Measles hits the Moravian-Silesian region

As of April 2017, 62 cases of measles were detected in the Moravian-Silesian region. Medical staff members who came into contact with infected patients also contracted the disease. The regional hygiene authority ordered mandatory vaccination for selected medical personnel.  In those facilities where a greater number of doctors and nurses fell ill, entire departments had to be closed. A similar situation also occurred in 2014 in the Ústí nad Labem region where the disease was found to be reintroduced from India.

Symptoms of the disease and its complications

Measles (morbilli) is a viral disease caused by the morbillivirus. The incubation period is usually anywhere between 10 to 14 days. The disease begins with a fever and catarrhal symptoms (a runny nose, cough and watering eyes). The mouth and the mucous membranes of the cheeks start showing so-called Koplik’s spots (small white spots with red borders). On the fourth to fifth day, a red rash starts appearing. This usually appears on the neck and the face, then spreading to the trunk and limbs. Once the rash appears, the patient ceases to be infectious.

Complications associated with the disease can also include pneumonia, inflammation of the middle ear and nasal sinuses, usually caused by secondary bacterial infections. The most severe, often life-threatening complications include pneumonia and encephalitis which is caused by the measles virus itself. Further complications can include paralysis and disabilities of the senses or intellect. Acute appendicitis with rapid rupture and subsequent peritonitis (inflammation of the appendix which then spreads to the rest of the body) is a serious problem that can also occur.

History of vaccination: protecting ones health make sense

From 1969, regular measles vaccination became a part of the Czechoslovak vaccination schedule. Six years later, then single-dose vaccinations turned to dual-dose ones.  From 1982, this further expanded by including vaccination against rubella, only for girls aged 12. In the following years, the occurrence of rubella among small children, especially boys, continued increasing. As a result, from 1986, general vaccination of all children at the age of 2 became a reality. At the time, vaccination was done with single vaccine against rubella (the RA27/3 strain) supplied by various manufacturers (Rudovax, Ervevax).

In 1987, two years after an general mumps vaccine (Pavivac), single vaccine against measles (Movivac) was replaced with a combined vaccine against measles and mumps, called Mopavac. In Czechoslovakia, the dual-dose vaccination against measles and mumps in short 6-10 month intervals was selected as the preferred method of applicaiton. The main reason for this was to ensure quicker and more robust protection against both diseases in the children’s population. Both vaccines were known for good tolerance with a high safety profile as well as excellent effects on the elimination of both diseases.

As of 1995, a combined vaccination was applied nationally to vaccinate the population against measles, mumps and rubella (Trivivac). Until the year 2000, all women in their fertile years who were not yet protected were vaccinated using the monovalent rubella vaccine.  In 2006, yet another trivalent vaccine surfaced commercially. It was named Priorix (MMR). One year later, Priorix Tetra was introduced also adding protection against chickenpox (varicella).

How are vaccinations against measles currently carried out?

Canadian Medical Care provides vaccination using the Priorix vaccine (585 CZK). If an adult patient did not undergo the disease, was born prior to 1969 or has any doubts, we recommend visiting a general practitioner to prescribe antibody tests. If the results are negative, we then apply one dose of Priorix.

Children receive the first dose after 15 months of age and the second one 6-10 months following the first one. Due to a planned change in the national vaccination schedule, as is already the case in many European countries, there is now a possibility to apply the second dose at pre-school or early school age. Based on a recent decree issued by the Ministry of Health, one dose of Priorix applied before the age of 3 is sufficient to enroll in collective schooling.