Measles is caused by the rubeola virus and is highly contagious. It is spread through droplets (sneezing) – either breathing these in or via skin contamination (then touching mouth, eyes etc).
Symptoms appear about 10–14 days after exposure. It begins like a fairly generic viral infection – fever, feeling unwell, tiredness, runny nose, sore eyes, cough. So it may appear to be similar to a cold in the early stages. Then the rash will start to appear – it typically starts on the neck, hairline and round the face. It spreads from there outwards to the trunk, shoulders and then on to the legs and arms. As the illness progresses the temperature can rise to quite serious levels and the patient feels really feverish (temperatures can rise above 105F). There can then be side effects as a result of the fever (eg diarrhoea).
Identifying the rash is critical. It is different to both the German Measles (smaller) and Chickenpox (blisters) rashes. The rash is red, raised and the spots can come through in clumps. It’s typically a really angry looking rash. However, if the person has partial immunity then sometimes there can be relatively few spots.
Another place to look is inside the mouth. There will be white spots (Koplik’s spots) on the inside of the mouth in many patients, giving a bumpy appearance to the mouth.
Measles is relatively rare now in many Western countries because of the MMR vaccination, although worldwide there are around 20 million cases per year. In Europe there would typically be millions of cases per year before vaccination was available, there are now a few thousand. However, where vaccination levels are low we are seeing outbreaks again.
In 2017 there were four times more cases of measles in Europe than in 2016: 21,000 reported cases (there are usually many unreported cases) and 35 deaths. The influx of unvaccinated individuals into Europe is partly responsible for the rise in numbers (where countries have been disrupted by war, children are less likely to be immunised), along with parents choosing not to vaccinate their children (eg UK), and a shortage of vaccine in certain countries (eg Romania). Fear of the vaccine is still a reason why some parents choose not to vaccinate in certain countries (eg UK), but some countries have now made it compulsory to vaccinate children (eg France, Italy, Germany).
For many children measles can be a fairly run of the mill childhood disease (like chickenpox), but in some people it can have very serious symptoms and side effects. Approximately 30% of people who get measles will have at least one side effect, and side effects are more serious and more common in very young children (younger than 5) and adults.
Death can occur, though rarely (approximately 3 deaths per 1000 patients in Western countries), but low death rates in Europe are because we have the healthcare systems in place to save patients who are also generally well nourished. Where death occurs, 60% of deaths are due to pneumonia. Measles can also affect the eyes and cause brain damage. Pregnant women who catch measles are at risk of premature labour and low birthweight babies, though it is not linked to birth defects. Where children are not well nourished (especially when they are low in Vitamin A) the death rate can be as high as 25%. It is also particularly dangerous for people with compromised immune systems.
People are typically infectious for about 8 days. Patients are infectious beginning when the nose starts running and before the rash appears and for about 4 days after the rash has appeared. You can have an emergency immunisation if you’re exposed and not immune, but you would need to talk to your doctor about this. I believe it has to be given within 6 days of exposure.
If a child gets measles then they need to stay at home (because it’s highly contagious) and be treated as for other viral illnesses. Give them rest, plenty of fluids, treat fevers (eg ibuprofen, sponging, cool rooms), monitor and report to doctors if patient deteriorates. Vitamin A supplements have been found to help in developing countries where patients may be deficient.
What causes measles?
The virus that causes measles is an airborne virus meaning it is contagious—highly so. The virus remains virulent for several hours after it has been expelled from an infected host by coughing, sneezing or can be spread by direct contact with saliva or nasal secretions (handling a used tissue for example).
Why does it still occur and spread? 20 years ago, we thought measles had been eradicated thanks to decades of immunization. But the anti-vax idiots (and they are idiots) have bought into scientifically discredited arguments that vaccines are dangerous (the disease is dangerous and possibility deadly, the vaccine—not so much), cause autism (no, it does not and current evidence indicates autism is evident before birth), and who knows what other ridiculous arguments in vogue at the moment.
Do you want to avoid getting the measles and perhaps suffering the long-term health effects? Get vaccinated. Get your children vaccinated. Ignore the anti-vax idiots.
What is the treatment for measles?
Measles in a healthy child, without any complication does not need any treatment except symptom control ( paracetamol for fever, home remedy for cough etc.) As it is a viral illness, antibiotics do no help. Keeping baby hydrated and properly fed helps.
Measles is more risky when child has underlying malnutrition or any other underlying chronic illness. Immunodefociency also makes it dangerous. In such situation chances of developing complications are high and in worst of cases may lead to death. Such cases need hospitalization, supportive antibiotics, fluids etc.
Immunity goes low, appetite reduced and cough, diarrhoea and even corneal damage may follow measles, therefore be careful for sometime, even after it is over.