Measles
Measles is a common childhood infection and is highly contagious. It causes more than 20 million cases worldwide although the incidence of Measles in US has seen a steady decline due to immunisation drive. It is caused by a virus belonging to the group Paramyxovirus.
Measles or “Rubella” is most commonly characterised by a widespread reddish rash which starts from the forehead and gradually spreads across the body to trunk and finally the legs. A couple of days before the rash appears, the child may develop runny nose, cough, red eyes and fever. The fever can be high grade and may touch 104F at times. Other than this the child may become lethargic, may not like to feed or feeds difficultly. Another characteristic feature of measles is the “Koplik's Spots”. These are reddish spots over a blue base present inside the mouth.
Measles is commonly seen in school going children. This is because for the first 6 months the baby is protected by maternal antibodies transferred through the placenta. Then on the child is mostly inside the home and hence is not exposed to the virus. A child first gets exposed to the virus when he/she goes to school from other kids who may have measles.
Measles is an extremely contagious disease and almost 90% of unvaccinated individual living in the same house as the patient is likely to contact the infection. Measles is contagious for 1-2 days before onset of rash up to 4-5 days after the rash develops. It is spread by coughing, sneezing and by contact with respiratory secretions.
Although measles mostly resolves over a period of few days with not much harm, sometimes it can lead to a condition called as aseptic meningitis, a condition associated with irritation of the covering of the brain. A child with meningitis typically presents with incessant crying, headache, vomiting, altered sensorium and neck stiffness. In some rare cases measles may lead to deafness at a later stage.
There is no treatment to kill the virus; all treatment in measles is supportive. Children with measles should be isolated and not sent to school or public areas. They should be fed the normal diet and should be made to drink plenty of fluids. Fever can be controlled by tepid sponging and medicines like paracetamol. Aspirin should not be used in children for controlling fever. Other than this there is nothing much to do except wait for the disease to resolve spontaneously.
Since measles is contagious 2 days before onset of rash, the best way to prevent measles is by immunisation. Children are generally given the triple shot of MMR (Mumps, Measles and Rubella) at 18 months of age. It is not advisable to give this shot to children less than 12 months of age, but it can be given in times of epidemics.
The measles vaccine should not be administered to children with allergy to neomycin or gelatine. The commonest side effect associated with vaccine is a fever with flu like symptoms developing 6-10 days after the shot. It may sometimes be associated with measles like rash which is not contagious and fades away spontaneously in 2-3 days time.
Children with measles will do well with Vitamin A supplementation. It is advisable to administer 50,000 units of Vitamin A to children with Measles.
Measles which was once a common childhood disease, measles is now totally preventable by immunisation and every child should be administered a shot of measles vaccine as due.
