These days we have read on the website of the AEPED Vaccine Advisory Committee, about an alert from the World Health Organization regarding an increase in reports of measles cases in Europe. This increase also implies the risk of extension to countries with vaccination coverage below 95%. We are talking about measles and it seems that we are going back to the past, and in fact in 14 countries of our continent endemic transmission still persists (among them are Belgium, Georgia, Romania or Ukraine), although in another 37, they have managed to interrupt the transfer (2016 data), as is the case in Spain. It is understood that complete vaccination coverage is at 2 doses, which in Spain are administered at 12 months and 2-4 years of age. The measles vaccine is given in conjunction with rubella and mumps (MMR).
The WHO estimates that "no country and no individual is free from being exposed to the measles virus, due to the level of interconnection." What is measles? You may have heard about it, but without really knowing what it is about: we are talking about an infectious disease that a few decades ago was quite common; it is not benign like chickenpox, Ya que can lead to serious complications, even death. The establishment of extended vaccination systems was a success, and consequently the rates of affected decreased considerably (with variations according to countries). What is happening now is that as a result of this and other vaccines are rejected or delayed by some parents, now there are more children, adolescents without immunization, with the consequent exposure suffered by the child and youth population, since in the event of a contagion, the risk of infection increases.
Along with this predisposing factor, coexists the possibility of transmission due to displacement to other countries with measles outbreaks; there are actually many places where it is still common. Taking into account the ease with which it is transmitted, and that it is associated with dangerous complications, it is recommended to vaccinate babies until their complete immunization (2 doses).
Measles: we tell you what you need to know.
As I have anticipated, contagion is very easy: by air when the infected person coughs (or sneezes) in the presence of other. Body fluids contain infection and when expelled (even by droplets) can be inhaled. Another type of more direct contact with saliva or mucus also poses a risk, as well as intimate contact with the affected person. There is another possible route: the virus is deposited on surfaces, or simply suspended in the air, and is active for approximately 2 hours.
It is a respiratory infectious viral disease, whose initial symptoms are fever that lasts two days, followed by more specific manifestations such as runny nose, cough or conjunctivitis (pink eye). It is also characterized by a rash (or exanthema) on the face and neck (upper part), which then spreads over the body (arms, hands, legs and feet.
The disease process is as follows: contagion (from 4 days before the first infected person has the rash), after about 8 to 12 days, the first symptoms appear [high fever (40º) of 2 or more days], respiratory symptoms and conjunctivitis, rash for 5 days, and disappearance of the same in the reverse order of its appearance. Since the rash is no longer visible, 4 more days will pass during which the second infected can still infect.
As you can see, we are talking about 3 weeks from the contagion, through the incubation period, symptoms and subsequent disappearance. The duration and the virulence of this disease justify the need for prevention. Today it is rare in developed countries with high vaccination coverage, while 95 percent of deaths occur in developing countries that have a very low per capita income and poor health infrastructure.
Complications after contracting measles.
I will mention first that the first symptoms (fever, cough, runny nose ...) tend to get worse on the third day of illness. But they can also live with complications that can be very dangerous and more serious: pneumonia, ear infection; but also encephalitis, brain damage, even death.
Treatment and care of measles patients.
It should be insulated, and care should be taken to keep it hydrated and as comfortable as possible. As in the case of chickenpox, it is totally contraindicated to administer aspirin, as it is related to Reye's syndrome.
A child with measles should stay home for a week (at least) after the rash appears. There are usually spots called Koplik's, which appear inside the mouth and are red with a white or bluish center. There are children who develop the disease during a hospital stay for other reasons (and after being infected), in these cases they cannot share the common rooms of the Pediatric ward. On the other hand, complications sometimes motivate a visit to an emergency service, where health personnel will dictate the steps to follow.
If the breathing is noisy all the time, motor skills are impaired, you have a very severe headache, feel very ill, or vomit, head to the Hospital. And although they are not so urgent situations, you will have to speak with the pediatrician if the patient is a baby, the fever lasts after 4 days of rash, suffers from an immunosuppressive disease, coughs a lot or suffers from earache.
In the event that it occurs, the illness must be reported to the child's school. As 90% of unvaccinated people who are in contact with a sick person are at risk of contagion.
Images - Thomas godart, Wellcome Images, PS UsGov, Dave haygarth
More information - Kids Health, CDC