Measles, symptoms and treatment

The measles It is not a disease out of date or from "another era". Measles is one of the main causes of infant death in the world. In countries that have been lucky enough to have a safe and effective vaccine, this disease has been prevented and made invisible. Anti-vaccine movements in developed countries and the lack of immunity of many children to this virus have been some of the causes of the resurgence of a disease that seemed from the past.

What is measles?

It is a very contagious and serious caused by a virus of the family of paramyxoviruses. It only affects humans and not animals. This virus infects the respiratory tract and, from there, it spreads to the rest of the body. It is characterized by a rash It begins on the face and spreads to the body and extremities. It is transmitted through contact with the patient's skin and the air, through respiratory secretions from sneezing and coughing. It mainly affects the kids, although adults can get it.

Symptoms

Has a period of incubation of about 14 days. The first sign of measles is high fever, which usually appears 10 or 12 days after exposure to the virus and usually lasts for about a week. At first, the child has symptoms of a respiratory infection: cough, runny nose (runny nose), red and watery eyes.

The most characteristic of measles that will allow us to differentiate it from a common cold are some white spots that appear on the oral mucosa, on the inside of the cheeks and are called Koplick's spots. It is very typical to also have muscle pain and discomfort when looking at the light (photophobia). About three days later, patches appear on the skin, a rash that begins on the face, neck and spreads to the entire body, including the palms of the hands and soles of the feet. After five or six days the rash disappears, leaving a slight peeling of the skin. The person who passes the measles becomes per vine immunea, that is, it does not become infected again or develop the disease.

Treatment

There is no specific treatment to eliminate the measles virus. The treatment offered to the patient is symptomatic, such as medicines to lower fever. Hygiene and support measures such as washing the eyes with physiological saline and leaving the child at rest with dim light that does not bother him, can improve the well-being of the patient.

Serious complications of measles can be avoided with supportive treatment that ensures good nutrition, adequate fluid intake, and treatment for dehydration.

and otitis are treated with antibiotics.

All children diagnosed with measles should receive two dosage of vitamin A supplements with an interval of 24 hours between the two, even in supposedly well-nourished children. This treatment appears to protect and prevent eye injury and blindness and can reduce measles mortality by up to 50%.

Why does it produce so many deaths?

Most of the deaths are due to complications in children under the age of five and over 30. The virus and infection affect other parts of the body, less or more seriously causing:

• Blindness
• Severe diarrhea - In countries with poor health care, it can lead to dehydration and death.
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• Severe pneumonia: infection of the lung.
• Encephalitis: infection of the central nervous system that is accompanied by a very important inflammation of the brain. One of the most serious late (apart from death) and disabling sequelae of nervous system involvement is subacute sclerosing panencephalitis.
• Mortality is higher in children with malnutrition, vitamin A deficiency or an immunodeficiency (alteration of the immune system).
• Complications can also be very serious in pregnant women and can be the cause of abortion or premature delivery.

Subacute Sclerosing Panencephalitis: The Bitter Side of Measles

The subacute sclerosing panencephalitis (PEES) is a rare and fatal disease that progressively affects the central nervous system. This caused by measles virus infection. In countries where vaccination is not available to everyone, this degenerative disease is relatively common.

It develops months or years after the measles episode and causes mental deterioration progressive (developing blindness, dysphagia, or difficulty swallowing) seizures and eventually the death of the child in one to three years after its inception. Its incidence is between 7 to 300 cases per million infected, being more frequent in men. In countries where the vaccine is applied massively, it is an almost unknown entity. We do not have any drug to cure it.

Who is most at risk of getting infected?

Unvaccinated Babies and Pregnant Women they are those most at risk of becoming infected and developing severe forms of the disease. Obviously, the risk is for any unvaccinated individual. Living in a country with a poor health system makes its population very vulnerable. The 95% of deaths measles occur in poor countries.

The role of vaccination

In 2016, 89,780 people died from measles worldwide, most of them children under the age of five. Despite this high figure, it was the first time that the number of deaths from measles fell below 100,000 deaths per year.

Measles has reduced global mortality from this disease by 84% between 2000 and 2016, from 550,100 to 89,780 in just under two decades.

In 2016, approximately 85% of the world's child population received a dose of measles vaccine through regular health services before reaching one year of age. In 2000, that percentage was 72%.

Between 2000 and 2016, the measles vaccine prevented 20.4 million deaths, making this vaccine one of the best investments in public health.

Before the measles vaccine was introduced in 1963, large measles epidemics occurred every two to three years, causing up to 2.6 million deaths per year.

The measles vaccine: the best strategy for its prevention

Mass immunization, that is, the application of the vaccine to all children within the vaccination calendar of the countries, is the best strategy for their vaccination. It is a very safe vaccine, applied for more than 50 years, effective and cheap (vaccinating a child against measles costs less than 1 euro).

What happens when families do not want to vaccinate?

Lack of contact with a disease and false beliefs on the side effects of vaccines have led many families to stop vaccinating their children. Measles was, practically, a disease unknown to the West, neither patients saw nor children sick with measles nor the misfortune of deaths from it. The systematic vaccination of the population was one of the causes that caused this idyllic situation.

Anti-vaccine movements have left many children without vaccination coverage in a world where the measles virus is present. In 2017, multiple cases of measles have been reported in almost all the countries of the European Union (given the serious complications and its high contagiousness, it is a disease that must be reported to the health authorities, so its incidence is recorded every year) , increasing its incidence in Europe by 400%. Of the 21,315 cases reported, 35 died. Obviously, none of these cases were vaccinated.

In countries like ours, suffering from measles should be something almost anecdotal (except for people from disadvantaged countries who arrive with the infection due to the lack of vaccination in their countries of origin).

It is also true that during the years in which excellent vaccination coverage was achieved, the measles virus stopped circulating on the continent, but at the same time the natural immunity acquired by being in contact with the disease decreased. Right now measles virus is contagious again and it becomes a threat in the heart of Europe.

• The most characteristic of measles that allows it to be differentiated from a cold are white spots on the oral mucosa and on the inside of the cheeks (Koplick spots).
• Mass immunization, that is, the application of the vaccine to all children within the vaccination calendar of the countries, it is the best strategy for their eradication.
• There is no specific treatment to eliminate the virus, but it is symptomatic. Serious complications can be avoided with a supportive treatment that guarantees good nutrition and hydration.

Pediatric Specialist