Measles
We discussed in this column before the topic on MEASLES and because of the program of our Department of health about the MR SIA which stands for Measles Rubella Supplemental Immunization Activity, as a practicing pediatrician and as a strong advocate of vaccinations, i will talk about measles today.
Measles is also known as Rubeola and one of the vaccine preventable diseases and is one of the most common acute childhood diseases. It has a high attack rate, highly contagious and it has an incubation period of two weeks.
The upper respiratory passage is the portal of entry of the virus. This period corresponds to the prodromal manifestations. Then, the virus spreads through the blood to lymphoid tissues where more severe amd extensive reactions and viral multiplication happen thus causing generalized viremia and this is the time that the patient is highly infectious. At this period, the patient will have high fever with rashes.
So what will the child manifes if being infected with measles virus? There is an incubation period of two weeks as i have mentioned then catarrhal symptoms start in the nasal cavities then the conjunctivae and oropharynx that spreas to the bronchi resulting in rhinitis, conjunctivitis and bronchitis.
Upon physical examination, the physician can see whitish pinpoint dots with reddish areola in the inner cheeks opposite the lower molars.
This is called “koplik’s spots”. And because some will really have high grade fever, there is anorexia and irritability. A fine rash appears first on the bridge of the nose and hairline, sides of the neck, then the trunk and finally to the extremities.
When the rashes reach the lower extremities, this is also the time that the fever will start to subside.
The rash will fade as the same order as they appear from the face downwards leaving a dirty brown pigmentation and desquamation.
In some cases, measles may start with acute tonsillitis, nose bleeding and diarrhea. There were also reported cases of encephalitis and bronchopneumonia.
A rare and severe form of measles is called “ Black measles” which shows bleeding and Hemorrhagic rash, epistaxis, bleeding in the stool and the patient will be very toxic.
So to reiterate and to emphasize, the complications of measles are the following:
1. Pneumonia
2. Otitis media
3. Sinusitis
4. Furunculosis
5. Kerato-conjunctivitis
6. Bronchiolitis
7. Myocarditis ( inflammation of the heart)
8. Nephritis
9. And hepatitis
Measles is a highly contagious disease but one among the vaccine preventable diseasse.
The vaccine available is a safe and effective live attenuated measles vaccine that has been in used since 1962.
Children who have not been vaccinated during infancy maybe immunized at any age.
But the usual schedule that we are following is that we give measles vaccine as early as 6 months old then another dose at 1 year and 3 months together with mumps and rubella vaccine and another dose between 4-6 years old.
Adults who have not had measles should be immunized too. When measles is endemic or epidemic in a community, all children 6 months old and beyond should be vaccinated.
There is no contraindications to receiving the vaccine unless there is a high grade fever, the schedule may be postponed.
So dear mommies and care givers, please have your children vaccinated. Let us protect them! Let us immunize them! Give them the MR-SIA!