Infectious Disease Measles: Risk Of Infection, Symptoms, And Treatment

Measles is still a dangerous childhood disease that can also affect adults. Today, infections are no longer so widespread in Germany. This is primarily due to the introduction of the measles vaccination about 40 years ago.

However, anyone who is not immune to this dangerous disease as a child or adult is very likely to get it if they come into contact with the viruses. This is because the disease is exceptionally contagious.

The virus is transmitted very quickly from one person to another. This happens via droplet infection, for example when speaking, sneezing, or coughing. Anyone who uses a drinking glass or other object that a measles sufferer has had in his or her hands can also become infected.

Measles Should Not Be Underestimated

Measles is caused by the measles virus. It is highly contagious. The pathogen, which belongs to the paromyxovirus family, is spread all over the world.

Caution: Measles viruses are exceptionally contagious. Out of 100 people who have not yet contracted measles and have not had protection by measles vaccination, 95 fall ill after contact with the virus.

This happens through droplet infection already when speaking, sneezing or coughing. If a sick person touches an object, this also carries the dangerous virus to someone else under certain circumstances.

In the Federal Republic of Germany, the number of cases has fallen sharply since the introduction of measles vaccination. However, outbreaks of measles do occur from time to time.

In developing countries in Asia and Africa, measles is still one of the most common infectious diseases. Here there is hardly any measles vaccination, the infections unfortunately still often end fatally.

Symptoms Of Measles

A sick child goes through two phases of measles. They are accompanied by bouts of fever. If you notice the first measles symptoms in your child, you should quickly consult a pediatrician. Because of the possible complications, this disease is by no means harmless.

Longer Incubation Period

Virus and the first symptoms, measles takes some time. Until the outbreak of the first stage of the disease, this incubation period lasts about eight to ten days. Until the second stage of the disease usually pass two weeks.

The Preliminary Stage

The so-called prodromal stage begins at the latest 10 days after your child has been infected. The signs of the disease are initially quite nonspecific, as they are more like the flu. Symptoms include a mild fever, runny nose, and sore throat.

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In addition, there is a dry cough. It can be extremely painful. In addition, the young patient is fatigued, tired, and complains of headache and abdominal pain. Other signs are a strong sensitivity to light.

An accompanying conjunctivitis in the child is noticeable by watery eyes. The face of the patient is bloated.

From the second day, characteristic spots, Koplik spots, appear on the mucous membrane of the cheeks. These are white coatings. They look like lime splashes and are surrounded by a reddish yard.

On the third day, the first severe episode of fever follows. The mucous membrane throughout the mouth and throat is reddened. After about five days, at the end of the preliminary stage, the fever drops again.

The Main Stage

In the subsequent exanthem stage, the typical skin rash appears. The term exanthem is derived from the Greek word exanthem. It means something like “I blossom”. The second episode of fever sets in.

The symptoms that already appeared in the preliminary stage, such as conjunctivitis in the child, now become stronger. Often, the lymph nodes in the area of the neck are also swollen. Together with the increase in fever, the exanthema appears. This involves bright red, interfluent spots 3 to 6 mm in diameter.

The rash begins behind the ears. From there, it spreads over the face and body. Only the palms of the hands and the soles of the feet are spared. After a few days, the spots turn darker and become brownish-purple. Finally, they fade after about seven days.

The skin becomes scaly. The other symptoms also weaken, and the fever subsides. Once the rash has disappeared completely, it can no longer infect anyone. If no other complications occur, then the period for recovery lasts about two weeks.

Measles: Dangerous Complications Possible

Not every measles infection runs its course without complications. On the contrary, the late effects of measles are still feared today. A patient has an attacked immune system for several weeks due to a viral infection. Other pathogens of serious diseases, such as bacteria, then have an easy time.

In Connection With Measles Occur Most Often:

Agonizing: The Croup Syndrome

Inflammation of the mucous membrane around the larynx is also possible. Here doctors speak of croup syndrome, also known as pseudocroup. At night, those affected have severe attacks of barking, dry cough. Often there is difficulty breathing and, in extreme cases, shortness of breath.

Can Measles Be Fatal?

Toxic (also foudroyant) measles are fortunately rare. But they do occur and therefore you should never underestimate this disease in your child. Affected patients not only develop a very high fever but also bleeding on the skin and mucous membranes. If this complication occurs, the mortality rate is high.

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Encephalitis, also known as encephalitis, is rightly feared. This complication affects the patient four to seven days after the onset of the measles rash. Then, in addition to severe headaches, fever also occurs.

Disturbances of consciousness can lead to coma. Up to 20 percent of those affected die. In up to 30 percent of cases, encephalitis caused by measles leads to permanent damage to the central nervous system.

Severe Complication: SSPE

Subacute sclerosing panencephalitis (SSPE) is a justifiably feared late consequence of measles infection. It occurs when the disease seems to have been overcome for a long time, namely after six to eight years.

SSPE is always fatal. It is a chronic inflammation of the brain in which the measles viruses that have entered the brain multiply greatly. This causes nerve damage.

The first signs are behavioral changes. Neurological disorders follow, such as muscle twitching to seizures and nerve failures. In the final stage of the disease, all brain functions fail. Then the patient dies.

Note: For every 100,000 measles patients, there are between four and eleven cases with SSPE. Children under the age of five are particularly susceptible to the fatal late stage. In their age group, it is estimated that there are about 20 to 60 cases of SSPE per 100,000 measles cases.

Mandatory Reporting Of Measles

Measles is a notifiable disease. If the first symptoms appear, you must therefore immediately present your child to a doctor. The physician must report the suspicion, the illness, and also death from measles to the responsible health office together with the name of the patient.

Measles Vaccination Is Now Mandatory

For years, the Standing Commission on Vaccination (STIKO) at the Robert Koch Institute (RKI) has recommended that parents have their babies and young children vaccinated. Adults who have not yet been vaccinated against measles should also do so.

The German government has now decided on July 17, 2019, a vaccination obligation against measles. A measles vaccination is therefore necessary for children who attend a daycare center. Likewise, schoolchildren must become immune to the disease through vaccination.

An adult who works in a daycare center, school, or another community facility also has a vaccination obligation. Exception: he has already gone through the measles. Last but not least, refugees in a shelter are subject to mandatory vaccination, whether child or adult.

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The vaccine is a so-called live vaccine. The reason: it contains attenuated measles viruses. However, they have lost their effect partially or completely. After vaccination, the human immune system nevertheless reacts by forming antibodies against the viruses – this is why the measles vaccination is called active vaccination.

A child or an adult needs some time for the formation of antibodies. After about six weeks, the antibodies can be detected in the blood.

Two vaccine doses must be given for the vaccination to have its full effect. Babies receive the first vaccination between the 11th and 14th month. The second should then be given from 15 to and 23 months.

Important MMR Vaccination

Usually, the vaccine is given together with those against mumps and rubella. This combination is known not only to parents of young children as MMR vaccination.

Although an adult – except for the mentioned groups – is not subject to mandatory vaccination, the STIKO recommends that the measles vaccination in the form of the MMR vaccination be given as a single dose.

An adult should do this if he.

  • Did not receive measles vaccination as a child.
  • Did not receive it in the recommended dose.
  • Does not remember if he or she was vaccinated.

An adult born after 1970 should definitely take this recommendation seriously. In this group, many people are not vaccinated and also did not have measles as a child. If an adult becomes infected with the measles, they are much more likely to face complications.

Very rarely: Side effects of vaccination

In general, vaccination against the infectious disease is well tolerated. However, there are cases in which there is redness, swelling or even pain at the injection site.

The neighboring lymph nodes then also swell. In addition, there is a slight fever, headache or faintness. However, these symptoms are only temporary and soon subside.

About five percent of vaccinated persons develop so-called vaccine measles in the second week after vaccination. These are weakened measles symptoms: Moderate fever, a little rash, respiratory symptoms. Vaccine measles are not contagious!

If an unprotected adult has contact with a sick person. He can still be vaccinated up to three days afterwards. This usually prevents an outbreak of the disease. This vaccination works best with the MMR vaccine

Nest protection lasts only a short time

If you carry antibodies against measles in your body, you transfer them to your unborn child during pregnancy via the umbilical cord. Your maternal antibodies remain in the fetal body of your baby and prevent infection

However, this nest protection only lasts until a few months after birth. Usually until the sixth month. Therefore, your child should receive an effective protection through a measles vaccination.

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Measles: How the doctor detects the virus

The measles symptoms, such as conjunctivitis in the child in the early phase or rash in the main phase, already put the doctor on the right track.

The problem is that there are some diseases with similar symptoms, including scarlet fever, rubella, or ringworm. Therefore, an examination in the laboratory must confirm the suspicion of measles. Various tests are possible. The most common is the detection of antibodies against the measles virus.

The blood of a patient is used as a sample. If an inflammation of the brain is suspected, cerebrospinal fluid (CSF) may also be used. The test is usually positive when the typical rash already appears. Before that, antibodies are often not yet detectable.

Detection of viral genetic material (measles virus RNA). Here, the doctor takes a saliva or urine sample, fluid from the tooth pockets, or a throat swab. This contains traces of viral genetic material. They are amplified by the so-called polymerase chain reaction (PCR) so that they can then be clearly identified.

Cultivation of the measles virus. Here, the samples are exposed to optimal conditions for growth – this allows the pathogens to be cultivated and identified. The procedure is complex and is rarely used.

The WHO Is Hunting The Virus

The goal is to eliminate measles worldwide by 2020. This is the goal set by the World Health Organization (WHO). But for this to happen, at least 95 percent of the population worldwide must be immune to the virus through measles vaccination.

What Diseases That Have Been Overcome Can Do

Even a disease that has been overcome makes one immune to the measles virus. In Germany, therefore, the idea prevailed for decades that children had to contract measles in order to provide themselves with immunity. So-called measles parties were notorious.

Today it is clear that an illness is no trifle. For the viruses weaken the immune system for years and can sometimes even have fatal consequences later.

This is because the pathogens can virtually disable the immunological memory in humans. They attack the immune cells that are able to recognize the pathogens that the body actually already knows.

As a result, the body’s defenses cannot be mobilized. This immunodeficiency, also called immunological amnesia, poses problems. It lasts for years and not just for one or two months, as is often believed.

As a result, if a child contracts measles, he or she may die as an adult from a disease that might not normally have been fatal.

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