Overview of Measles

What is Measles? Measles is an acute infectious disease caused by a virus that can occur in many subjects, especially children. Measles is very contagious and can cause outbreaks. Although most children with the disease can recover after a while, in children with low resistance such as infants, the disease can progress severely and cause complications later.

Causes of Measles

The causative agent of measles is identified as a virus belonging to the genus Morbillivirus of the family Paramyxoviridae. This is still considered a dangerous disease in young children with the risk of death if not detected early and treated properly.

Symptoms of Measles

After being infected with measles, the incubation period can be from 7 days to 2 weeks. Then, the symptoms of measles have the following manifestations:

• In the initial stage of the disease, children often have a high fever (over 39°C). When the fever subsides, a rash characteristic of fever will appear at the same time.
• The progression of measles rash is very typical: the rash starts behind the ear (neck area), then spreads to the face and gradually down to the chest and abdomen and finally the whole body. The rash of measles is a papular rash (raised rash on the skin surface) after it disappears, it will leave a characteristic dark skin streak called “tiger skin stripes”.
• In addition to the above manifestations, children with measles often have some accompanying symptoms such as: red eyes, runny nose, cough or sometimes diarrhea.

Complications of measles: the most common are otitis media, pneumonia, encephalitis, diarrhea, corneal opacity, laryngitis, severe malnutrition…

Transmission of Measles

Measles is highly contagious with the following characteristics:

• Measles is spread from sick people to healthy people mainly through the nasal and throat secretions of people infected with measles released into the air when coughing, sneezing and healthy people inhale air droplets containing the virus.
• Measles can be transmitted before and after a few days of symptoms appearing.

People at risk of Measles

Measles is concentrated in some high-risk groups such as:

• People who have not been vaccinated against measles, especially young children (infants), will be very susceptible to infection when exposed to measles sources.
• People who frequently travel internationally, especially to developing countries where measles is common. If individuals go to these areas without taking preventive measures, the possibility of infection will be very high.
• People who are deficient in vitamin A in their daily diet are more likely to develop severe disease and experience dangerous complications if they get measles.

Prevention of Measles

There are 4 proactive, simple and effective measures to prevent measles today:

• Proactively vaccinate against measles: According to the expanded immunization program, children aged 9 months are recommended to receive free measles vaccine at medical facilities. Along with that, to ensure sustainable immunity, it is necessary to get a second booster shot when the child is 18 months old.
• Isolate sick children well: Measles spreads very quickly, so when a sick child is detected, it is necessary to immediately take the child to a medical facility for examination and treatment, and isolate the source of the disease to avoid spreading to the community.
• Implement disease prevention measures for medical staff and family members: Wear medical masks when caring for sick children, this is also a measure to prevent cross-infection to other children in hospitals with measles patients.
• Wash hands thoroughly, following the routine hand washing steps as instructed before and after caring for sick children with the goal of preventing cross-infection.

Diagnostic measures for measles

Diagnosis must be based on both clinical symptoms of measles and necessary tests:

Clinically: there are typical symptoms such as fever, rash with cough, red eyes (conjunctivitis) or runny nose.

Testing:

• MAC-ELISA test is used to detect measles-specific IgM antibodies in serum, most commonly used in the definitive diagnosis of measles.
• Immunofluorescence technique to detect viral antigens in measles patient specimens (nasopharyngeal secretions, blood). This test is rarely used in clinical practice.

Treatment measures for measles

Principles of measles treatment:

• Isolation of measles patients
• Supportive treatment:
• Clean skin, eyes, mouth and throat
• Improve nutrition
• Reduce fever
• Supplement vitamin A
• Treat complications:
• Treat antibiotics if there is bacterial superinfection
• Limit fluid transfusion if there are complications of pneumonia, encephalitis or myocarditis
• If there is acute meningitis, supportive treatment is needed to maintain the patient’s vital functions