MEASLES

About Measles
Measles, also called rubeola, is a highly contagious respiratory infection that's caused by a virus. It
causes a total-body skin rash and flu-like symptoms, including a fever, cough, and runny nose.
Though rare in the United States, 20 million cases happen worldwide every year.

Since measles is caused by a virus, there is no specific medical treatment for it and the virus has to
run its course. But a child who is sick should drink plenty of fluids, get lots of rest, and be kept from
spreading the infection to others.

Signs and Symptoms

While measles is probably best known for its full-body rash, the first symptoms of the infection are
usually a hacking cough, runny nose, high fever, and red eyes. Children who get the disease also may
have Koplik's spots, small red spots with blue-white centers that appear inside the mouth.

The measles rash breaks out 3-5 days after symptoms start, and can coincide with high fevers up to
104°F (40°C). The red or reddish-brown rash usually first shows up 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 gradually go away after a few days.

Contagiousness

Measles is highly contagious — 90% of people who haven't been vaccinated for measles will get it if
they are near an infected person. Measles spreads when people breathe in or have direct contact with
virus-infected fluid, such as the droplets sprayed into the air when someone with measles sneezes or
coughs. A person who is exposed to the virus might not show symptoms until 8-10 days later.

People with measles are contagious (can spread the disease) from 4 days before the rash appears
until about 4 days after it does, and are most contagious while they have a fever, runny nose, and
cough. Those with weakened immune systems due to other conditions (like HIV and AIDS) may be
contagious until they recover from measles.

Recent Outbreaks
Measles is very rare in the United States. Before measles vaccination became available in the 1960s,
more than 500,000 cases were reported every year. Back then, about 500 people died of the disease
each year, and around 4,000 people a year had encephalitis(swelling of the brain) from the disease.

Due to widespread immunizations, the number of U.S. measles cases declined steadily to a low of 37
people in 2004. From 2000 to 2007, only about 63 cases per year were reported.

But recent years have seen spikes in measles outbreaks, including 131 cases in the first half of 2008
and 644 cases in 2014. Most U.S. outbreaks begin with people who were infected outside of the
country, with the disease spreading quickly in areas where too few people have received the vaccine.
About 85% of people infected with measles were not immunized or their immunization status was
unknown, although they were eligible to receive the vaccine.

The people at highest risk of getting measles during these outbreaks are infants (who aren't old
enough to get the vaccine), pregnant women, and people with poor nutrition or weakened immune
systems.

Exposure

During a measles outbreak, an injection of measles antibodies (called immune globulin) can help
protect people who haven't been vaccinated if they come into contact with an infected person (called
"exposure"). The injection is most effective if it's given within 6 days of exposure. These antibodies
can either prevent measles or make symptoms less severe.

For women who are not pregnant and people not in one of the other at-risk groups, the measles
vaccine may offer some protection if given within 72 hours of measles exposure.

Unvaccinated people who are exposed to measles and show symptoms of the virus should seek
medical care. Otherwise, they should stay home and not return to childcare, school, or work until 21
days after they were exposed.

Prevention
The most important thing you can do to protect your kids from measles is to have them vaccinated
according to the immunization schedule prescribed by your doctor.
Older kids are usually immunized against measles according to state and school health regulations.
For most, measles protection is part of the measles-mumps-rubella vaccine (MMR) or measles-
mumps-rubella-varicella vaccine (MMRV) given when they're 12 to 15 months old and again when
they're 4 to 6 years old.
Infants are generally protected from measles for 6 months after birth due to immunity passed on by
their mothers. Measles vaccine usually is not given to infants younger than 12 months old. But if
there's a measles outbreak, or a child will be traveling outside the United States, the vaccine may be
given when a child is 6-11 months old, followed by the usual MMR immunization at 12-15 months and
4-6 years of age.

The measles vaccine sometimes causes side effects in kids who don't have underlying health
problems. The most common reactions are fever 6-12 days after vaccination (in about 15% of kids
vaccinated) and a measles-like rash, which isn't contagious and fades on its own (in about 5% of
vaccinated kids).

As with all immunization schedules, there are important exceptions and special circumstances. Your
doctor will have the most current information about vaccine recommendations.

The measles vaccine should not be given to these at-risk groups:

 pregnant women
 kids with untreated tuberculosis, leukemia, or other cancers
 people whose immune systems are weakened for any reason
 kids who have a history of severe allergic reaction to gelatin or to the antibiotic neomycin, as
they could have serious reactions to the vaccine

Because certain people cannot receive the measles vaccine for health reasons, it's all the more
important to make sure that children who can get the vaccine get it on schedule. At-risk children
depend on "herd immunity." This means a high percentage of people have been immunized against a
disease, which prevents the disease from spreading in a population and helps prevent outbreaks.

Treatment
There is no specific medical treatment for measles. To help manage symptoms, which usually last for
about 2 weeks, give your child plenty of fluids and encourage extra rest. If a fever is making your
child uncomfortable, you can give a non-aspirin fever medicine, such as acetaminophen or ibuprofen.
Remember, you should never give aspirin to a child who has a viral illness, as its use in such cases
has been associated with the development of Reye syndrome.
Kids with measles should have their condition closely monitored by a doctor. In some cases, measles
can lead to other complications, such as otitis media, croup, diarrhea, pneumonia, and encephalitis,
which may require antibiotics or hospitalization.
In developing countries, vitamin A has been found to decrease complications and death associated
with measles infections. In the U.S., vitamin A supplementation should be considered for children
between 6 months and 2 years old who are hospitalized with measles and its complications.

Also, all kids over 6 months old with certain risk factors — such as vitamin A deficiency, a weakened
immune system, or malnutrition — might benefit from vitamin A supplementation.

Children with measles should be quarantined for 4 days after their rash appears. If they have a
weakened immune system, they should stay in isolation until they make a full recovery and all
symptoms are gone.

When to Call the Doctor

Call the doctor immediately if you suspect that your child has measles. Also, it's important to get
medical care after measles exposure, especially if your child:

 is an infant
 is taking medicines that suppress the immune system
 has tuberculosis, cancer, or a disease that affects the immune system

Most important: remember that measles, a once common disease, is preventable through routine
childhood immunization.

Medical news…………………………….

Measles, also known as rubeola or morbilli, is a highly infectious illness caused

by the rubeola virus.

Measles is an endemic disease, meaning it is continually present in a community and

many people develop resistance. However, if measles enters an area where the people
have never been exposed, the result can be devastating.

A measles outbreak in 1592 on the island of Cuba killed approximately two-thirds of the
native population. A couple of years later, half the indigenous population of Honduras
died.
Over the last 150 years, the total global measles death toll is an estimated 200 million
people.

This article will explain the cause of measles, its symptoms, treatment, and prevention.

Contents of this article:

 Symptoms
 Cause
 How does measles develop?
 Diagnosis
 Treatment
 Complications
 Prevention
 When should children be vaccinated?
Fast facts on measles
Here are some key points about measles. More detail and supporting information is in
the main article.
 Measles is a highly infectious condition

 Symptoms of measles can include watery eyes, sneezing, and a dry hacking cough

 It takes 1-3 weeks for the measles virus to establish itself

 There is no specific treatment for measles; prevention is better than cure

 Pregnant women should not take the vaccine

 Scientists have identified 21 strains of the measles virus

Symptoms of measles

Measles symptoms can often include a reddish-brown spotty rash.

Measles is an infection caused by the rubeola virus; its symptoms always include fever

and at least one of the three C's - cough, coryza (runny nose), and conjunctivitis.
Symptoms will appear about 9-11 days after initial infection.
Measles symptoms may include the following:
 Coryza - runny nose.

 Dry hacking cough.

 Conjunctivitis - swollen eyelids, inflamed eyes.

 Watery eyes.

 Photophobia - sensitivity to light.

 Sneezing.

 Fever - this may be mild to severe and can reach 40.6 degrees Centigrade for a
number of days. Fever may drop and then rise again when the rash appears.
 Koplik's spots - very small grayish-white spots with bluish-white centers in the mouth,
insides of cheeks, and throat.
 Generalized body aches.

 Rash - 3 to 4 days after initial symptoms, a reddish-brown spotty rash appears. The
rash can last for over a week. It usually starts behind the ears and spreads all over the
head and neck. After a couple of days, it spreads to the rest of the body, including the
legs. As the little spots grow, many of them will join together.

Although the majority of childhood rashes are not measles, a child should be taken to
the doctors if:

 A parent suspects it could be measles

 Symptoms do not improve, or get worse

 The fever rises to above 38 degrees Centigrade

 When other symptoms have resolved except for fever

Cause of measles
Measles is caused by infection with the rubeola virus. The virus lives in the mucus of the
nose and throat of an infected child or adult. The infected person is contagious for 4
days before the rash appears and continues so for about 4-5 days afterward.

Infection can arise through:

 Physical contact with an infected person

 Being nearby infected people if they cough or sneeze

 Touching a surface that has infected droplets of mucus (the virus remains active for
2 hours) and then putting fingers into the mouth, or rubbing the nose or eyes
How does a measles infection develop?
As soon as the virus enters the body, it multiplies in the back of the throat, lungs, and
the lymphatic system. It later infects and replicates in the urinary tract, eyes, blood
vessels, and central nervous system.

Experts say it takes 1-3 weeks for the virus to establish itself. However, people show
symptoms 9-11 days after acquiring the infection.

A person who has had measles before does not become infected again; cases of re-
infection are very rare. However, anyone who has never been infected or vaccinated
that breathes in infected droplets or is in close physical contact with an infected person
is likely to become ill.
Approximately 90 percent of people who are not immune will develop measles if they
share a house with an infected person.

Diagnosing measles
A doctor will be able to diagnose measles fairly easily if the signs and symptoms are
present. A blood test will confirm the presence of the rubeola virus.

In most countries, measles is a notifiable disease. This means that doctors have to
notify the authorities of any suspected cases. If the patient is a child, the doctor will also
notify the school.

A child with measles should not return to school until at least 5 days after the rash has
appeared.

Treatments for measles

There is no specific measles treatment. If there are no complications, the doctor will
recommend plenty of rest and normal measures to control the fever and
prevent dehydration (drink fluids). Symptoms will usually go away within 7-10 days.

If a child has measles, the following measures may help:

 Fever - if the temperature is high, the child should be kept cool, but not too cold.
Tylenol (paracetamol, acetaminophen) or ibuprofen are effective in controlling fever, as
well as aches and pain. Children under 16 should not be given aspirin. Check with a
doctor about acetaminophen dosage - too much can harm the child, especially the liver.
 Smoking - do not smoke near the child.
 Photophobia - as the child may be sensitive to light, keeping the lights dim or the
room darkened may help. Sunglasses may also help.
 Conjunctivitis - if there is crustiness around the eyes, gently clean with a warm,
damp cloth.
 Cough - cough medicines will not relieve the cough. Humidifiers or placing a bowl of
water in the room may help. If the child is over 12, a glass of warm water with a teaspoon
of lemon juice and two teaspoons of honey may help. Do not give honey to infants.
 Dehydration - make sure the child is hydrated. If the child has a fever, they can
become dehydrated more quickly. Encourage the child to drink plenty of fluids.
 Isolation - during the contagious stage, infected children should be kept away from
school and should not return to activities that involve human interaction. Non-immunized
people who have never had measles should be kept out of the house.
 Vitamin A supplements - studies have shown that vitamin A supplements
significantly help prevent complications caused by measles. Supplements are
recommended for children with vitamin A deficiency and children under the age of 2 who
have severe measles. Vitamin A deficiency is virtually non-existent in developed
countries, but fairly common in much of the developing world.

As measles is caused by a virus, antibiotics will not have any effect on it. However,

antibiotics may sometimes be prescribed for any additional bacterial infections that
develop.

Complications of measles

Vomiting is a common complication of measles.

Complications from measles are fairly common and are more likely to be worse for
patients who have weak immune systems, such as those with HIV/AIDS or leukemia,
those with vitamin deficiency, and very young children.

Adults over the age of 20 are more likely to have complications than healthy children
over the age of 5.
Complications can include:

 Diarrhea.
 Vomiting.

 Eye infection.

 Laryngitis and bronchitis - laryngitis is inflammation of the voice box;

bronchitis is inflammation of the inner walls of airways. About 4 percent of people with
measles have difficulties breathing.
 Otitis media - inner ear infection and inflammation.

 Febrile seizure - Occurs in 1 in 200 cases. They may be alarming, but children
usually make a full recovery.

 Pneumonia - patients with a weakened immune system who develop measles are
vulnerable to developing bacterial pneumonia (Streptococcus pneumoniae), which can
be fatal if not treated.

The following less common complications are also possible:

 Hepatitis - liver complications in childhood measles are rare and temporary.

However, it can be severe in children receiving hepatotoxic drugs (medications which
may be toxic to the liver). Acetaminophen (Tylenol, paracetamol) can harm the liver if the
dose is too high.

 Encephalitis - approximately 1 in every 1,000 patients with measles

develops encephalitis. This is an inflammation of the brain which can cause vomiting and
convulsions. Coma and even death is possible but rare. Encephalitis may occur soon
after measles, or several years later.
 Thrombocytopenia - low platelet count. The blood's ability to clot is affected. The
patient may bruise easily.

 Squint - eye nerves and eye muscles may be affected.

The complications listed below are very rare, but possible:

 Neuritis - infection of the optic nerve, which can lead to blindness.

 Heart complications.

 Subacute sclerosing panencephalitis (SSPE) - Occurs in 2 in every 100,000 cases.

SSPE is a brain disease which can occur months or years after measles infection and
causes convulsions, motor abnormalities, mental retardation, and death.
 Other nervous system complications - toxic encephalopathy, retrobulbar neuritis,
transverse myelitis, and ascending myelitis.

Pregnancy
Measles during pregnancy can cause miscarriage, premature labor, or low birth
weights. If an individual is planning on getting pregnant and has not been vaccinated
against measles, they should speak with their doctor.

Prevention of measles
People who have already had measles are immune and will not get it again - cases of
re-infection are extremely rare. Experts say that, if you were born or living in the United
States before 1957, you will be immune.

For people who are not immune, there is the measles vaccine.

Measles vaccination
The World Health Organization (WHO) says that nearly 600 million children received the
measles vaccine between 2000 and 2007, resulting in a 74 percent drop in global
deaths caused by measles - and a drop of about 90 percent in the eastern
Mediterranean and Africa regions. 

Autism concerns and the MMR vaccine

In many countries, concern grew about an alleged link between the MMR vaccine
and autism risk - caused by mercury (thimerosal) in the vaccines. Several extensive
studies from North America, United Kingdom, France, Germany, Scandinavia, and
Japan have found no evidence of a link. Scientists and virtually all doctors believe the
risk does not exist - this includes hundreds of thousands of scientists and doctors
worldwide who have no vested interest in the outcome of those studies.
When should children be vaccinated?
Children should receive the MMR (Mumps, Measles, Rubella) vaccine when they are
between 12 and 15 months of age, and then again (a booster) before entering school
when they are 4-6 years old. Babies carry their mother's immunity for a few months after
birth if their mothers are immune.

Sometimes babies require vaccination before they are 12 months old. This may happen
if there is a serious outbreak in their area, or if they are going to travel to an area with a
serious outbreak. In such cases, they can receive the vaccination from the age of 6
months and will need a booster when they are 12 months old.

Adults do not require a vaccine in the U.S. if:

 They were born before 1957 in the U.S., or lived there before 1957

 Received two MMR shots after they were 12 months old

 Had one MMR vaccine plus a second dose of measles vaccine

 Are found to be immune to measles, mumps, and rubella after a blood test

The vaccine should not be taken by:

 Pregnant women

 Women who plan to become pregnant very soon (check with a doctor)

 People who are seriously allergic to gelatin or neomycin (antibiotic)

Anybody who has a condition or disease that affects their immune system, as well as
people receiving treatment which weakens their immune system should ask their doctor
whether they should receive the vaccine.