Measles (morbilli)

To prevent measles, vaccination against this disease has been conducted continuously in our country since 1971. Thus, a period of almost 20 years without measles was achieved until 2017, when the virus was reintroduced into the country and caused an epidemic due to the decline in the number of vaccinated children. Vaccination coverage of children has improved, but not enough, because we still have reported cases of measles.      

Disease signs and symptoms

The child becomes infected 7 to 15 days before the first disease symptoms appear. The disease begins with: fever, cough, runny nose and red watery eyes, followed by the appearance of a reddish blotchy rash in 2 to 3 days. A characteristic sign of this disease are Koplik's whitish-bluish spots on the inside of the cheeks, which can be seen before the appearance of the rash. The rash starts on the hairline and then spreads to the face, upper neck and down to the chest, over the limbs, to the hands and feet. It fades and disappears in the same order in which it appeared and lasts for a maximum of 5 to 6 days. Other signs of the disease are loss of appetite, diarrhea, and generalized swelling of the lymph nodes.

An infected person is contagious about 4 days before and after the rash appears.

Complications

Complications occur in 30% of affected children: diarrhea with dehydration, ear infections, pneumonia, encephalitis, permanent nerve damage (most often blindness). Due to these complications, in developed countries, 0.2% of affected children die, while in underdeveloped countries this rate is substantially higher, even up to 25%, with malnutrition and vitamin A deficiency as contributory factors.

Medications

There is no specific medicine for measles; in practice, medicines are used to relieve the discomfort. Paracetamol is given to lower fever and relieve headache. The child is offered more fluids than usual and allowed to rest in a slightly darkened room. Sufficient intake of vitamin A is ensured.  

Prevention

Active immunization against measles is carried out with a combined vaccine containing vaccines against measles, mumps and rubella (German measles) at the age of 12 to 15 months, and the second dose, revaccination, is given to children before starting school, at 6/7 years of age. When these children are vaccinated regularly, they also protect children who cannot receive the vaccine, because they prevent the spread of the virus. The vaccine should not be given to people with immunodeficiency (weak immune response), people who have a stronger allergic reaction to any of the vaccine components and pregnant women.

Children who cannot receive this vaccine and come into contact with the measles virus can receive immunoglobulin during the first six days of infection to prevent the disease or to alleviate its course.

Persons who recover from measles acquire long-term immunity.