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Measles Not Just a Little Rash

Maria Chinky B. GUINGAB, Family Medicine Physician

Once thought to have been a thing of the past, measles has recently made a comeback. The trail of its return starts with an unvaccinated traveler visiting Shanghai, a city still widely affected by measles. Once done with their visit, the traveler continued on, but not alone. Accordingly, it has been reported that a number have been reported since late January, of this year (2016). For that reason, the Shanghai Disease Control and Prevention Center urges all parents to have their children vaccinated at their earliest convenience.

Measles defined

Measles is a highly contagious acute viral respiratory illness. It is characterized by high fever, cough, coryza or runny nose, and red watery eyes (conjunctivitis). Two or three days after symptoms begin, tiny white spots (Koplik spots) may appear inside the mouth. Three to five days after symptoms begin, a rash will break out. It usually begins as flat red spots that appear on the face, at the hairline, and spread downward to the neck, shoulders, arms, legs, and feet; small raised bumps may also appear on top of the flat red spots. The spots may become joined together as they spread from the head to the rest of the body. When the rash appears, a person’s fever may spike to more than 104° Fahrenheit or 40’ Celcius. After a few days, the fever subsides and the rash fades.

How is Measles transmitted?

Measles is a highly contagious virus that lives in the nose and throat mucus of an infected person. It can spread to others through coughing and sneezing. Infectious droplets from the respiratory secretions of a patient with measles can remain airborne for up to two hours. Therefore, the illness may be transmitted in public spaces, even in the absence of person-to-person contact. Measles transmission between airplane passengers in airports and during flight has been described, and large outbreaks can occur in areas of crowding such as schools and densely populated communities.

Infected people can spread measles to others from four days before through four days after the rash appears.

How is Measles treated?

For most people, there is no specific treatment. If you or your child is diagnosed, here are some care recommendations:

rest, drink plenty of fluids, and take acetaminophen or Paracetamol to help with fever and aches. Do not take aspirin. Doctors may give Vitamin A to some children with measles.

What are the complications?

Measles can be serious in all age groups; however, children younger than 5 years of age and adults older than 20 are more likely to suffer from measles complications.

Common complications include ear infections and diarrhea. Some people may suffer from severe complications, such as pneumonia (infection of the lungs) and encephalitis (swelling of the brain). They may need to be hospitalized due to the possibility of facing serious medical issues.

Measles may cause pregnant woman to give birth prematurely, or to have a low-birth-weight baby.

Can measles be prevented?

Yes, measles can be prevented, and quite easily. The MMR (measles, mumps, rubella) vaccine prevents infection. All children should get the MMR vaccine when they are 12 to 15 months old. Then they need a second shot when they are 4 to 6 years old. A child should have the second shot before he or she starts school. People need 2 doses of the MMR vaccine to protect against measles. Some babies and children need to get the vaccine earlier than usual, if they:

  • Live in an area where there is a measles outbreak
  • Need to travel to an area where there is a measles outbreak

Some older children and adults also need the MMR vaccine, such as:

  • Hospital or healthcare workers
  • Students who don’t have written proof of 2 shots

The MMR vaccine has a small amount of gelatin and an antibiotic. If you or your child have any allergies, or had a bad reaction to a vaccine, tell your doctor or nurse.

References: Vaccination is key to fighting measles by Cai Wenjun. February 17, 2016.