Measles/Rubeola is a disease caused by a virus that is acute in nature (occurs in a short time) and is highly contagious. References to the disease measles can be found as early as the 7th century. The disease was described by the Persian physician Rhazes in the 10th century as "a more feared disease than smallpox." 

 

IS MEASLES A SERIOUS DISEASE?

The answer is yes. Measles is still a common and often fatal disease in the developing world. The number of reported measles cases worldwide increased by 79 per cent in the first two months of 2022 compared to last year due to a decrease in immunization coverage (during the pandemic era). 

 

WHAT ARE THE SYMPTOMS OF A CHILD AFFECTED BY MEASLES?

After the incubation period of 11 to 12 days, the children will show the following symptoms:

High fever, 

redness in eyes (conjunctivitis), 

runny nose and cough 

Then it will be followed by a rash appearing 2-4 days after the fever arises (when the fever is still high)

A distinctive sign on examination is the presence of Koplik Spots, greyish-white patches with a red base on the inner cheeks.

Generally, children with measles will be weak and at risk of dehydration if fluid intake is inadequate. 

 

WHAT IS THE TYPE OF RASH IN MEASLES?

The measles rash is maculopapular (reddish and slightly arising, not filled with fluid), usually lasting 5 to 6 days. The rash appears initially on the hairline and then extends to the upper face and neck. Over the next 3 days, the rash gradually spreads to the body until it reaches the hands and feet. 

 

ARE ALL FEVERS AND RASHES DEFINITELY MEASLES?

Not necessarily, so there are a lot of differential diagnoses of measles. One of them is Exanthema Subitum (Sixth Disease). This is the milder form of the disease. The patient also has a fever and what distinguishes it from measles is that the rash arose when the fever improved. In addition, the child does not have redness in the eyes. This condition generally does not require special treatment because of self-limiting disease.

 

IS RUBELLA ALSO MEASLES?

Well, rubella or German measles (German measles) is also one of the differential diagnoses of measles. Generally, this disease mildly affects children or adults. However, this disease becomes very dangerous when suffered by pregnant women because it can cause the fetus to suffer from Congenital Rubella Syndrome (CRS), with symptoms as follows:

cataracts (turbidity of the lens of the eye), 

congenital heart disease, 

hearing loss, and 

developmental delays, including speech delays and intellectual disabilities.


 

HOW CONTAGIOUS IS MEASLES?

Measles is highly contagious, with a probability of transmission reaching >90% in children exposed to measles. Humans are the only reservoir (where the virus develops), so the disease is very likely to vanish. Nevertheless, measles is highly contagious, especially between 4 days before to 4 days after the rash first appears.

 

HOW IS IT TRANSMITTED?

Measles transmission occurs from individual to individual through respiratory droplets.

It may also transmit through airborne transmission in an enclosed area (e.g., air-conditioned room) up to 2 hours after a person infected with measles is in the area.

 

HOW DO YOU PREVENT CHILDREN FROM SUFFERING FROM MEASLES?

The only prevention is by giving vaccinations. There are currently 3 types of combined vaccinations containing attenuated measles virus, which can be seen in the following table:

 

Vaccine

Ingredients / Compotitions

MR

Measles, Rubella

MMR

Mumps, Measles, Rubella

MMRV

Mumps, Measles, Rubella, Varicella

 

The schedule of administration is as follows:

At the age of 9 months, children are given the MR vaccine. Still, if up to the age of 12 months, they have never received the MR vaccine, they can immediately be given the MMR vaccine. 

If the child is already 18 months old, you can give another dose of MR or MMR.

The third dose of vaccine is again given when the child is 5-7 years old (in elementary school, in the BIAN program)

The effectiveness of these three measles vaccines is very high, reaching up to 95% in the first dose and 99% after the second dose.

 

WHAT TO DO IF A CHILD HAS MEASLES?

Suppose the child shows symptoms leading to measles. In that case, parents should immediately take the child to a paediatrician/other health services to get the proper treatment. Suppose the doctor has confirmed that the child has measles. In that case, the child should be isolated (not invited out) for approximately 14 days and be given medication according to the condition.

To maintain optimal children's immune systems, always provide adequate and balanced nutrition, get enough rest, and wash their hands after going outside. Avoid taking children to public places when it is not urgent. And remember to always check the vaccination record, so the child gets the vaccine on schedule.  

Suppose you have any questions regarding your child's vaccination status. In that case, we at Kenak Medika General Hospital team are always ready to meet your need. 

 

Reference:

  • Measles cases are spiking globally | UNICEF. https://www.unicef.org/stories/measles-cases-spiking-globally
  • Guidance on the investigation, diagnosis and management of viral .... https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1116128/viral-rash-in-pregnancy-guidance.pdf