Measles (rubeola)

By Kemboi Kibet, MU-SOM class of 2014

Measles also known as rubeola is a highly infectious childhood disease caused by a virus. Measles can be very fatal but its incidence has reduced drastically due to its vaccine. There has however been a sudden rise in measles occurrence because parents refuse to let their children to get the vaccine out of fear that the MMR vaccine which protects against measles, mumps, and rubella can cause autism. Studies have however shown no relation of the vaccine to autism. The disease is known to cause a rash and fever in children although sometimes occurs in adults too. Measles has no specific treatment plan because it is caused by a virus and the disease has to run its cause. Infected children should get plenty of fluids and enough rest.

There are two types of measles cause by two different virus.

Red measles, hard measles or measles is caused by the rubeola virus. This is what people refer to when they say measles. It can cause pneumonia and encephalitis although people can recover without any problems

Three day measles or German measles is caused the rubella virus. This is often milder than red measles although can serious birth defects when pregnant people get it and transfer it to unborn child.

CAUSES

The virus is spread through the respiratory route. When an infected person gets the disease and sneezes or talks, infected droplets get into the air and susceptible people get the virus by breathing it in. The virus can also land on a surface and infect it. You can then get the virus by touching your eyes, nose or mouth after touching the infected surface. Infected people can carry the virus in the mucus in their nose or throat for a while before becoming sick so they may spread the disease even without knowing they have it. People who have had an active measles infection and people who have been vaccinated against the virus have immunity towards it.

RISK FACTORS

Vitamin A deficient People who do not have enough vitamin A are more likely to get the disease

No vaccination Children who do not get vaccinated against the disease are susceptible to the virus

Susceptible individuals travelling to developing countries can easily catch the virus

SYMPTOMS

Symptoms of measles show 7 to 14 days after exposure. These include

fever
runny nose
dry cough
redness and irritation of eyes
full body rash
light sensitivity
sore throat
Koplik’s spots (tiny white spots inside the mouth

The measles rash typically starts from the forehead and then spread downward to the face ,neck , trunk, arms and lower limbs. It develops 2 to 4 days after infection. They may appear as appear as flat, discolored areas .Solid, red, raised areas that later join together.

The infection of measles is often sequential over a period of two to three weeks

The first seven to 14 days after you’re infected is the incubation and infected period. The measles virus incubates and there are no symptoms at this stage

Nonspecific signs and symptoms stage is when you get runny nose,inflamed eyes, cough and sore throat. This period last a couple of days.

Acute illness and rash stage is when the face and the rest of the body breaks out in rash. Fever may also set in.

The last stage is the Communicable period when infected people can spread the virus starting four days before the rash appears and ending when the rash has been present for four days.

TEST AND DIAGNOSIS

Doctors usually diagnose measles based on symptoms, patient’s history and physical exam alone. A blood test may be done to confirm the rash

TREATMENT

There is no specific way to treat measles however medication can be given to make patient comfortable

Pain relievers and fever reducer such as acetaminophen (Tylenol, Liquiprin Drops, and other brands) and ibuprofen (Advil, Motrin, others) or naproxen (Aleve). Dont give aspirin to children due to risk of Reye’s syndrome .

Lots of bed rest

Drinking plenty of fluids to prevent dehydration

Giving vitamin A to people who have low levels of the vitamin

Antibiotics to treat any secondary infections like pneumonia

Pregnant women, infants and people with weakened immune systems who are exposed to the virus may receive an injection of proteins called immune serum globulin. These may prevent the disease or if you get the disease, it will be mild.

Nonimmunized people, including infants, may be given the measles vaccination within 72 hours of exposure to the measles virus. This may protect them from the disease or they may get a milder form of measles

PREVENTION

The sure way to protect your child from measles it to get them vaccinated.

Infected people should be isolated to prevent others from getting the virus

COMPLICATONS

ear infection
pneumonia
pregnancy problems such as preterm labor or low birth weight
low platelet count
encephalitis
bronchitis

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