Measles – risk of infection, symptoms, complications, vaccination, treatment

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Measles is an infectious disease that usually occurs in childhood. It is caused by the rapidly spreading measles virus (paramyxovirus), which makes it very contagious. Infection with measles occurs through droplets, i.e. through direct contact with an infected person. The characteristic symptoms of measles are fever, rash and photophobia.

Measles – information about the disease

Measles is an infectious disease of the respiratory tract, caused by the measles virus (paramyxovirus). Although an effective vaccine has been developed, the disease still remains one of the leading causes of death in children in developing countries. All children who lack immunity and have previously had contact with the virus are infected. Measles in children is much more severe than in adults. The first measles virus was isolated in 1954, it came from an 11-year-old boy from the USA.

Measles are characterized by a rash that appears all over the body and the presence of flu-like symptoms, e.g. cough, high temperature, runny nose. A child with measles should drink plenty of fluids and, above all, rest as much as possible. In addition, it is important to isolate the patient so that measles is not passed on to other people.

Measles in adults now it is becoming more common and its symptoms are similar to those of children. The age of the patient plays an important role here – the older he is, the more severe and more dangerous the course of measles is, especially if the patient suffers from cardiovascular ailments.

You should discuss symptoms of measles with your GP as soon as possible. You can now make an appointment online via the halodoctor.pl portal as part of the National Health Fund.

How does measles become infected?

The measles virus is infected by droplets, i.e. as a result of direct contact with the virus carrier. Rarely, cases of sick people who become infected with measles through contact with objects used by an infected person can be observed (infection by contact with the patient’s clothing is possible, but at a short distance). Incubation period: It usually takes 9-11 days from infection to the onset of typical measles symptoms. It also happens that the incubation period lasts up to 21 days.

Measles is an infectious disease – contagious is 3-5 days before the rash appears and 3 days after the rash appears. Measles cases are mainly observed in winter and early spring.

Measles – how contagious is it?

Measles is a highly infectious disease, as the risk is as high as 75-90% for susceptible individuals. in case of home contact. The risk of infection is particularly high in the early stages of the disease, when the symptoms are not very specific. During this period, i.e. when the patient does not have a rash yet, the ailments resemble other viral infections, e.g. influenza or conjunctivitis.

Measles infection can occur with high probability in unvaccinated or unvaccinated people when they have them direct contact with a sick person or stay with him in one room for more than 20 minutes. The infection is spread by airborne droplets and direct contact with the secretions from the patient’s respiratory tract. Additionally, the measles virus can survive in the air and on surfaces for up to 2 hours.

Measles – symptoms

As the disease progresses, the symptoms and their intensity change. In the course of measles, we can distinguish:

1. Measles hatching period: lasts 9–14 days – usually asymptomatic, sometimes the child may feel generally unwell and generally weak;
2. Dead period: at the beginning, fever appears (mild or moderate, its peak occurs around the fourth or fifth day after the beginning of the catarrhal phase), with rhinitis, conjunctivitis, and a slight swelling of the eyelids and disgust with light (“rabbit eyes”). In addition, pharyngitis and laryngitis can be observed along with a dry, very bothersome cough. In the 2nd-3rd catarrhal phase appear the so-called Fiłatow’s triangle and Koplik’s spots. They are pinpoint white spots surrounded by a red border, located on the cheek mucosa at the level of the molars and premolars;
3. Rash period: together with the rash, there is a high fever, often reaching 40 degrees Celsius, and a general deterioration of the child’s condition. Occasionally, shortness of breath, cyanosis, increased heart rate and a characteristic distinct drowsiness and apathy may appear (the child “sleeps” with the measles). The rash first affects the face and the area behind the ears, then spreads over the neck, upper chest, and back to the entire torso and limbs. The nature of the rash is gradually changing. At the beginning, there are few, scattered, small spots of a dark pink color, of which there are more and more during the day, becoming more and more convex, resembling lumps. As measles develops, the papules become larger and larger and fuse together; they can cover almost the entire skin, leaving only white streaks in some places (the so-called leopard skin). The rash disappears in the order in which it appeared;
4. Recovery period: the rash will slowly turn pale, moreover, the coughing will disappear and body temperature will return to normal. The sick person heals, which may take several days.

Measles in children and a characteristic rash

The rash accompanying measles is specific. At first, thick spots appear that merge into vivid red spots with lumps of uneven shape. At first, the skin eruptions appear behind the ears, then progress to the face, neck, torso, arms and legs. In addition, the oral mucosa becomes slightly red. With the appearance of the rash, the temperature drops and although the child still has rhinitis and cough, he slowly recovers. After a few days of illness, the rash begins to peel off by itself. There are cases of children who have a very severe course of measles, accompanied by a hemorrhagic rash and convulsions.

Other symptoms of measles in children include:

1. sore throat,
2. high temperature,
3. rhinitis,
4. dry cough),
5. photophobia,
6. redness of the eyes.

What does measles look like? In the course of the disease, an infected child develops various symptoms, including the characteristic rash. The skin lesions are red, confluent, maculopapular. The management and spread of rash are described above.

Measles – complications

The occurrence of complications in people who contracted measles affects approx. 30 percent. sick. Complications after measles usually affect the youngest patients, especially the unvaccinated! Then, bacterial pneumonia, middle ear and laryngitis may appear, as well as diarrhea and convulsions.

The most severe ailments concern especially young children, people with immunodeficiencies and the elderly. The most dangerous are neurological complications:

1. primary encephalitis;
2. meningitis;
3. inflammation of the spinal cord, polyneuritis or inflammation of the cranial nerves;
4. subacute sclerosing encephalitis (LESS), which develops many years after the onset of measles (5-8 years on average, but sometimes even 15 years), and is fatal.

Measles and vaccination

In children (in the first 6 months of life), immunity is passed on by the mother. However, older children require measles vaccine. The measles vaccine is also part of the vaccine against: rubella, mumps and measles (MMR vaccine) or measles, mumps, rubella and varicella (MMRV vaccine). Measles vaccines should not be given to children under one year of age. The only indication is the child’s trip abroad or the presence of measles. The most common target group are children aged 12 to 15 months.

The vaccine is given to people who are at risk of measles, that is:

1. people with impaired immunity,
2. women planning pregnancy,
3. children suffering from cancer,
4. children who show severe allergic reactions to antibiotics.

In people with measles, who are unvaccinated and at risk you are given immunoglobulin (an injection of antibodies). For its effectiveness to be high, it should be administered within a few days of contact with the person with the disease. With an injection, it is possible to stop measles or to reduce its symptoms. A similar degree of protection is provided by a measles vaccine administered within 72 hours of exposure, but in people who are not at risk!

Keep in mind that measles vaccines, while effective, often have side effects. The most common reactions are local reactions (redness, swelling and pain at the injection site), as well as the occurrence of fever 6–12 days after vaccination. In addition, rashes have been reported in some people that are the same as with measles. However, it resolves on its own.

When it comes to severe negative measles vaccination reactions, they are very rare. These include febrile seizures and mild encephalitis that resolve on their own and do not have long-term consequences.

see also: Facts and myths about vaccinations

Can I get measles despite being vaccinated?

The effectiveness of vaccination against measles is high – in the case of people who received two doses of the vaccine, it is around 98-99%. If the vaccinated person develops measles, there is a good chance that the disease will be mild and severe complications can be avoided.

Most patients who develop measles develop lifelong immunity to the disease causing it. However, this is not always the case. Measles protective antibodies can be lost in some diseases, in particular tumors involving the haematopoietic system (e.g. leukemia). The problem of lack of immunity to measles may also arise in people suffering from disruption of cellular immunity.

Measles – diagnosis of the disease

Measles is diagnosed by a doctor who, based on the symptoms, decides whether the child can be treated at home or hospitalized. In the event of a clear clinical picture indicating measles, it is possible to diagnose it efficiently. However, the symptoms at the catarrhal stage of the disease development are not always specific.

The diagnosis of measles can prove problematic in its mild course, when the patient is partially immune, or in infants with immunity to the mother. Virological or serological tests may be performed to confirm the infection. Infection with measles virus differentiates from other viral diseasesincluding erythema, rubella, dengue and Coxsackie virus infection. Measles-like symptoms (rashes) can also be the result of scarlet fever or drug-induced reactions, and the rash and conjunctivitis may indicate Kawasaki syndrome.

Measles – treatment

Treatment for measles does symptomatic characterand there is no single effective treatment for measles. Relief of the symptoms is of great importance. First of all, your child should drink plenty of fluids and get plenty of rest. If the patient develops a fever, an antipyretic preparation, e.g. ibuprofen or paracetamol, may be administered. It is important that the medicine does not contain aspirin as this can lead to Reye’s syndrome in the event of a viral disease. In addition, it is necessary to frequently ventilate the room where the child lives (the air should be humidified to avoid additional irritation of the mucous membranes).

The diet of a child with measles should contain foods that are easy to swallow. During treatment, the child should also take vitamin A. Parents should remember that measles in some cases leads to complications, so medical supervision of the patient is important.

Read more:

1. Measles – WHO is alerting about the record increase in the incidence in Europe in 2018
2. Coronavirus has stopped measles epidemic?
3. Infectious diseases of childhood in adults

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