Measles – symptoms, transmission, and preventionArticle
27. 10. 2021
Measles is a highly contagious viral infection that spreads very easily, and puts small, unvaccinated children at the highest risk. Measles can have very serious health complications and can even be fatal, especially in paediatric patients. Although safe and effective vaccinations exist, large-scale epidemics still occur. In this article, you will learn what causes measles, what the symptoms are, how they are treated and why vaccination is the only meaningful prevention.
What exactly are measles?
Measles (Latin morbilli) is an extremely contagious infectious exanthema disease of viral origin. The specific causative agent is the very durable Morbillivirus, which comes from the Paramyxoviridae family (the origin of rubella and mumps) and is able to cause giant epidemics (see section Measles vaccination). The only natural host for this virus is humans, with measles most commonly affecting pre-school children during the change of seasons from winter to spring.
Symptoms and incubation period
The first signs of measles usually appear 10 to 14 days after infection, but the patient is infectious 2 to 4 days before a visible rash occurs and up to 5 days after its remission. Most (!) patients recover completely within 10 to 14 days and subsequently acquire lifelong immunity.
The symptoms of measles, which are essentially the same in children and adults, can be summarized as follows:
- The initial symptoms are similar to the common cold with a cough and mild fever
- small greyish-white spots on the inside of the cheeks
- sore, red eyes that may be sensitive to light
- a high temperature (fever) that can reach up to 41 ⁰C between the 3rd and 7th day,
- red rash lasting 4 to 7 days (first on the face, then all over the body).
How measles spread
The measles virus is contained in tiny water droplets that spread to the nearby surroundings when the patient coughs or sneezes. And such inconspicuous droplets can fly through the air even for several hours, hit various surfaces and stay there for up to 2 hours. As mentioned above, the infected person can transmit measles before and after the visible rash. Measles spread very efficiently among unvaccinated individuals - it is estimated that 1 infected person on average can transmit the disease to about 12 to 18 other people.
Treatment of measles
"There is no specific treatment for measles as of yet. Most patients recover with supportive care, such as hydration and antipyretics. As part of preventing the further spread of the disease, various quarantine measures are being introduced to prevent access to school or work for the infected, even those who have come into close contact with it, or are not vaccinated against measles, ”explains Dr. Petr Žáček, MBA, paediatrician and chief physician at Canadian Medical.
Because the disease is of viral origin, antibiotics are of no use in the treatment. However, they are sometimes used to treat complications of bacterial origin that sometimes accompany and complicate the course of measles, such as pneumonia or ear infections (see below).
Complications and risks of measles
Measles is therefore mostly dangerous because of the complications of bacterial origin associated with them. Measles is among the leading causes of death in children worldwide, especially in underdeveloped countries. The measles mortality rate is 1-3 people in 1,000 cases, with the highest risk groups being children under 5 and in immunocompromised people.
Complications can occur in 30% of infected children and adults. These include ear infection and diarrhoea. Other serious complications of measles are:
- Pneumonia - this complication is the most common cause of death, especially in small patients.
- Inflammation of the brain tissue (encephalitis) - occurs in about 1 in 1,000 cases. It is a serious condition that leads to permanent neurological damage in about 1 in 4 patients.
Subacute sclerosing panencephalitis (SSPE) - is a very rare complication of a prolonged measles virus infection. It is a disease in which nerves and brain tissue gradually degenerate and is more likely to occur with measles infections at a younger age. SSPE usually appears 7 to 10 years after measles. Symptoms include personality changes, gradual deterioration of mental status, muscle cramps, and other neuromuscular symptoms. There is no cure for this disease, and it always leads to death.
The only effective measure for measles is vaccination, which reduces the number of patients and deaths - even after the disease starts to spread. The problem, however, is that the number of immune people (i.e., successfully vaccinated or people who have had an illness) must be at least 95% to prevent new epidemics. Therefore, it is very important not to delay or refuse vaccinations in children, not least in terms of the potential complications and fatal consequences of this insidious disease.