What is measles?
Measles is a very contagious respiratory infection. It causes a total-body skin rash and flu-like symptoms. 20 million cases happen worldwide every year. With about 50,000 deaths in India due to Measles and rubella
Measles (also called rubeola) is caused by a virus, so there’s no specific medical treatment for it. The virus has to run its course. A child who is sick should stay at home or day care to prevent spreading the infection.
What are the signs and symptoms of measles?
The first symptoms of a measles infection are usually a hacking cough, runny nose, high fever, and red eyes. Kids also may have Koplik’s spots (small red spots with blue-white centers) inside the mouth before the rash starts.
The rash breaks out 3–5 days after symptoms start, sometimes along with a high fever up to 104°F (40°C). The red or reddish-brown rash usually begins as flat red spots on the forehead. It spreads to the rest of the face, then down the neck and torso to the arms, legs, and feet. The fever and rash slowly go away after a few days.
Measles is very contagious. In fact, 9 out of 10 people who aren’t vaccinated for measles will get it if they are near an infected person.
How do people get measles?
Measles spreads when people breathe in or have direct contact with virus-infected fluid. It can pass through droplets sprayed into the air when someone with measles sneezes or coughs. Someone exposed to the virus might not show symptoms until 8–10 days later.
How is measles treated?
There is no specific medical treatment for measles. To help manage symptoms:
give your child plenty of fluids encourage extra rest give Paracetamol, if a fever makes your child uncomfortable. Never give aspirin to a child who has a viral illness, as such use is linked to Reye syndrome.
Kids with measles should be closely watched by a doctor. In some cases, measles can lead to other complications, such as ear infections, croup, diarrhoea, pneumonia, encephalitis (irritation and swelling of the brain)
Can measles be prevented?
The best way to protect your kids is to make sure they’re immunized against measles by getting vaccinated with two doses at 9 months and 15 months.
For most kids, measles protection is part of the measles-mumps-rubella vaccine (MMR) or measles-mumps-rubella-varicella vaccine (MMRV) given when they’re 9 months and 12 to 15 months old and again when they’re 4 to 6 years old.
It’s important for all kids who can get the vaccine to get it on schedule. At-risk people (such as those with weakened immune systems) can’t get the vaccine and depend on “herd immunity.” This is when a lot of people are immunized against a disease, which prevents it from spreading and helps prevent outbreaks.
Most of the people who got measles were not vaccinated.
Those at highest risk during an outbreak are:
- infants who aren’t old enough to get the vaccine
- pregnant women
- people with poor nutrition or weakened immune systems
If they have contact with someone who has measles, doctors can give an injection of measles antibodies (called immune globulin). It’s most effective when given within 6 days of contact. These antibodies can either prevent measles or make symptoms less severe.
The measles vaccine may offer some protection to women who are not pregnant and people not in an at-risk group if given within 72 hours of measles exposure.
What is Rubella?
Rubella virus is single stranded RNA virus of the Togaviridae family (genus Rubivirus). Rubella virus infection gives rise to two distinct clinical entities based on when the virus is acquired. When acquired postnatally (after birth to adulthood), the virus produces a mild illness with a characteristic rash.
However, when acquired during fetal development, the virus gives rise to the congenital rubella syndrome (CRS), which can be devastating and can cause death of the fetus (baby in the womb). Its association with CRS led to the development of an effective vaccine in 1970. In countries that have adopted effective rubella vaccine strategies, the rates of natural rubella infection and CRS have reduced. Unfortunately, many areas of the world lack effective rubella vaccine programs, and some people in the countries with access to the vaccine choose not to vaccinate. This leaves a substantial portion of the world population susceptible to rubella virus infection and CRS.
What damage can Rubella infection cause?
In postnatal Infection 20-50% of infected individuals are asymptomatic.Younger patients are often asymptomatic until rash onset but can have mild coryza and diarrhea. Rubella demonstrates a distinctive pattern of lymphadenopathy manifest by enlargement of the post-auricular and sub-occipital nodes.
In CRS all organ systems can be involved in the rubella-infected fetus, leading to an impressive array of possible findings at birth. CRS is characterized by the classic triad of cataracts, cardiac abnormalities, and deafness. Findings in infants with CRS include: Sensorineural hearing loss, Cataracts, pigmented retinopathy, glaucoma, Congenital heart disease (like Patent ductusarteriosis (PDA),peripheral pulmonic stenosis), Microcephaly(small head and brain), meningoencephalitis(brain infection), Hepatosplenomegally, Thrombocytopenic purpura, Large anterior fontanel, Cryptorchidism/inguinal hernia etc and even death.
How can rubella infection be prevented?
Rubella vaccine is a live attenuated virus vaccine. Three separate rubella vaccines were licensed in the United States in 1969. Since 1979, a single vaccine (the RA 27/3 strain) has been licensed in the United States. It is currently available combined with measles and mumps vaccines (MMR) or with measles, mumps, and varicella vaccines (MMRV).
The rubella vaccine is safe and immunogenic. Ninety-five percent or more of vaccinated people at least 12 months of age develop serologic evidence of immunity after a single dose, and immunity lasts for at least 15 years in more than 90% of those vaccinated. At least one dose of rubella-containing vaccine is recommended for all children 9 months of age or older. A second dose of rubella-containing vaccine is recommended at 15 months to 5 years of age to produce immunity in those who fail to respond to the first dose.
By choosing not to vaccinate, one not only continues to be susceptible to the infection but also remains as a potential threat, of transmitting the infection to other people.
Issued in public interest by Indain Academy of Pediatrics (IAP), Nagaland
