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Libreta de salud infantil familiar digital




Measles

It is a disease of the viral type characterised by the presence of fever, catarr and spots on the skin.

 No so long ago its incidence was significant but with the vaccines it decreased considerably, which does not mean it has disappeared.


 

 This disappearance will probably come true when all children are vaccinated and the response is adequate.

 

 Mandatory vaccination from infancy including the dose of the Viral Triple Vaccine (measles, mumps, rubeola) get good levels of immunity among children.

 

 In the Province of Buenos Aires, Argentina, the recommended vaccination scheme against measles is as folows:

  • 6 months old: vaccine against measles.
  • 12months old: Viral Triple Vaccine.
  • Between 6 and 12 years old: a new dose of Viral Triple Vaccine.

 

Besides, according to indications of the Provincial or National Ministry of Health vaccination campaigns are implemented taking into account the rise of measles incidence rates.  The latest campaign was carried out in the year 1998; it had an excellent response on the part of the people and the cases of measles decreased.

 

 Nowadays, the recommendation of the vaccine when the child is 6 months old.  Anyway, this may be modified:  return to vaccination against measles at the age of 9 to 12 months and a supplement of Viral Triple between the 15th and 18th months of life, when starting school and at the age of 12 years.

 

 In each country the scheme may vary a little but not in its essence: having the biggest quantity of vaccinated children possible or all of them, which would be ideal.

 

A vaccine avoids an innumerable quantity of problems in children. 

 

 Measles is a very contagious viral disease.

 

 The incubation period is of 8 to 12 days from contact.

 

 The transmission period can vary between 4 days before the appearance of the spots until 4 or 5 days after that (some authors say that until 7 days after the appearance of the spots).

 

The breathing isolation of the patient during that period is recommended, and during the whole disease if the patient is immunocompromised.

 

 

 Signs and symtomps
The Typical Measles starts as an unspecific febrile disease accompanied by what the pediatricians call triple catarrh, which involves nasal catarrh, bronchial catarrh and conjunctivitis (conjunctival catarrh).  Within  24 hours before the appearance of the spots on the skin (morbilliform exanthema) we can see some lesions   in the region of the oral mucosa, called Koplick’s Spots, which are characteristic of measles; sometimes these lesions are not visible because they disappear quickly.

 

 The eruption on the skin is red, it does not often itch.   It normally starts in the back of the ears and scalp spreading afterwards to all the body (face, chest, back and limbs) in the term of 2 to 4 days.

 

In the face and chest the spots may form vast areas which start to disappear approximately a week later in the same order they appear.

 

 In the case of children under 9 months old, the measles can appear in a light way due to the presence of protective mother antibodies; the same happens with those children who have previously received gamma-globulin (this type is called Modified Measles).

 

 The atypical measles occurs in patients who received vaccination to dead virus (between the years 63 and 68) and it may present unusual, unspecific, prolonged and severe manifestations.

 

 In the case of children having immunodeficiencies the disease can be very serious with a higher possibility of complications and risks.

 

 Complications:
laryngitis, otitis (the most frequent one), bronchiolitis, pneumonia, bronchitis, diarrhea, purpura, problems with the appendix, acute encephalitis (between 0.5 and 1 out of 1000 may present it with a mortality rate of 11%).  Other complications of  neurological type are the Guillian Barré Syndrome and neuritis.

 

 There is a belated complication which is not frequent (1.2 cases out of 100,000): Subacute Sclerosis Panencephalitis, which has a long incubation period of about 7 years, causing progressive damage of the intellectual level and conscience, it is not habitual but it exists.

 

 Treatment: antipiretics, nebulizations, ocular drops and antibiotics (only if the patient presents complications of bacterial type).

 

 

 Prevention

 Vaccination
  In some cases the pediatrician will indicate the use of gamma-globulin when there is intimate contact with people likely to have the disease (always under medical control).

 Remember.

 The measles diagnosis must be made by a professional according to the symptoms of the patient and after having discarded the possibility of other causes of disease.

 If there is epidemiological necessity or doubt about the diagnosis, the doctor will request the corresponding serology (blood test to confirm the diagnosis)


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