, fever, confusion and vomiting. Its complications can be seizures, hallucinations, memory problems, etc. In some cases the infected person can become comatose, and death or brain injury may occur.
- Pregnancy Problems such as misscarriage, preterm labor, low birth weight, stillbirth. Measles may also be transmitted from mother to child if she was infected close to her delivery date.
- In rarer cases it can lead to panencephalitis (Dawson disease) which is usually fatal.
Measles severe complications are common in immunocompromised persons (HIV/AIDS, poorly nourished young children, infants -less than 5 years-), etc.
Measles virus can kill cells that produce antibodies. This weakens the immune system and leaves it open for other diseases to take hold.
In most cases Measles goes by in 7 to 10 days after incubation without complications. But if you think you or someone close to you have measles or you were in contact with someone who has it you should consult with your doctor. Especially if the infected person is a child, takes medicine or has a disease that affects their immune system.
Once Measles develops in the host there is no antiviral treatment. Most of the medications given are aimed to treat the symptoms. The usual treatment involves:
- Rest: this helps to boost your immune system.
- Hydration: plenty of fluids.
- Ibuprofen or acetaminophen for the fever.
- Humidifier: it can ease the coughing and sore throat.
- Vitamin A supplements: they can help diminish the risk of getting eye damage and blindness.
In case of malnutrition, vitamins are given to boost the antibody response to the virus and reduce the risk of complications. It should be noted that you should never give aspirin to children as it is linked to Reye Syndrome.
Even though mothers who are immune to measles pass their antibodies to their children, they usually fade over the course of the first 9 months becoming susceptible to infection. For this, mass vaccination campaigns are key to stop measles spread, especially in developing countries where death rates are high.
In developed countries measles is virtually eliminated, though it is important to keep vaccination rates high. Measles is still common worldwide and unvaccinated travelers could create outbreaks.
Vaccines with 2 doses have a high effectiveness (97%) at preventing measles infection. They usually are administered together with Mumps and Rubella vaccines (MMR Vaccine) and in other cases against chicken pox too (MMRV vaccine).
When to get vaccinated:
- Children: first dosis at 12 months, it is commonly administered as MMR vaccine for measles, mumps, rubella, with the second dose given at the age of 4 to 6.
- Teenagers: if not given as the previously mentioned 2 doses of the vaccine might be needed.
- Adults: if you are exposed to measles (traveling or working in places with high risk of contagion) and you don’t have proof of immunity (lab confirmation of immunity, written documentation of your vaccinations or previous illness).
When to delay vaccination or NOT get vaccinated:
- During Pregnancy
- People who have reported life threatening reactions to neomycin or another component of the vaccine.
- People who have hiv/aids, or another immune system disorder
- An ongoing cancer treatment which affects the immune system
- If you have tuberculosis
- If you take steroids or other medication that suppress the immune system
- Have taken another vaccine in the past month
If you have measles or if there is an outbreak in your area, you should be in isolation for about eight days. Measles is extremely contagious. The infected person should be kept away from the rest of the household.
Practice good hygiene and don’t share personal belongings with people who might be ill.
It is important to be sure that anyone who is in direct contact with the infected person is at no risk of getting measles. If they are not, they should get vaccinated as soon as possible.