Measles

measles summary

Measles is an infectious disease that can cause epidemics, especially in children. In Brazil, part of the population is not fully vaccinated (that is, they have not taken the 2 doses), which causes measles epidemics. Measles is an infectious disease that can cause epidemics, especially in children. In Brazil, a part of the population is not fully vaccinated. In certain places, especially in Northern Europe, the situation is the opposite. As an example, there is the case of Finland, whose vaccination coverage was 95% in 2006 and 2007 and no case of measles was registered. Brazil must reach a 95% vaccination coverage rate to eradicate the disease and have the same success as Finland.

Measles is usually characterized by a rash and fever.

When treatment is not fully effective, measles can lead to complications such as encephalitis ( meningitis ), otitis media, bronchopneumonia and even blindness (reaching the cornea), as it happens in some very poor countries in Africa. The disease is especially dangerous for pregnant women.

Treatment is mainly based on symptom reduction. As the disease is viral, antibiotics are not the first line of treatment, but can be prescribed by the doctor to prevent bacterial infections, especially opportunistic ones. Rest is an important measure.

The main preventive measure, and perhaps the only one, is vaccination. Vaccination is carried out in young children up to 12 months, with a booster before 24 months (two doses are necessary to guarantee immunity).

Vaccinating your child is fundamental to ensure their health, and also an important act for the public health of society that aims to eradicate the disease.

Without an important population vaccination program, there are frequent measles epidemics.

Definition

Measles is an infectious disease caused by the Mobili virus of the Paramyxovirus type. Measles generally affects children and can appear at any time of the year, with a higher prevalence in late winter and early spring.

Why is measles so contagious?
Measles is one of the most contagious infectious diseases.
The measles virus enters the body through the respiratory (air) tract, particularly after an infected person coughs or sneezes. Contagion is usually done by inhaling droplets. Because they are tiny droplets, they can remain suspended in the air for up to two hours after the person with measles has left the area, according to the Mayo Clinic . This means that you can get measles even if you are not in direct contact with an infected person. Hence the importance of vaccination to prevent the onset of epidemics.
In rarer cases, the virus can also enter through the eyes.

The disease is characterized by rash and fever . If not treated well, measles can lead to serious complications such as encephalitis ( meningitis ), otitis media, and bronchopneumonia.

The disease is particularly dangerous for pregnant women, as it can cause miscarriage or premature delivery.

It is estimated that measles was first described in the ninth century, but it was not until 1963 that the measles vaccine emerged. (more on: treatments).

Distant origin
A German study published in June 2020 showed that the measles virus would have appeared around 500 BC in humans, when it would pass from animals (cattle) to humans. Researchers from the Robert Koch Institute, who carried out this work based on genetic analyses, believe that a high population density in ancient cities like Babylon (currently in Iraq) would be the cause of human contamination.1.

Epidemiology

– The number of measles cases worldwide increased by 30% over the course of 2017 compared to 2016, according to a WHO statement dated 29 November 2018. In 2018, the number of measles cases increased by 10% compared to to 2017, from January to November. The WHO recalls that measles can be fatal with many serious complications. Vaccination is the only effective method of preventing the disease. In 2017, WHO reported 190,000 cases of measles worldwide and 110,000 deaths, mostly children. The number of actual measles cases worldwide in 2017, i.e. unknown to WHO, was much higher and estimated at around 6.7 million.

In November 2016, WHO reported that 400 children die each day from measles, mostly in poor countries in Africa and Asia.

In September 2016, the WHO reported that measles had so far been eradicated from the American continent. This is the first region where measles eradication has been achieved. According to WHO, this eradication was possible due to intense efforts to vaccinate the population across the continent carried out in recent decades, both in North America and Latin America. In the American continent, the last endemic case of measles was in 2002. Since 2002, other cases have been observed in the American continent, especially in 2014 in Southern California, but it was a species of the virus imported from another continent.

However, in July 2018, the Brazilian newspaper Folha de S.Paulo reported that measles was once again present in 11 countries on the American continent, including Brazil, with hundreds of confirmed cases during the first half of 2018.

Before measles vaccination was implemented globally in 1980, an estimated 2.6 million people died each year from this infectious disease.

Measles cases in Romania
In 2016 in Romania, 8 babies or young children died from the consequences of measles. In 2016, Romania reported around 1,700 measles cases as of December 19, 2016. Most of these cases involved children younger than 12 months.
That is why the Romanian health authorities, together with UNICEF and WHO, have suggested or proposed to reduce the age of first measles vaccination from 12 months to 9 months.

Causes

The virus responsible for measles is Morbillivirus belonging to the family of Paramyxoviridae.

Man is the only host of this virus, which is transmitted directly, that is, by spreading droplets or by direct contact with the secretions of the nose and throat of infected people (coughing and sneezing of the person as a virus). Indirect transmission (objects touched by infected people) is rare due to the poor survival of the virus outside the host.

The incubation time of the disease is 8 to 13 days (time between infection and the first symptoms of the disease). It is possible to carry the virus without knowing it. Transmission occurs approximately six days before and four days after the appearance of the first red patches on the skin.

Due to its high risk of transmission and probability of causing epidemics, there is a vaccine against the disease, which is combined against rubella , measles and mumps , which are three diseases that affect children (ROR vaccine – triple viral).

Once acquired, measles gives the sufferer immunity for life. It is therefore very rare for this person to contract the disease again. The vaccine also allows you to get immunity.

Groups of risk

The main risk groups are:

– Persons not yet immunized (often children)

– Pregnant

– Immunosuppressed people

Measles is a very contagious disease. All people who have not yet had the disease or have not yet been vaccinated are at risk of contracting it. The virus is easily transmitted, especially in very frequented places, such as schools, public transport or large spaces (malls, gyms, etc.).

The severity is even greater for pregnant women not immunized against the virus, as there is a risk of miscarriage in the first trimester and premature birth in the 2nd and 3rd trimesters. There is also a risk of malformation of the fetus throughout the pregnancy.

In immunosuppressed people there is a risk of complications such as pneumonia, for example.

Symptoms

Once the virus has been contracted, the incubation time is 8 to 13 days, as we saw in the “causes of measles” section. The characteristic symptoms are:

– high and sudden fever

– runny rhinitis (runny nose)

– conjunctivitis

– cough

– swollen face

– inside the mouth showing whitish spots

– loss of appetite

– rash in the form of reddish plaques appearing about 3 to 4 days after the first symptoms, starting behind the ears and moving to the face and trunk.

It is estimated that after a week the fever and rash subside, however, the cough can last for two weeks or more.

As you can see in the causes , experts estimate that measles only occurs once in a lifetime, it is very rare to get measles a second time.

Diagnosis

The diagnosis of measles is essentially made through the presence of characteristic symptoms of the disease, but it can also be confirmed by the existence of specific antibodies against the virus, in the case of serology.

Complications

Measles symptoms usually resolve quickly and may leave a persistent cough.

The main complications of measles are opportunistic respiratory infections such as purulent rhinitis, laryngitis , pharyngitis, otitis and bronchitis . Measles can sometimes cause encephalitis or meningitis (neurological complications). However, these serious complications are rare (around 1 in 1000). Meningitis is fatal because it destroys brain cells.

An immediate complication of measles can be laryngitis which can cause breathing difficulties that can lead to asphyxiation (rare).

There are cases where complications can be more serious, such as in immunosuppressed people or pregnant women.

Measles in the pregnant woman

– abortion not 1st trimester

– premature birth in the 2nd and 3rd trimesters

– risk of malformation for the fetus throughout the pregnancy.

Measles in immunosuppressed people

– pneumonia intersticial grave

In addition, measles can lead to blindness, especially because of damage to the cornea. We examined a case of a woman who gradually lost her sight after having measles in childhood some 50 years ago. She had to undergo a corneal transplant to regain her full vision.

Eye problems occur especially in very needy countries (lack of care and vitamin A). WHO provides a guide for clinicians.

Here’s an excerpt from the WHO:

MEASURES TO TAKE TO PREVENT BLINDNESS LINKED TO MEASLES

Treatment of eye injuries due to measles depends on the skills of local health personnel, available drugs and facilities. General guidelines:

1. Any eye injury that occurs during measles deserves urgent treatment;

2. Any child who manifests monocular vision loss should be referred immediately to an ophthalmology specialist.

Treatments

To treat measles, the doctor will essentially use symptomatic treatment, that is, to relieve the symptoms. However, to prevent measles, which tends to cause sometimes deadly epidemics, researchers have developed a vaccine.

1. Measles medication and care

– rest

– antipyretics (medicines that reduce fever , such as paracetamol )

– cough medicine

– antibiotics (they prevent possible opportunistic infections and are purchased strictly under medical prescription)

We emphasize that antipyretic drugs are essential in young children, when the fever is higher than 38.5 °C (risk of convulsions).

We also observed that measles wounds or red plaques do not itch and, therefore, do not require specific care, as is the case with chickenpox , for example.

2. The measles prevention vaccine

In Brazil, health authorities recommend vaccination against measles in combination with mumps and  rubella . This is the MMR or MMR vaccine.

Vaccination age in Brazil

In Brazil, the first dose of the triple viral vaccine (SRC) is usually applied at 12 months of age and the second dose is applied between the ages of 4 and 6 years.

Note that in some countries such as France, the second dose is administered before two years of age (15-24 months).

Measles vaccine notes (usually incorporated into the combination SCR vaccine)

– The MMR vaccine is usually given as an injection in the arm.

– There may be some pain and swelling at the injection site, but it usually goes away quickly.

– The vaccine is effective as early as 3 days after the first injection. In other words, the body is immunized against measles three days after the first dose.

– In case of vaccination in adults (without childhood vaccination), carry out the second dose one month after the first. Do not wait months or years, as in young children. Ask your doctor, as there may be differences in each country and in each age group.

– Variations in vaccination can be observed between countries and regions. WHO recommends that the first dose of the vaccine be administered when the child reaches an age between 9 and 15 months and the second dose, through routine immunization programs, when the child enters the second year, when the child begins his education, or in children under five years of age, during mass immunization campaigns.

WHO recommends that all children receive two doses of measles vaccine.

WHO would like to have measles vaccination coverage nationwide of 90% for the first dose of measles vaccine and 80% coverage in all districts or equivalent administrative units.

– You should know that the measles vaccine is recommended in all countries of the world. Most industrialized countries provide MMR (measles-mumps-rubella) MMR.

According to British health authorities (NHS), the SCR vaccine is recommended more than individual vaccines because the success rate is higher. The combination vaccine is easier to reach large scales. In the case of individual vaccines it would be six injections (instead of two injections of the combined SCR), so the adherence rate would be lower and therefore coverage would be lower.

– Remember that absolutely no correlation has been established between the SCR vaccine and autism or autistic disorders (source: WHO, April 2013).

– If you are sick, especially with fever or flu-like symptoms, you should postpone vaccination for a few days, because in this case 100% immunization cannot be guaranteed. So, wait until you are completely cured before getting vaccinated.

– It is estimated that 2% of vaccinated people who received 2 doses of measles vaccine are not fully immunized and may develop the disease. In other words, the effectiveness of two doses of measles vaccine is 98%.

What to do if you have not been vaccinated or if you have only received one dose?

Anyone born after 1980 must have received two doses of the SCR vaccine and is effectively protected against measles. If this is not the case for your child, teenager or yourself, late vaccination is recommended:

– With one dose for those who received a single injection;

– With two doses for those who received none. Remember that in the case of vaccination in adults (not childhood vaccinations), perform the second injection one month after the first dose. Do not wait months or years, as in young children.

Talk to your doctor or ask your pharmacist. Note: Measles vaccine is not recommended during pregnancy.

Pregnant women and prevention serum

For pregnant women, in which case the vaccine is contraindicated, there is a preventive serum (administration of gamma globulins containing specific antibodies to the virus antigens).

The prevention serum is especially recommended for:

– People for whom the vaccine is contraindicated (pregnant women, newborns)

– Persons not yet immunized who have been in contact with a sick person (to be administered within 72 hours of exposure).

measles alternative

To reinforce the defenses (through trace elements)

There is no specific medicine that fights measles in oligotherapy, however, a measure of the Cobre-Ouro-Silver medicine, 1 to 2 times a day, allows you to reinforce the immune system, which plays a favorable role in measles therapy.

Tips

– Isolate the patient, as the disease is highly contagious

– Prevent people around you (family, schools, friends, etc.)

– Get plenty of rest

– Against conjunctivitis : wash your eyes with a cotton pad soaked in saline solution

– Leave the child in the shade, as the light is almost always painful

Prevention

Prevention relies mainly on vaccination (combined vaccine: measles-mumps-rubella ROR-triple viral).

– The combined vaccine (against measles, mumps and rubella = ROR- triple viral) is indicated for all non-immunized people (children from 1 year old). It should be applied in two doses, starting from the child’s ninth month of life. Consult your doctor or pharmacist for more information about measles vaccination (as well as when to have the second dose). We emphasize that the vaccine is effective 2 days after the first dose.

However, for pregnant women who cannot take the vaccine due to contraindications, there is a preventive serum that consists of administering gammaglobulins containing specific antibodies to the virus antigens.

Vaccination should not be given to the following types of patients:

– With congenital or acquired immunodeficiency;

– History of an anaphylactic reaction to the previous dose;

– Pregnant women;

– People who had an anaphylactic reaction after using neomycin, or ingestion of gelatin;

– Persons who received blood or derivatives between 3 months and 11 months before the date of vaccination, depending on the product received.

Serum prevention is mainly recommended for:

– people who cannot get the vaccine (pregnant women, newborns)

– people not yet immunized who have been in contact with a sick person (take the vaccine within 72 hours of exposure).

Jeanne Kenney
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I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

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