Measles

Definition

Measles mostly affects children and typically occurs with a widespread rash. Infection with the measles virus weakens the immune system in the long term, which is why severe infections and complications can follow after the illness has gone through. Once the measles has healed, there is lifelong immunity against re-infection.

Measles symptoms

The disease proceeds in two phases.

• About ten days after infection, the first phase begins with a cold, fever, conjunctivitis and cough. It is very reminiscent of a cold. In addition, in rare cases, red or white spots can appear on the oral mucosa.
• The second phase then begins with the formation of a large reddish-spotted rash. This spreads from the ears over the whole body. It usually occurs three to seven days after the first symptoms and lasts for about four days. It is accompanied by high fever, severe malaise, and swollen lymph nodes.

Between the two stages, the fever may subside for a short time. Adults and children are affected by the same symptoms when infected with measles.

Causes and risk of infection

Measles is a highly contagious viral disease. It is spread by inhaling tiny air particles – so-called aerosols. You can get infected from your fellow human beings if they are a few meters away and cough or sneeze, for example.

Particular caution is required in the event of contact with a sick person and unclear or non-existent vaccination protection: In order to reduce the risk of infection and to alleviate the symptoms, a single vaccination should take place about three days after contact. For immunocompromised people there is the possibility of an immunoglobulin administration within six days after contact with measles patients. Immunoglobulin administration can also be considered for infants under six months and pregnant women. The body produces immunoglobulins, also called antibodies, as part of its natural defense against infections. Immunoglobulins attach themselves to the virus, rendering it harmless. If your own immune system has not yet produced any antibodies, these can be administered as an immunoglobulin infusion.

For healthy people, preventive vaccination is the best way to avoid measles infection.

If you or your child have contracted measles, there are a few rules to follow: There is a risk of infection around five days before and four days after the rash appears. During this time, you should keep away from unvaccinated and immunocompromised fellow human beings in order not to infect them. Before visiting a doctor’s office, you should give advance notice by telephone so as not to endanger other people. Sick and contact persons without vaccination protection should not visit community facilities for two weeks.

treatment of measles

The virus cannot be treated with medication. The therapy is therefore only aimed at the symptoms that occur. Antipyretics can be used for this. It is important to pay attention to physical protection, sufficient fluid intake and a balanced diet. If the disease progresses severely, intravenous fluids may be necessary.

Late damage and complications

The prognosis of the disease is usually good. Nevertheless, the disease carries some risks of complications and long-term damage. After the infection has subsided, there is often a temporary immune deficiency that can last from a few months to years. During this time there is a particularly high risk of developing middle ear infections, bronchitis or pneumonia.

In addition, in rare cases, encephalitis occurs, which can have serious consequences or even be fatal. Patients develop neurological abnormalities such as seizures. There is no causal therapy available, so only symptoms can be alleviated.

As a very rare complication, subacute sclerosing panencephalitis (SSPE) can occur, which can usually occur 4-10 years after the infection has gone through. Patients usually die within one to three years. There is usually a history of measles before the age of two.

vaccination

Vaccination has been recommended for many years to provide effective protection against measles, mumps, rubella (MMR) and possibly chickenpox. The vaccination also works against the temporary immune deficiency that accompanies the infection.

The vaccination is a so-called “live vaccine” with reproductive but weakened pathogens. In some cases, local reactions, fever and the occurrence of so-called “vaccination measles” are reported. These can be seen as the body’s normal response to the virus. They are not contagious and heal quickly and without consequences.

• In infants and young children, two vaccinations should be given between the ages of 11 and 14. month of life and the 15th-23rd month of life. There should be a minimum interval of four months between vaccinations.
• For unvaccinated adolescents under 18 years of age, a two-dose vaccination is also used, which is given four to six weeks apart.
• For adults born after 1970, the Standing Committee on Vaccination recommends a one-off measles vaccination. People who have only been vaccinated once during their childhood should also receive a second vaccination.

In the event of an outbreak, occupational risk and immunocompromised people, special rules apply that should be discussed with a doctor if necessary.

Myth: Measles vaccination and autism

The assumption that measles vaccination is related to autism was spread by a fake study and was subsequently refuted by various studies. In very rare cases, a measles infection occurs despite vaccination, since the vaccination does not offer 100% protection. According to reports, the course of the disease is weakened and milder in these cases.

When to see a doctor

A doctor should always be consulted if the symptoms are unclear and a noticeable skin rash occurs. Since some childhood diseases are accompanied by a rash, special caution is required here. By asking a few specific questions, the doctor may be able to identify or rule out measles:

• Is there vaccination protection against measles and rubella?
• Did you last take any medication (e.g. antibiotics)?
• Does the rash itch?
• From where to where does the rash spread? Is the cheek mucosa also affected?
• Are there other symptoms (e.g. fever)?

The doctor can also provide information about vaccinations and how to behave in the event of illness. In addition, he can help to identify other infected people and initiate possible measures to prevent an epidemic.

Measles in pregnancy

Should the expectant mother become infected with measles during pregnancy, this poses no risk to the development of the unborn child in the womb. There is the possibility of an immunoglobulin administration after contact with a sick person with insufficient vaccination protection. Pregnant women should consult a doctor immediately if they suspect it.

How can Med-Healths help?

You or your child has a skin rash and you are not sure which disease it is? This is where a doctor can help you through Med-Healths. Send a photo via the app or show the rash during the video call. The doctor will help you classify the symptoms and make a diagnosis. He can also refer you to a specialist for further treatment for a more detailed physical examination. Since measles is highly contagious, a video consultation before visiting a doctor’s office makes sense. The doctor can also explain vaccinations or measures to prevent infection in the video call.