Measles

Reviewed by Dr John Pillinger, GP

What is measles?

Measles is one of the most contagious viral diseases. It is caused by paramyxo virus and is the most unpleasant and the most dangerous of the children's diseases that result in a rash. This is due to the complications of the disease.

How is measles transmitted?

Droplets transfer the infections. Although the sick person may be in isolation, the disease may still spread from room to room.

Anybody who has not already had measles can be infected.

Infants up to four months of age will not be infected if their mother has had measles herself because they will be protected by her antibodies.

The incubation period - the time between infection and the outbreak of the condition - is usually one to two weeks.

Patients are infectious from four days before the onset of the rash until five days after it appears.

What are the symptoms of measles?

After about 14 days the following symptoms start showing:

a fever at about 39ºC.

a cold.

coughing, possibly with a barking cough.

sore throat - the lymph nodes in the throat may swell.

reddish eyes.

sensitivity to light.

greyish spots, the size of grains of sand may appear in the mucous membrane of the mouth just around the molar teeth. These are called Koplik's spots and can be seen before the rash appears.

after three to four days the temperature may fall, although it can run high again when the rash appears.

the rash usually begins around the ears and spreads to the body and the legs within a day or two.

at first the spots are very small - a couple of millimetres - but they double in size quickly and begin to join together.

the spots are a clear red colour.

the temperature, which may run as high as 40ºC, may stay that high for a couple of days. Then it disappears together with the rash, which may leave some brown spots.

after a week the child will be fit again.

Children who have had measles cannot return to school or childcare before they recover and the temperature is gone.

The doctor should give children under the age of one who are exposed to the disease an immunity injection within five days.

In the UK all children between the age of 12 and 15 months are offered the MMR vaccination, which will protect them from measles, mumps and rubella.

How are measles treated ?

The treatment is to stay in bed in a cool room without any bright lights. Medicines for coughing and reducing the temperature should only be given after consulting a GP.

Future prospects

The doctor should be consulted immediately if the condition of the child gets worse or the temperature stays high.

The doctor must make sure there are no further complications such as:

pneumonia

inflammation of the middle ear

inflammation of the nervous system. Luckily, this seldom happens and is the exception rather than the rule.

Once a person has had measles, they can never catch it again as the disease gives lifelong immunity.

Measles and pregnancy

If you are planning a pregnancy, you should make sure that you have a measles vaccination unless you have had the disease in the past.

Having measles during a pregnancy can result in an infection of the unborn child and may in the worst case result in the death of the baby.

If in doubt you should consult your GP in order to get the MMR vaccine. This vaccine cannot be given during pregnancy.

The recent large rise in the number of cases of measles in the UK has been directly linked to a fall in the number of children receiving the MMR vaccine.

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