Measles, also called rubeola, is largely a preventable disease but unfortunately, it still occurs in several countries. Widespread vaccination has prevented large outbreaks but the reluctance of some individuals to have their children vaccinated is believed to be the cause of recent outbreaks, of measles in several countries.
What is measles?
Measles is a highly infectious viral illness that can be very unpleasant and sometimes leads to serious complications. In the past few years there has only been a few cases of measles in Anguilla, mainly because of the effectiveness of vaccination programmes on the island.
Anyone can get measles if he/she has not been vaccinated or have not had it before, although it is most common in young children.
Measles is a highly contagious illness caused by a virus that replicates in the nose and throat of an infected child or adult. Then, when someone with measles coughs, sneezes or talks, infected droplets spray into the air where other people can inhale them.
The infected droplets may also land on a surface where they remain active and contagious for several hours. You can contract the virus by putting your fingers in your mouth or nose, or rubbing your eyes after touching the infected surface.
About 90 percent of susceptible people who are exposed to someone with the virus will be infected.
What are some symptoms of measles?
Measles signs and symptoms appear around 10 to 14 days after exposure to the virus. Signs and symptoms of measles typically include the following:
• Fever
• Dry cough
• Runny nose
• Sore throat
• Inflamed eyes (conjunctivitis)
• Tiny white spots with bluish-white centers on a red background found inside the mouth on the inner lining of the cheek — also called Koplik’s spots
• A skin rash made up of large, flat blotches that often flow into one another
Diagnosis
If you are your child has symptoms and signs suggestive of measles please seek medical advice. It is best to phone before you visit your doctor or clinic as they may need to make arrangements to reduce the risk of spreading the infection to others. An experienced and qualified doctor can usually diagnose measles based on the disease’s characteristic rash as well as a small, bluish-white spot on a bright red background — Koplik’s spot — on the inside lining of the cheek. If necessary, a blood test can confirm whether the symptoms are truly measles.
Treatment
There is no specific treatment for an established measles infection. However, some measures can be taken to protect vulnerable individuals who have been exposed to the virus. Various medications are used in the management of measles. Hospitalization might be required in some cases.
What are some complications of measles?
Measles can be a mild disease, but in some cases several complications can occur. Complications of measles may include:
• Ear infection. One of the most common complications of measles is a bacterial ear infection.
• Bronchitis, laryngitis or croup. Measles may lead to inflammation of your voice box (larynx) or inflammation of the inner walls that line the main air passageways of your lungs.
• Pneumonia. Pneumonia is a common complication of measles. People with compromised immune systems can develop an especially dangerous variety of pneumonia that is sometimes fatal.
• Encephalitis. About 1 in 1,000 people with measles develops a complication called encephalitis. Encephalitis may occur right after measles, or it might not occur until months later.
• Pregnancy problems. If you are pregnant, you need to take special care to avoid measles because the disease can cause preterm labor, low birth weight and maternal death.
Prevention
In a measles outbreak there are several things you can do to prevent measles infection. If someone in your household has measles, you should take these precautions to protect vulnerable family and friends:
• Isolation. Because measles is highly contagious from about four days before to four days after the rash breaks out, people with measles should not return to activities in which they interact with other people during this period.
It may also be necessary to keep nonimmunized people — siblings, for example — away from the infected person.
• Vaccinate. Be sure that anyone who is at risk of getting the measles, who has not been fully vaccinated receives the measles vaccined, as soon as possible.
Two doses of the vaccine are usually given for full protection.
Preventing new measles infections
If you have already had measles, your body has built up its immune system to fight the infection, and you cannot get measles again.
Islandwide vaccination of all at risk individuals is important to prevent measles outbreaks. This effect is called head immunity. Herd immunity can drop in any country if vaccination rates decline.
In 1998, a now-discredited study was published erroneously linking autism to the measles, mumps and rubella (MMR) vaccine. Several studies have confirmed the safety and effectiveness of the MMR vaccine. There is no link between MMR vaccine and autism.
Conclusion
Measles is a highly contagious viral illness, although mild in many cases, that can result in several complications, some of which can be life threatening. Vaccination has prevented many cases of measles in Anguilla, but with several individuals now refusing to be vaccinated the risk of a measles outbreak is high. Measles can be prevented by a vaccination. The measles vaccination is safe and effective. If you have any concerns about measles contact your healthcare provider.
Ask Your Dr is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG is an obstetrician/Gynaecologist and Family Doctor with over thirty-six years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5928).
