Measles have an incubation period of six to nineteen days, but the usual number is set at two weeks. The disease is very infectious. A sick person is infectious about seven days before the rash occurs and for a further five days after its occurrence. Although most people connect the disease primarily with the rash, measles have other typical symptoms. The disease spreads through droplet contact transmission and survives for up to 36 hours outside of the organism.
First of all, slight increases in body temperature or a fever occur. This is accompanied by a dry cough, a cold, conjunctivitis and also involves increased sensitivity to light. In three to five days, the typical red and red-brown rash (often graduated) occurs. Within two days, this rash spreads from the face to the torso and the limbs, while temperature normalizes as the rash spreads. Therefore, if your child has a sudden rash without symptoms similar to a cold or a cough, it will most likely not be measles. The exact diagnosis has to be established by a doctor however. A similar rash could be a mere allergic reaction or scarlet fever, which is treated differently.
Establishing the Diagnosis
Doctors diagnose measles by looking at the location where the diseases occurs. The actual progression of the disease on the individual as well as a physical examination is the primary method of detection. Two to three days before the actual rash, the insides of the cheeks or the soft and hard palate display characteristic white spots, the so-called Koplik’s spots, which look similar to salt grains on a surface. To confirm the disease with certainty, a serological antibody examination (IgM + IgG) of the blood can be carried out.
Progression of the Disease and Its Treatment
In a normal progression of measles, a person is usually healthy within a week. Otherwise, only the symptoms are treated. These include the cough and lowering the accompanying fever. The disease is caused by a virus and therefore treatment with antibiotics only makes sense when the natural progression of the disease is accompanied by a secondary bacterial infection.
Risk of Complications
Complications occur with up to thirty percent of those who contract the disease and are varied. The most common ones include pneumonia, inflammation of the middle ear or diarrhea. In rare cases, it can also cause infection of the brain. This naturally carries with it a significant change in treatment.
Vaccination and Prevention
The best prevention is sufficient hygiene and wearing a face mask when treating the ill. The most effective method of prevention is naturally widespread vaccination. Currently, the Priorix vaccine is used and applied in two doses. The first dose is administered at the fifteenth month of age. Up until 1975, only one dose was used, which later proved to be less effective. Today, small epidemics of the disease occur with people vaccinated in the first half of the 70s, while with children, this practically does not happen. There are approximately 20 reported cases of measles in children each year, none followed with lethal complications. Doctors believe that should the vaccination percentage of measles in children fall below 95%, the disease could start spreading faster.
When a person is not sure whether he/she has been vaccinated, a simple antibodies test could be carried out. In an urgent situation, for example during an acute epidemic, it is far more effective and simpler to receive one dose of the new vaccine. Immunity to the disease also occurs following having contracted it already. Globally, approximately 200,000 children succumb to the disease. Wherever measles occur, a vaccine can be applied within 72 hours of coming into contact with the disease and the subsequent risk of getting ill falls by at least 90%.
Barbara Taušová – pediatrician, founder, executive head and director of private family medical center Canadian Medical Care in Prague, owner of a private pediatric office in Prague.
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