Some diseases that once led to epidemics, thanks to vaccination, it was possible to forget - for example, smallpox, which took the lives of millions of people, now exists only in laboratories. Unfortunately, in 2019, the WHO named the anti-vaccination movement one of the main threats to humanity - and outbreaks of seemingly disappeared diseases are being recorded all over the world. According to the WHO, 2256 measles cases were registered in Russia last year; in Ukraine, the situation is much more complicated - more than 53 thousand cases in 2018. We will tell you why measles is dangerous and how to protect yourself from it.
Text: Ksenia Akinshina
How does measles manifest
Measles is one of the most contagious diseases in the world. The virus is transmitted by airborne droplets - through sneezing, coughing and close communication. The virus remains active in the air and on surfaces for up to two hours, spreads very easily with the flow of air - for example, through ventilation systems, so compliance with hygiene rules does not help protect against measles. An affected person can transmit the virus before the rash appears and up to four days after the rash has cleared.
The first symptoms of the disease usually begin a week or two after infection: the temperature rises, the eyes turn red and watery, a cough and a runny nose appear. All this is very similar to the course of an acute respiratory viral infection. But two to three days after the first symptoms, the so-called Koplik spots appear on the mucous membrane in the mouth - small whitish-gray spots with a red border. Most often they are located on the inside of the cheeks, behind the lower molars. This is the earliest and most undeniable symptom of measles.
Three to five days after the onset of the disease, the second period of the disease begins - a rash. The rash in the form of small pink spots quickly spreads throughout the body. First, the rashes appear on the face - on the hairline, then go down to the neck, trunk, arms, legs and feet. The pink spots turn into a bright red itchy rash. During this period, the temperature can rise to 40 degrees, the cough can intensify. The order of appearance and disappearance of the rash is very characteristic with measles: on the sixth or seventh day of illness, the rash spreads to the chest, back, abdomen and hips, and on the eighth day, having reached both feet, it begins to disappear in the same sequence - the head, face, neck and etc. For some time after this, brownish spots remain at the site of the rash.
Why is she dangerous
If everything were limited to a rash and a high fever, measles would not be so scary - but a third of those who get sick develop complications. Most often this occurs in small (under five) children and in adults (over twenty). The most common complications of measles are ear infections, which can lead to hearing loss, and diarrhea. In addition, one in twenty children will develop pneumonia, one in a thousand will develop encephalitis (cerebral edema), and one or two in a thousand will die from measles. Among children, the most common cause of death is pneumonia, and among adults, encephalitis.
In addition, there is a long-term complication that can appear seven or even ten years after a person has had measles. This is subacute sclerosing panencephalitis, a progressive brain disease. It causes cognitive impairment and seizures and is usually fatal. For pregnant women, measles is dangerous because it can lead to premature birth or the birth of an underweight baby.
The highest risk of measles and its complications is in young children who have not been vaccinated. But anyone who has not been given the measles vaccine can get infected - or anyone who, after being vaccinated, has not developed immunity to the disease.
How to treat
As with most viral infections, there is no specific medicine for measles. All that can be done is supportive care to avoid complications. It is important to eat well, drink plenty of water; for vomiting and diarrhea, solutions are administered to help restore fluid and electrolyte balance. Antibiotics are prescribed for eye, ear, and pneumonia infections. Studies have shown that with a lack of vitamin A, two doses of this vitamin can help reduce the incidence of complications associated with eye damage and, in some cases, reduce mortality.
How to protect yourself
The only way to protect yourself from measles is through vaccination. WHO estimates that vaccination prevented 20.4 million measles deaths between 2000 and 2016. The measles (and rubella and mumps) vaccine is given twice: between the ages of 12 and 15 months, when babies usually lose their maternal antibodies passed through the placenta, and at 4–6 years of age. The MMR vaccine (measles, mumps, rubella - that is, against measles, mumps and rubella) is produced by different companies and can be registered under different names.
The US Centers for Disease Control and Prevention (CDC) website has recommendations for vaccinating specific populations - for example, anyone traveling abroad over 6 months of age must be vaccinated against measles. Children vaccinated under one year old should receive two more doses of the vaccine - at the age of 12 to 15 months and another after 28 days. Women of reproductive age who do not have laboratory-proven immunity to measles should be vaccinated with at least one dose of the vaccine. This vaccine is not given during pregnancy.
A large selection of informational posts about measles and algorithms for actions in different situations (for example, after contact with a sick person) is on the blog of pediatrician Sergei Butria. Sites like the CDC have questions and answers about measles, vaccinations, and various emergencies. After contact with a person infected with measles, you need to find out whether you are vaccinated against measles and whether immunity has been preserved - for this, an analysis is done for antibodies to the measles virus. However, vaccination can be done in any case, if there are no contraindications. If they are (for example, pregnancy or severe immunodeficiency), then you can enter a special immunoglobulin.
In any case, given the increase in incidence, it is worth checking your vaccination status - if possible, raise your medical documents. If the vaccine was injected twice, then you do not need to repeat it, if once, then another one is needed, and the unvaccinated need to be vaccinated twice. If records are not available, you can test for measles antibodies to see if you are immune to the infection - and decide on vaccination depending on the results. The vaccination can be done free of charge at the city clinic or contact a private one that you trust.
Photos: Kateryna_Kon - stock.adobe.com