Measles: Understanding the causes and treatment

Measles is an highly infectious illness caused by the Rubeola virus.

If measles however invade an environment where people have never been exposed, the effect can be catastrophic.

Vaccination stops many measles outbreaks from happening around the world. The World Health Organization (WHO) reports that 2.6 million people die each year from measles who did not receive the vaccine.

Important facts about measles

  • Measles is a highly infectious condition
  • Scientists have identified 21 strains of the measles virus
  • Symptoms of measles can include watery eyes, sneezing, and a dry hacking cough
  • There is no specific treatment for measles. Prevention is better than cure
  • Pregnant women should not take the vaccine

What is measles?

Measles is a infectious disease which can easily spread.

Also known as rubeola or morbilli, measles is an infectious disease, meaning it is continuously present in a community, and resistance grows in many people.

It is an uncomfortable condition but one that usually goes around within 7 to 10 days without treatment.

An individual gains immunity for the rest of their life, after a bout of measles. A second time they would rather unlikely contract measles.

Symptoms

A child suffering from measles
Measles is often noticed through a breakout of spots.

The symptoms of measles always include fever and at least one of the three Cs:

  • cough
  • coryza, or runny nose
  • conjunctivitis

Symptoms will appear about 9 to 11 days after initial infection.

Symptoms may include:

  • runny nose
  • dry hacking cough
  • conjunctivitis, or swollen eyelids and inflamed eyes
  • watery eyes
  • photophobia, or sensitivity to light
  • sneezing
  • a reddish-brown rash
  • Koplik’s spots, or very small grayish-white spots with bluish-white centers in the mouth, insides of cheeks, and throat
  • generalized body aches

Fever often happens. This can range from moderately extreme to 40.6 degrees Centigrade. It may last many days, and when the rash occurs, it can fall, and then rise again.

Following initial signs the reddish-brown rash occurs around 3 to 4 days. This may last for more than a week.

The rash normally starts behind the ears and spreads over head and neck. It extends out to the rest of the body after a few days including the legs. They often join in as the spots expand.

Most rashes in childhood are not measles but a child will see a doctor if:

  • a parent suspects the child may have measles
  • symptoms do not improve, or they get worse
  • the fever rises to above 38º Centigrade (ºC) or 100.4º Fahrenheit (ºF)
  • other symptoms resolve, but the fever persists

Complications

A child receiving Measles vaccination
The measles vaccine is widely available and is said to have dropped global rates of measles by over 75 percent.

Complications are relatively common from measles. Some people can be dangerous.

Patients with a poor immune system, such as those with HIV, AIDS, leukemia, or a vitamin deficiency, very young children, and adults over the age of 20 are the most at risk.

Older adults are more likely to encounter problems than stable children over age 5.

Complications can include:

  • diarrhea
  • vomiting
  • eye infection
  • respiratory tract infections, such as laryngitis and bronchitis
  • difficulty breathing
  • ear infections, which can lead to permanent hearing loss
  • febrile seizures

Patients with a weakened immune system that have measles are more vulnerable to bacterial pneumonia. This can be fatal if not treated.

As well as the following less common complications:

  • Hepatitis: Liver complications can occur in adults and in children who are taking some medications.
  • Encephalitis: This affects around 1 in every 1,000 patients with measles. It is an inflammation of the brain that can sometimes be fatal. It may occur soon after measles, or several years later.
  • Thrombocytopenia, or low platelet count, affects the blood’s ability to clot. The patient may bruise easily.
  • Squint: Eye nerves and eye muscles may be affected.

Complications that are very rare but possible include:

  • Neuritis, an infection of the optic nerve that can lead to vision loss
  • Heart complications
  • Subacute sclerosing panencephalitis (SSPE): A brain disease that can affect 2 in every 100,000 people, months or years after measles infection. Convulsions, motor abnormalities, cognitive issues, and death can occur.
  • Other nervous system complications include toxic encephalopathy, retrobulbar neuritis, transverse myelitis, and ascending myelitis.

Pregnancy

Measles can lead to miscarriage, early delivery or a low birth weight during pregnancy. A woman intending to become pregnant and not being vaccinated will seek advice from her doctor.

Types

There are two types of measles:

  • Measles: This is the standard form caused by the rubeola virus.
  • Rubella, or German measles: This is caused by the rubella virus.

Rubella is usually viewed as mild but presents greater risk to unborn babies than to young children if a woman contracts the virus while pregnant.

As normal measles it is neither as contagious, nor as serious.

The vaccination against measles, mumps, and rubella (MMR) includes all forms of immunizations.

Causes

Measles is caused by Rubeola Virus infection. The virus resides inside the mucus of an infected child or adult’s nose and mouth.

The disease is contagious for 4 days until the rash occurs, and it remains infectious for about 4 to 5 days afterwards.

Infection spreads through:

  • physical contact with an infected person
  • being near infected people if they cough or sneeze
  • touching a surface that has infected droplets of mucus and then putting fingers into the mouth, or rubbing the nose or eyes

The virus remains active on an object for 2 hours.

How does a measles infection develop?

It multiplies in the back of the throat, the lungs and the lymphatic system as soon as the virus enters the body. In the urinary tract, skin, blood vessels, and central nervous system it later infects and replicates.

It takes 1 to 3 weeks for the virus to develop itself, but signs begin within 9 to 11 days of initial infection.

Whether they breathe in infectious droplets or are in direct physical contact with an infected person, someone who has never been contaminated or vaccinated is likely to become sick.

Approximately 90 percent of non-immune individuals can experience measles if they share a home with an infected person.

Treatment

Measles gives people a fever.
Measles gives people a fever.

There is no medication related to that. If no problems occur, the doctor will prescribe rest and plenty of fluids to prevent dehydration.

Symptoms usually go away within seven to ten days.

Will aid with the following measures:

The following measures may help:

  • If the child’s temperature is high, they should be kept cool, but not too cold. Tylenol or ibuprofen can help control fever, aches, and pains. Children under 16 years should not take aspirin. A doctor will advise about acetaminophen dosage, as too much can harm the child, especially the liver.
  • People should avoid smoking near the child.
  • Sunglasses, keeping the lights dim or the room darkened may enhance comfort levels, as measles increases sensitivity to light.
  • If there is crustiness around the eyes, gently clean with a warm, damp cloth.
  • Cough medicines will not relieve a measles cough. Humidifiers or placing a bowl of water in the room may help. If the child is over 12 months, a glass of warm water with a teaspoon of lemon juice and two teaspoons of honey may help. Do not give honey to infants.
  • A fever can lead to dehydration, so the child should drink plenty of fluids.
  • A child who is in the contagious stage should stay away from school and avoid close contact with others, especially those who are not immunized or have never had measles.
  • Those with a vitamin A deficiency and children under 2 years who have measles may benefit from vitamin A supplements. These can help prevent complications, but they should only be taken with a doctor’s agreement. If you want to buy vitamin A supplements.

Antibiotics do not help with the measles virus, but they can also be prescribed if there is an underlying bacterial infection.

Diagnosis

A doctor can usually diagnose measles by looking at the symptoms and signs. A blood test indicates that the rubeola virus is present.

The measles is a notifiable illness in most countries. The doctor will inform the authorities of any suspected cases. If the patient is a child the doctor must inform the school as well.

Not until at least 5 days after the rash occurs should a child with measles return to school.

Prevention

People who have already had measles are generally resistant, so it is unlikely they will get it again.

People who are not immune should take measles vaccine into consideration.

Measles vaccination

In the United States, the vaccine for measles, mumps, and rubella (MMR) is regularly administered at age 12 to 15 months, followed by a booster shot before starting kindergarten at age 4 to 6.

Newborns bear their mother’s immunity for a few months after birth if their mothers are healthy, but often before the age of 12 months and as early as 6 months the vaccine is recommended.

This can happen if in an area where there is a significant epidemic they are, or are likely to be, in.

The WHO reports that measles vaccination campaigns resulted in a global decline of 79 percent in measles deaths from 2000 to 2015, avoiding about 20.3 million deaths.

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

  • were born or lived in the U.S. before 1957 in the U.S., unless they work in a healthcare setting and have no evidence of immunity
  • 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:

  • women who are pregnant or plan to become pregnant soon
  • people with a serious allergy to gelatin or neomycin, an antibiotic

Anyone whose immune system may be weakened by a disease or a restrictive treatment may ask their doctor whether they will receive the vaccine.

An possible correlation between the MMR vaccine has been worried about a risk of autism but scientists have found no proof of a connection.

The CDC points out that 90 percent of fatal cases were among people with no history of vaccination during an epidemic of measles in the United States between 1989 and 1991.

They say:

“The most important cause of the measles resurgence of 1989-1991 was low vaccination coverage.”

The CDC urges people to vaccinate their children, to prevent the spread of measles and the possibility of an outbreak.The CDC encourage people to have their children vaccinated, to prevent the spread of measles and the risk of an outbreak.

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