Return of measles: What is dangerous disease and how to protect against it
On some diseases that once led to epidemics, thanks to vaccination, we managed to forget - for example, smallpox, which took the lives of millions of people, now exists only in laboratories. Unfortunately, in 2019, WHO called the anti-vaccination movement one of the main threats to humanity — and outbreaks of seemingly disappeared diseases are recorded all over the world. According to WHO, there were 2,256 measles cases in Russia last year; In Ukraine, the situation is much more complicated - more than 53 thousand cases in 2018. We tell you what makes measles dangerous and how to protect yourself from it.
Text: Ksenia Akinshina
How does measles manifest
Measles is one of the most contagious diseases in the world. The virus is transmitted by airborne droplets - when sneezing, coughing and close communication. The virus remains active in the air and on surfaces for up to two hours, it spreads very easily with air flow - for example, through ventilation systems, so adherence to the rules of hygiene does not help protect against measles. A sick person can transmit a virus before the rash appears and up to four days after it disappears.
The first symptoms of the disease usually begin in a week or two after infection: the temperature rises, the eyes turn red and watery, a cough and a runny nose appear. All this is very similar to the course of acute respiratory viral infection. But two or three days after the first symptoms, so-called Koplik spots appear on the mucous membrane in the mouth - small whitish-gray spots with a red border. Most often they are located on the inside of the cheeks, behind the lower molars. This is the earliest and undisputed symptom of measles.
Three to five days after the onset of the disease begins the second period of the disease - a rash. A rash in the form of small pink spots quickly spreads throughout the body. First, the rash appears on the face - on the hairline, then lower down to the neck, torso, arms, legs and feet. Pink spots turn into a bright red itchy rash. During this period, the temperature may rise to 40 degrees, cough may increase. The order of appearance and disappearance of the rash is very characteristic of measles: on the sixth or seventh day of the disease, the rash spreads to the chest, back, stomach and thighs, and on the eighth day, reaching both feet, it begins to disappear in the same sequence - head, face, neck and etc. Some time after this, brownish spots remain on the site of the eruptions.
How is she dangerous
If everything was limited to a rash and fever, measles would not be so terrible - but a third of the patients develop complications. Most often this occurs in small (up to five years) children and in adults (over twenty years). The most frequent complications of measles are ear infections that can lead to hearing loss, as well as diarrhea. In addition, one out of twenty children develops pneumonia, one out of a thousand has encephalitis (brain edema), and one or two children out of a thousand die as a result of measles. Among children, the most common cause of death is pneumonia, among adults encephalitis.
In addition, there is a long-term complication that can occur seven or even ten years after a person has had measles. This is a subacute sclerosing panencephalitis - a progressive disease of the brain. It causes cognitive impairment and seizures, and is usually fatal. For pregnant women, measles is dangerous because it can lead to premature birth or the birth of a child with insufficient weight.
The highest risk of measles and its complications is in young children who have not been vaccinated. But anyone who has not been vaccinated against measles, or who has not developed immunity to the disease after vaccination, can become infected.
How to treat
As with most viral infections, there is no specific medicine for measles. All that can be done is to carry out maintenance therapy to avoid complications. It is important to complete nutrition, plenty of drinks; in case of vomiting and diarrhea, solutions are administered to help restore the balance of fluid and electrolytes. For infections of the eyes, ears and pneumonia, antibiotics are prescribed. Studies have shown that with vitamin A deficiency, double administration of this vitamin helps reduce the incidence of eye complications and, in some cases, reduce mortality.
How to protect
The only way to protect against measles is by vaccination. According to WHO estimates, in 2000-2016, 20.4 million measles deaths were prevented due to vaccination. The vaccine against measles (as well as rubella and parotitis) is administered twice: between the ages of 12 and 15 months, when maternal antibodies transmitted by the placenta and in 4-6 years old usually disappear in infants. The MMR vaccine (measles, mumps, rubella - that is, against measles, mumps and rubella) is made by different companies and can be registered under different names.
On the website of the American Center for Disease Control and Prevention (CDC) there are recommendations for vaccination of special population groups - for example, anyone traveling abroad over the age of 6 months should be vaccinated against measles. Children vaccinated up to one year should receive two more doses of vaccine - between the ages of 12 and 15 months and another one after 28 days. Women of reproductive age who do not have laboratory-confirmed immunity to measles should be vaccinated with at least one dose of vaccine. During pregnancy, this vaccine is not administered.
A large selection of information posts about measles and algorithms of actions in different situations (for example, after contact with the sick) is in the blog of pediatrician Sergei Butriy. Sites such as the CDC have questions and answers about measles, vaccinations, and various emergency cases. After contact with a measles-infected person, you need to find out if you have been vaccinated against measles and whether immunity has been preserved - for this, an antibody test for the measles virus is done. However, vaccination can be done in any case, if there are no contraindications. If they are (for example, pregnancy or severe immunodeficiency), then you can enter a special immunoglobulin.
In any case, given the increasing incidence, it is worth checking your vaccination status - if possible, raise medical records. If the vaccine was administered twice, then it is not necessary to repeat it, if once, then one more is needed, and the unvaccinated should be vaccinated twice. If the records are not available, you can do a test for antibodies to the measles virus and see if you have immunity against this infection - and decide on vaccination depending on the results. Vaccination can be done free of charge in the city clinic or go to a private one you trust.
Photo: Kateryna_Kon - stock.adobe.com
