Measles transmission routes
Measles is transmitted with droplets of fluid that is released from the respiratory tract of a sick person when coughing or sneezing. Pathogens fall into the body of a healthy person through the mucous membrane of the mouth or conjunctiva of the eye. There is a prodromal, or initial, period characterized by symptoms similar to a cold, fever, cough and conjunctivitis, and the period of appearance of a typical rash. A child who suffers from measles is most contagious in the prodromal period, before he develops a rash. As a rule, measles results in complete recovery.
Relieving Symptoms
As for many viral diseases, there is no specific treatment for measles. Common activities include abundant drinking and taking paracetamol to lower temperature. In the prodromal period, diagnosis of measles is difficult. However, a doctor may suspect something more severe than a simple cold if the fever and symptoms of the disease persist for a long time. Pronounced conjunctivitis can also suggest a measles. A characteristic feature of measles is the presence of Koplik spots on the mucosa of the oral cavity. These small white spots first appear on the cheeks opposite the molars of the lower jaw and gradually spread throughout the mucosa of the oral cavity. Koplic's spots can be detected 24-48 hours before the appearance of the rash. One of the main symptoms of measles is the presence on the skin of a typical maculopapular rash (red spots with an elevation in the center). In the beginning, the rash appears behind the ears and along the hair growth line at the back of the head, and then spreads to the body and limbs. Individual spots merge and increase in size, forming foci of a red lesion. The rash lasts about five days. Then the spots start to heal, get brown color, after which the upper layer of the skin exfoliates. The rash is extinguished just as it appears: in the beginning it disappears on the head, and then on the body and limbs.
Complications of measles
As a rule, measles results in complete recovery. However, some children develop complications that can have short-term and long-term consequences. Complications of measles can be divided into two main groups:
Leaking without the defeat of the nervous system
Complications of this group usually have an easy and predictable course. Often there is inflammation of the middle ear (otitis media), as well as complications from the upper respiratory tract, such as laryngitis. Secondary bacterial pneumonia may develop: as a rule, it can be treated with antibiotics. Other complications include corneal ulceration and hepatitis.
Neurological complications
Neurological complications are associated with the defeat of the nervous system. Febrile convulsions are the most common form of seizures; they develop in some children with measles amid high temperature. Encephalitis (inflammation of the brain) develops as a complication of measles in about 1 in 5,000 children. Usually it occurs about a week after the onset of the disease; while children complain of a headache. Although in the measles, as with any viral disease that occurs with fever, the headache occurs quite often with encephalitis, it is accompanied by drowsiness and irritability.
Symptoms of measles encephalitis
Children with measles encephalitis look sick, tired and drowsy, but also show signs of anxiety and excitement. Against the background of encephalitis in children, the state of health worsens, convulsions may develop. Gradually the child falls into a coma. Mortality from measles encephalitis is 15%, which means that every seventh child who dies dies. In 25-40% of surviving children, there are long-term neurologic complications, including hearing loss epilepsy of limb paralysis and learning difficulties. Subacute sclerosing panencephalitis (PSPE) is a rare complication with a prolonged and debilitating course. It occurs in 1 out of 100,000 children who have had measles, but has not manifested itself for about seven years after the illness. The patient develops unusual neurologic symptoms, including discordant movements of the body, as well as speech and vision disorders. For several years the disease progresses and takes a more severe form. Over time, dementia and spastic paralysis develop. The diagnosis of SSPE is often not possible to put right away, but the disease can be suspected by clinical manifestations. The diagnosis is confirmed by the presence of measles antibodies in the blood and cerebrospinal fluid, as well as by characteristic changes in bioelectric potentials on the EEG. In children with weakened immunity, measles usually develops more severely and for a long time: their health suffers more than the well-being of children with normal immunity; they often develop complications and a higher death rate. Among immunodeficient patients (including cancer patients), giant cell pneumonia is a frequent complication. can end with a fatal outcome. Effective treatment of measles does not exist, although measles pneumonia can be treated with an antiviral drug ribavirin in aerosol form.
Vaccination
Reducing the incidence of measles is associated with the introduction of effective measles vaccine in the 60s of the last century (in the USSR, mass vaccination against measles began in 1968). Before the vaccination, measles incidence varied from 600 to 2000 cases per 100,000 people in different years. By the early 2000s, this indicator in Russia was already less than 1 person per 100 thousand, and by 2010 the goal was to reduce it to zero.