What is measles?
Measles is a disease caused by the measles virus and affects mainly children. The measles virus belonging to the virus family Paramyxoviridae, genus morbilli. It is a single-stranded RNA virus.
There is a cheap and safe vaccine against measles is available, which is offered to all children in Belgium and the Netherlands. Especially in developing countries, however, hundreds of thousands of children die every year from measles.
Incubation period and infectiousness
The incubation period of measles is 7 to 14 days. It is a highly contagious virus that only affect humans.
The measles virus is in the nose and throat of infected persons. The virus is spread through the air (coughing, sneezing, talking).
A person is contagious from about 4 days before the appearance of symptoms. A person is contagious for all he feels sick or look sick.
Symptoms and treatment of measles
Measles has a gradient in two stages. The virus settles first in the airways. Then come the lymphocytes infected with the virus in the blood, and the appearance of red spots on the skin.
Usually, the disease process begins therefore with symptoms that resemble a sturdy flu or cold (fever, cough, runny nose, inflamed eyes). Measles is often only recognized when visiting the characteristic red spots with white dot on the inside of the cheeks (so-called. Koplik-spots). These are followed by further increasing fever and measles typical light itchy few red spots, first in the face, then behind the ears and then in the neck. The fever can be high for a second time, and then drops the results from the trunk to the arms and legs. The large and small red spots gradually merge into an even redness. Measles is the most contagious 1-3 days before and up to 5 days after onset of rash.
There is no treatment against measles. 1 week after symptoms disappear measles usually returns spontaneously. If complications occur include medications and / or hospitalization required.
Complications
At 10 to 20% of the cases, complications, such as pneumonia or otitis media. In 1 in 1,000 cases, a much-feared complication, namely encephalitis. A patient might then fall into a coma. Rarer is the subacute sclerosing panencephalitis, which is caused by a slowly progressive measles virus infection in the brains.
A serious complication can lead to death of the patient. Encephalitis can cause permanent damage.
Measles epidemiology
For 1-2 per 1,000 patients a measles infection is deadly off. The mortality from measles in a developing country like Nigeria with 5-10% is much higher than in a country like Germany, where since 2000, about 1 in 10,000 infected persons (that's 1 to 2 persons per year) died of measles.
In 2011, an estimated 158,000 people worldwide died from the effects of measles. This particularly applies to children younger than 5 years. As a result of malnutrition, mortality highest among children in developing countries, especially in parts of Africa and Asia. Between 2000 and 2011, mortality fell by 71% through targeted vaccination campaigns.
Measles prevention
It is possible to be vaccinated with the MMR vaccine (measles, mumps, rubella). The vaccination since 1976, included in the Dutch National Vaccination Programme (14 months and 9 years), which is performed by the Youth Health (consulting and GGD). The Flemish vaccination program of Child and Family encourages you to vaccination at the age of 12 months and a second time at an age between 10 and 13 years. The vaccine protects 85% after the first vaccination and for 97% after the second vaccine.
The vaccine also offers protection if administered within 3 days after contact with measles.
95 percent of the Dutch population has been vaccinated since 1976; The vaccination is considered 'high'.
In developing countries, it is recommended to give children vitamin A with measles. This reduces the risk of blindness, and reduces the mortality from measles by 50%.
Side effects of the MMR vaccination
The MMR vaccination usually shows few side effects. If they occur, they are mild and take them shortly. Side effects only begin 5 to 12 days after vaccination.
- 1 in 10 to 20 children after the first MMR listless, getting fever and / or rash. It usually takes 1 or 2 days.
- Some children have high fever and severe rashes.
- At very high fever, some children may have febrile seizures. This is done at 1 in 5000 to 10,000 children.
- Very rarely a shortage of platelets. That's to 1 in 25,000 children and self-limiting.
- Very rarely have children joints. Also, which of course go again. In adults, this is more common.
- After the second MMR are rarely symptoms.
Because the MMR vaccine is a live attenuated vaccine, it must not be given to pregnant women. Women need up to four weeks after MMR vaccination avoid becoming pregnant.
Measles epidemics
Because in some areas, not enough people are vaccinated, sometimes even small epidemics, even in the Western world. In October 2014 for example, broke into the German capital Berlin, a measles epidemic. In February 2015 died a toddler of eighteen months from the disease. As a precaution, some Berlin schools remained closed thereafter. German media reported that the first death from measles was in Berlin since 2001. Doctors advised parents to keep their babies at home, for fear of contamination and for a possible chronic meningitis. The contamination originated mainly in asylum seekers from the Balkans, but then spread to also include Berliners. The epidemic has the discussion about the obligation of vaccination also placed on the political agenda.
In January 2015, there was an outbreak of measles in the United States. There were established more than a hundred cases of the disease in that month in fourteen different states. Most patients were not vaccinated. Although measles declared eradicated in 2000 in the US, the disease is again on the rise by the anti-vaccination movement. In 2014 there were more than 600 cases of measles in the US, the largest number in more than twenty years. Some parents refuse to have their children vaccinated against the disease, partly because of a perceived (but nonexistent) connection between the vaccine and autism.