Measles
DEFINITION:
A
viral illness associated with specific symptoms and a rash.
Also known as rubeola.
SYMPTOMS:
Cough, coryza (runny nose), and conjunctivitis (pink eye)
are the three C's of measles. These occur with a fever, then
Koplik spots. Koplik spots are grayish white dots surrounded
by redness in the mouth. If Koplik spots are seen then it
is definitely measles. The rash then occurs, which starts
behind the neck, goes over the head, down the face and down
the body. Fever to over 104 degrees can occur with this rash.
The rash is described as maculopapular, meaning large and
small red spots.
CAUSES:
A virus.
CONTAGION:
Measles is contagious throughout the course of the illness
by respiratory transmission. The incubation period is 10 to
14 days.
DIAGNOSIS:
Usually
made by the symptoms of the child. A blood test can be checked
to confirm the diagnosis, although this is rarely needed.
OUTCOME:
Usually good. There is a death rate of 1 to 2 for every 1,000
cases. Death is usually due to complications, such as pneumonia
or overwhelming bacterial superinfection. With vaccination
it is very unlikely that someone would contract measles.
TREATMENT
AND DISCUSSION:
Measles used to be a common occurrence in pediatrics before
the days of vaccination. Since vaccination, this disease has
become very rare. However, because of missed vaccines or some
people's objections to vaccination, this disease can still
be contracted. Vaccination is about 95% effective, and as
time progresses, the measles virus is being slowly eradicated.
In susceptible individuals, about 90% will contract the illness
if exposed. The illness is contracted by exposure to respiratory
droplets from an infected individual, such as from coughing
or sneezing. Measles then follows three stages: an incubation
stage, prodromal stage and maculopapular rash stage. The incubation
stage lasts about 14 days. The prodromal stage, which lasts
about 5 days, includes the three C's of measles. The rash
lasts about 7 to 10 days. There is no treatment for measles
since it is a virus. If there are no complications, the disease
will follow its natural course and disappear. If there are
complications, treatment can be started. Treatment can include
oxygen if pneumonia develops, or antibiotics if a bacterial
superinfection occurs. Encephalitis, or swelling of the brain,
can occur with measles. There is no specific treatment for
this.
Vitamin A has been found to help lessen complications in children
with measles and this can be given in a confirmed case. The
best treatment for measles is prevention through vaccination.
The MMR vaccine is given at 1 year of age and a booster dose
is given at 4 to 6 years of age, although the second dose
can be given at any time during childhood, as long as one
month has passed since the first vaccine. During an outbreak,
the measles vaccine can be given as early as at 6 months of
age. Measles immune globulin can be used to prevent contracting
the illness. It can be given up to 6 days after exposure for
susceptible children. This is usually used in children with
an immunosuppressive disease where the measles could be very
devastating. For children under 6 months old, nothing is needed,
since mother's immunity to measles protects the child from
birth to 6 months of age.
ONE DOCTOR'S OPINION:
Vaccinate, vaccinate, vaccinate. The only way to wipe this
virus off the face of the earth is to vaccinate. Medicine
eradicated small pox through vaccine, and it is getting very
close for measles. Since measles is a virus, there really
is no good treatment. Most children will survive, but some
won't. Outbreaks still occur and it always seems to be in
communities with a low vaccination rate. People don't fear
measles like they should and like they used to, because not
many people see it anymore due to proper vaccination. I think
some people unfoundedly fear vaccination more than they fear
the devastating illnesses that vaccines prevent. My advice?
Vaccinate.
