Healthy Line: Measles Symptoms, Complications, and Prevention

 

Measles: A Comprehensive Overview of Causes, Symptoms, Complications, and Prevention

 

Introduction

Measles is a highly spreadable disease called rubeola that is mostly seen in kids, but unvaccinated individuals of all ages can get it too. Even though a vaccine exists, measles is still a big health concern in areas where not many people get vaccinated. The virus that causes measles is part of the Paramyxoviridae family and is spread when people breathe in infected droplets.

Here, we look closely at measles, discussing its origins, spread, symptoms, complications, methods of diagnosing it, treatment options and ways to stop it from spreading.

 

1. Etiology and Transmission

1.1 The Measles Virus

The measles virus is an RNA virus from the genus Morbillivirus. It spreads very easily, since R₀ is estimated at 12-18 which means each one infected might spread it to 12 to 18 people who have not had the virus yet.

1.2 Modes of Transmission

Measles is spread by:

·        Droplets that are airborne when someone coughs or sneezes

·        Infection can happen when nose or throat secretions from an infected person touch your mouth or nose.

·        If you touch anything infected, the virus may still be active for up to two hours.

Someone who has chickenpox can infect others from four days before they show the rash for up to four days afterward.

 

2. Clinical Presentation and Stages of Measles

Each part of the illness called measles is marked by its own set of symptoms.

2.1 Incubation Period (10-14 days)

After a person is infected, the virus takes 10-14 days to develop symptoms. The virus starts to multiply in your lungs and then infects nearby lymphoid tissues.

2.2 Prodromal Phase (2-4 days before rash)

At first, the symptoms look like those of a major cold.

·        Fever that is as high as 104°F (40°C)

·        Cough

·        A runny nose (coryza)

·        Conjunctivitis is when the eyes become red and watery.

·        Koplik’s spots (small, white spots with blue centers on the inner cheeks) are a sure sign of measles.

2.3 Rash Phase (3-5 days after initial symptoms)

A maculopapular rash is first noticed on the face (hairline and behind the ears) and then spreads to the trunk, arms and legs. The skin lesions are flat and red and they can join as they become larger. During this time, the person usually has their highest fever.

2.4 Recovery Phase (7-10 days after rash onset)

Symptoms get better gradually and the rash disappears the same way it appeared, often leaving behind a little brown discoloration and slight peeling.

 

Read also: Global Polio Eradication Initiative (GPEI)

3. Complications of Measles

Most people get better from measles, but it can cause serious health problems in:

·        Youngsters under the age of 5

·        People who are 20 years old or older

·        Pregnant women

·        Immunocompromised individuals

·        Patients with a lack of vitamin A

 

3.1 Common Complications

·        Diarrhea and vomiting (that can cause dehydration)

·        Otitis media is an ear infection that sometimes results in hearing loss.

·        Laryngotracheobronchitis (croup).

·        Measles infections are most likely to result in death because of pneumonia.

3.2 Severe and Life-Threatening Complications

·        One percent of encephalitis cases (1 in 1,000) end in death (15%).

·        Subacute sclerosing panencephalitis (SSPE) – a rare disease of the brain that develops 7-10 years following an infection.

·        In people with weakened immune systems, giant cell pneumonia can cause serious trouble breathing.

·        When pregnant women have miscarriages or preterm births

 

4. Diagnosis of Measles

4.1 Clinical Diagnosis

A healthcare worker may use the following to diagnose measles:

·        Fever, rash, cough, coryza and conjunctivitis are typical symptoms.

·        If the fever is present then Kolpik’s spots may also be present.

·        Whether the person had contact with a measles patient recently or traveled recently to places where the disease is common.

4.2 Laboratory Confirmation

·        This test (IgM antibody test) checks for a specific form of antibody related to measles.

·        RT-PCR tests for viral RNA in samples from the throat/nose, urine or blood.

·        Because viral culture grows slowly, it is less frequent.

 

5. Treatment and Management

There are currently no medications that treat measles infection. Managing this disease is about caring for the patient and stopping complications.

5.1 Supportive Measures

·        Fluids through either oral rehydration or IV (if that’s required)

·        You should give your child acetaminophen or ibuprofen to bring down the fever.

·        Taking vitamin, A (helps fight severe disease and reduces deaths, mainly in people with little vitamin A)

o   Dosage:

§  Infants under 6 months should receive 50,000 IU.

§  Children aged 6 to 11 months should get 100,000 IU.

§  Your child or adult should take 200,000 IU of vitamin D a day.

5.2 Antibiotics (if secondary bacterial infection occurs)

·        Amoxicillin is often given for pneumonia or otitis media infections.

5.3 Hospitalization (for severe cases)

·        Must be used for patients with encephalitis, severe dehydration or respiratory distress.

 

6. Prevention: Vaccination and Public Health Measures

6.1 Measles Vaccine (MMR or MMRV)

Taking two doses of the MMR vaccine is 97% likely to protect children from infection. Some countries give the MMRV shot for measles, mumps, rubella and varicella.

·        The first time you give the vaccine is when your child is 12 to 15 months old.

·        After the first dose, the second one should be given 4-6 years later (or at least 28 days after the first).

6.2 Post-Exposure Prophylaxis

·        Getting vaccinated within 72 hours after exposure can help avoid or lessen the chance of disease.

·        For high-risk peoples (infants, pregnant women, immunocompromised patients), IG should be given within 6 days.

6.3 Herd Immunity and Global Eradication Efforts

·        Herd immunity threshold requires about 95% of the population to get vaccinated.

·        The WHO is striving for global measles elimination, but outbreaks keep happening for several reasons.

o   Vaccine hesitancy

o   Healthcare systems that lack strength

o   Areas where vaccination is disrupted

 

7. Measles Outbreaks and Current Epidemiology

Even after being declared gone in the U.S. in 2000, outbreaks of malaria are still possible.

·        Cases brought into the country from abroad

·        People who do not get vaccinated such as religious or anti-vaccine groups

7.1 Recent Outbreaks

·        In 2019, there were 869,000 cases globally which was the most since 1996.

·        This year in the U.S., there have been clusters of unvaccinated children infected in Ohio, Minnesota and New York.

7.2 Global Burden

·        Before vaccination was available, measles killed an average of 2.6 million people per year.

·        During 2022, most malaria deaths took place in low-income countries, adding up to about 136,000 deaths.

 

8. Myths and Misconceptions About Measles

8.1 Measles is just a mild childhood illness.

·        Reality: This condition can end in complications that may be dangerous or even deadly.

8.2 The MMR vaccine causes autism.

·        In reality, lots of big studies (including CDC and WHO) have shown that the myth about MMR and autism started with a fraudulent 1998 study by Andrew Wakefield.

8.3 Natural infection is better than vaccination.

·        Reality: Getting sick from measles is dangerous, but vaccination keeps you safe.

 

9. Conclusion

Vaccination can prevent people from getting measles which is still a dangerous disease. Of all solutions, vaccination is the best way to stop the spread, reduce symptoms and save lives. The main goal of public health should be:

·        Reaching more people around the world with vaccines

·        Combating misinformation

·        Increasing the ability of countries to deal with outbreaks

If countries remain alert and vaccinate most people, measles could be eliminated everywhere, saving many lives.

 

References

·        The World Health Organization (WHO) has Measles Fact Sheets.

·        CDC Measles Guidelines

·        Lancet – Research on Measles Epidemiology

·        Journal of Infectious Diseases – Measles and How to Treat Its Complications