Measles

Definition

Measles is a viral infection most commonly affecting the children. It is also known as rubeola and should not be confused with German measles (rubella). Symptoms of measles includes fever, cough, running nose with rashes. It is a highly contagious disease that is spread through secretions. Most of the time measles is not considered to be a dangerous infection but this is untrue. Measles can progress into complications such as pneumonia, ear infection corneal ulceration and encephalitis. Death rate due to measles is particularly high in underdeveloped countries and among immunocompromised patients. There is no treatment available for patients suffering from measles. Vaccines and immunoglobins are known to protect an individual from measles.

 

Symptoms

 

The following symptoms appear within 7 to 14 days of contracting infection.

  • Cough
  • Conjunctivitis (pink eye)
  • High fever
  • Poor appetite
  • Intolerance to light
  • Skin rash that is characteristically red itchy lesions typically appear within few days of onset of fever. The rash usually starts at the back of the ear and spreads to other body parts. The rashes change color with time from red to brown and finally disappear. The rashes appear within 2 to 4 days of initial symptoms and persist for about 8 days.
  • Koplik’s spot: bluish white spot surrounded by white border found on the inner cheek usually on the first day of infection. This spot is diagnostic of measles, however, in most of the cases it is not found or disappears very fast

Complications of measles that may sometimes arise includes :

  • Ear infection
  • Bronchitis
  • Lung infection (pneumonia) which can be very serious in immunocompromised patients
  • Inflammation of brain tissue (encephalitis) immediately following measles or months later encephalitis may occur. Approximately 1 in 1000 people suffering from measles suffers develop encephalitis.
  • Visual impairment due to corneal ulceration permanent visual damage may occur especially in malnourished children typically suffering from vitamin A deficiency.
  • Miscarriage, low birth weight baby or preterm delivery may occur due to measles attack during pregnancy.
  • Platelet count may fall below normal level increasing chance of bleeding.

Complications are more common among adults suffering from measles rather than children.

Causes

Measles virus is an RNA virus belonging to the genus paramyxovirus. Humans are a natural host for the virus. Measles virus is highly infectious. About 90% of the people without a previous history of measles or vaccination coming in contact with a measles patient will be infected. The virus thrives in the mucosa of nose and throat of an infected adult or child. The person infected with measles remains infectious four days before the appearance of rash to four days after.

The virus spreads via respiratory route either directly or in aerosol form. A patient of measles infection may spread the virus while sneezing, coughing or talking or by direct contact with respiratory secretion like nasal secretion or sputum.

Risk factors

  • Unvaccinated adults and children
  • Immunocompromised people
  • Malnutrition especially in children
  • Vitamin A deficiency
  • Pregnancy

Treatment

Developing measles can be avoided by pre-exposure vaccination in the ideal situation. These days the MMR (measles-mumps-rubella) vaccination is used for children. However, this may not always be possible. Measles can be prevented or limited after being exposed to a person with the infection by two measures :

  • Vaccination within 72 hours of exposure.
  • Antibody (immunoglobulin) injection within 6 days of exposure. Usually given in pregnant women, infants, and people with poor immune status.

Once a person develops measles, the treatment is largely supportive or directed at complications should it arises. Medication that may be used for measles includes :

  • Antipyretics to reduce fever.
  • Antibiotics in case of secondary bacterial infection.
  • Vitamin A supplements.

 

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