The susceptibility to measles is almost universal. During the epidemic, everyone who does not contract measles and is susceptible to it, is ill with it. Epidemics are repeated periodically after 3-4 years, when a growing number of children susceptible to the disease. Individual cases of measles are always present. Because of the high susceptibility to measles, it affects children of preschool and primary school age. Measles, most often, affects children in children's groups. The transferred illness leaves lifelong immunity. Breast infants during the first 3-6 months of life have passive immunity acquired by the placenta from the mother. With a decrease in innate immunity, immunity to measles weakens, however, in the case of disease, the latter proceeds in mild, atypical form. A child born from a mother who does not have measles, naturally does not have passive immunity.
Clinical picture.
The incubation period - from the moment of infection to the beginning of the rash - lasts 14 days.
Prodromal period . In the second week of the latent period, there are fever, runny nose, cough, conjunctivitis. These catarrhal phenomena intensify. Cough becomes painful, there is watery eyes, photophobia. Swollen eyelids stick together. The mucous membrane of the mouth and throat are hyperemic. 2-3 days before the appearance of the exanthema, the temperature drops for a short time. During this period, a characteristic feature of measles is found: on the hyperemic mucosa of cheeks against small molars there are white spots, the size of a pinhead surrounded by a red border - the spots of Filatov-Koplik.
Almost simultaneously with these spots or shortly thereafter, an enanthema appears on the mucous membrane of the soft and hard palate: red spots, which sometimes can acquire the character of hemorrhages. Sometimes follicular tonsillitis is observed. The tongue is laid, there are cracks on the lips, the cervical lymph nodes are moderately enlarged.
The period of rashes. After 24-48 hours after the appearance of the Filatov-Koplik stains appears exanthema. The phenomena of general intoxication are amplified. A child, exhausted by fever, insomnia, restless cough, becomes listless, apathetic and looks seriously ill. At this time behind the ears, on the face, neck, scalp appear pink spots, the size of lentils. Then the rash spreads to the trunk, limbs and covers the whole body for two days. Initially, the individual elements of the rash have the character of pink papules, then turn into large, dark red spots that later acquire a copper-red color. Elements of the rash, merging with each other, leave the skin areas free only in the form of small islets. Drain rash is especially pronounced on the face and trunk.
The face of the measles patient, puffy, with puffy eyelids, is characteristic; lacrimation, photophobia, runny nose, red rash.
When the rash reaches its culmination, the symptoms of general malaise begin to decrease. The temperature decreases, then, after 2-3 days, become normal. The extinction of the rash occurs in the same sequence as the rash occurred. After 4-5 days, the elements of the rash take on the character of light brown spots. This pigmentation can be observed for 2 weeks. Simultaneously with the extinction of the rash begins small-pancreatic peeling of the skin.
The above clinical picture corresponds to a disease of moderate severity. There are mild forms of the disease, in which the rash and common symptoms are meagerly expressed. As with other infections, there are malignant measles.
Measles is dangerous in itself because of its complications.
An early complication is measles. Beginning in the catarrhal stage and mildly expressed laryngitis, which is observed in almost every case of measles, takes an exceptionally heavy character due to the development of laryngeal stenosis. Hoarseness strengthens right up to aphonia.
Inflammation of the middle ear. Otitis occurs in the catarrhal period or early in the period of convalescence.
Bronchopneumonia. Frequent severe complications in infants and young children, as well as weakened children.
Encephalitis. The most difficult, fortunately, a fairly rare complication of measles. Appears either at the end of the rash period, or in the early days of the period of convalescence, accompanied by a rise in temperature and severe cerebral symptoms.
Treatment of measles is symptomatic. It is necessary to comply with bed rest during the week and up to two weeks of home treatment. Because of photophobia, the child feels better in the semi-darkness. To mitigate the painful cough, air in the room is moistened with a moisturizer or wet sheets. If necessary, prescribe antipyretic and soothing cough remedies. In case of complications, antibiotics are used.
A week after the clinical recovery, isolation of the patient ceases. Now active immunization against measles is mandatory. Vaccination may be accompanied by an increase in temperature and the appearance of rudimentary exanthema.
The outcome of the disease depends on the patient's age, physical development, the combination of measles and other possible diseases. Measles can be a dangerous disease for sick infants suffering from dystrophy. Children older than three years usually tolerate it well.