Measles is the most infectious disease known in humans, and almost everyone gets it at some time, if not vaccinated. Before the measles vaccine was licensed in 1963, the USA had three to four million cases of measles every year, with several hundred deaths.
This disease is caused by a virus, the measles virus. It infects only humans, and has no animal host or reservoir.
Measles starts with fever, cough, and sticky eyes. The child has a sore mouth, and may find eating difficult. Diarrhoea usually occurs, and can be severe. Cough can sometimes be severe enough to disturb sleep.
The typical rash appears after 2-3 days of fever. It is red, and flat to slightly raised. It always appears first on the head and neck, and progresses down the body in orderly fashion, taking about two or three days to reach the feet. It fades in the same sequence. The fever is very high when the rash is present, and often drops abruptly after the rash has reached the feet.
Measles itself is a short and self-limited illness. However, it is dreaded for its complications, both immediate and long term. Even today, measles ranks second only to malaria in terms of deaths caused by complications of an infectious disease around the world.
During the acute attack of measles or shortly after, the child may suffer pneumonia, encephalitis (inflammation of the brain), ear infection, and infections elsewhere. Measles reduces the immunity of the child, and this effect persists for several weeks, making him easily susceptible to various infections. Among these infections, tuberculosis is important.
The measles virus itself causes pneumonia, which is very difficult to treat, since there is no specific drug available. Children who have had measles also get pneumonia caused by a secondary bacterial infection. Pneumonia is always a serious disease, but is more so in children with measles, because of the general weakening of the body's defence mechanisms.
Encephalitis occurs in one or two children among a thousand who have measles, but it is a serious illness and often fatal.
A delayed complication is Subacute Sclerosing Panencephalitis (SSPE), which affects the brain several years after the original measles attack. It is very rare, but is relentlessly progressive and invariably fatal.
Measles can be prevented by the use of the measles vaccine.
Measles is a viral disease, and we do not yet have an effective drug against it.
The best treatment today is rest and fever medicines. Fever can be quite high, and several doses of fever medicine may be needed every day.
Most children have a greatly reduced appetite when they have measles. A lot of liquids should be offered to the child at small intervals. This not only provides some nutrition, but also prevents dehydration, which is likely if the diarrhea is severe.
Measles is often accompanied by cough, and this can be very troublesome. Cough syrups do not usually help much.
Sometimes, measles can be severe, with profuse diarrhea, breathing difficulty owing to pneumonia, seizures, and other signs of serious disease. Immediate hospitalisation is essential in such children.
Dr. Parang Mehta,
Mehta Childcare,
Opposite Putli, Sagrampura,
Surat. Tel: +91 98241 53923.
Email:
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