Mechanisms of development and symptoms of measles in children and adults

Symptoms of measles in children (photos), treatment and prevention measures

Measles is one of the representatives of acute, highly contagious viral infections, characterized by inflammatory reactions in the mucous membranes of the oral cavity, conjunctiva and respiratory organs, accompanied by very high temperatures, intoxication symptoms, macular and papular rashes (see photo).

The causative agent of the disease is a filterable, negligible varion belonging to the Myxovirus family. It does not have high resistance in an open environment and dies quickly outside the body. A child can become infected with measles through contact with a carrier of the infection at the very peak of its infectiousness, several (3-4) days before the onset of the rash.

How does measles spread?

The virus spreads through the air, the current from which can even reach another floor through ventilation pipes. In a closed, cramped room, it easily affects the respiratory tract, mucous membrane of the throat and eyes. It also enters the body with droplets of saliva from a sick person when he sneezes or coughs. Sunlight quickly kills the measles virus. Disinfection of the room in which sick children were located is not required; good ventilation is sufficient, since the lifespan of the virus is only 2-3 hours at normal temperature.

If a child is not vaccinated on time, then in close contact with a sick person he will definitely get sick. The virus reaches its peak development towards the end of the incubation period and over the next few days. It is at this time that the patient is contagious to others and should not have contact with other children or attend kindergarten or school.

The measles virus, during its life processes, produces toxic substances that poison the body of children. A symptom of measles is a characteristic red rash on the face and body.

Definition of disease

Measles is an acute infectious disease caused by an RNA virus of the Morbillivirus genus.
It is characterized by low stability in the external environment. At room temperature it remains active for 24–48 hours. It dies quickly when dried, heated to 50°C, or exposed to ultraviolet radiation. The first detailed descriptions of the signs of measles appeared in the 17th century, although the disease itself has been well known to mankind since ancient times. In those days, the disease was often called the “childhood plague”, since it was practically not observed in adults. This was explained by the fact that more than 90% of people suffered the infection at an early age - from infancy to 10 years.

Measles is easily transmitted from one person to another, which is why epidemics have occurred regularly in the past. In many children, the disease progressed with the development of serious complications that led to death.

The measles virus was isolated and described in 1954. Nine years later, the first measles vaccine was created. By 1990, about 80% of the population had been vaccinated against measles in most countries. Thanks to this, a steady decline in the number of cases began. If in 1983 about 4 million cases of the disease were registered in the world, then in 1990 - 800,000¹. The mortality rate has also decreased significantly.

An unvaccinated child came into contact with a person with measles. What to do?

“An unvaccinated child who has not reached vaccination age (3-12 months) is given immunoglobulin. This must be done no later than 3-5 days from the moment of contact with the patient. A child over 12 months of age who has not previously been vaccinated for any reason or has been vaccinated once is given post-exposure prophylaxis with a live measles vaccine - within 72 hours of contact with the patient.”

Vanina Yulia Evgenievna

expert

Children's clinic "RebenOK", pediatrician

Measles continues to be a serious problem today. This infection has “matured” and now often affects not only children, but also adults. The last major measles outbreak was reported in almost all countries in 2017–2018. Experts from the World Health Organization largely attribute its occurrence to a decrease in the level of vaccination of the population. This was largely facilitated by the “anti-vaxxer” movement.

The WHO called population distrust in vaccination in 2021 one of the global problems of modern health care.

Illness in early childhood

Features of the course of measles in young children:

• Children under three months of age cannot become infected with measles - this is due to the fact that their mother passed on her immunity to them at birth. The woman herself was either vaccinated against measles or had it.
• Passive immunity, which lasts up to 6 months, protects infants at this age and they become infected extremely rarely.
• For early childhood, the atypical form of measles is more typical. There is a shortened catarrhal period, mild symptoms, the absence of Filatov-Koplik spots and enanthems on the oral mucosa. Sometimes the incubation period is replaced by a rash, and the catarrhal period is completely skipped.
• Although the symptoms in early childhood are not as severe, measles often causes complications. This is due to the fact that a weak immune system does not always know how to fight back a powerful virus that suppresses all the body’s defenses.

Vaccination

In Russia, routine vaccination against measles is carried out simultaneously with vaccination against other childhood infections - mumps and rubella. The first vaccination is given to babies at the age of 12 months. At this time, the protective antibodies they received from their mothers almost completely disappear in their body. Revaccination is performed before the child enters school - at 6 years of age.

Routine measles vaccination is also carried out for all adults under 35 years of age, if they have not previously had measles and have not been vaccinated.

The best protection against measles is vaccination. Photo: Amaviel/Depositphotos

The measles vaccine is usually well tolerated. There may be side effects - a slight increase in body temperature and mild soreness at the injection site.

Revaccination - once every 10 years

Some studies show that 10 years after vaccination, the level of antibodies in the blood of 30-40% of people decreases so much that the body can no longer provide protection against measles¹. Therefore, adults are recommended to have a booster vaccination every 10 years. It is especially important for workers in the fields of education, public utilities, social protection, and healthcare.

Measles symptoms, photo

Oddly enough, even the most perceptive parent will not see how measles begins (see photo). This insidious disease develops in stages, and the initial period can last weeks and not manifest itself at all. The child will continue to have fun and play, and at the same time the harmful virus will undermine his body from the inside.

1) Incubation period of childhood measles: 7–14 days (counted from the moment of infection until the immediate appearance of the first symptoms).

2. Catarrhal period, when children show the first signs of measles, reminiscent of all the symptoms of a cold:

• general malaise;
• lack of appetite;
• severe weakness;
• headache;
• insomnia;
• temperature 38–40°C;
• runny nose with purulent mucous discharge from the nose;
• swelling, redness of the eyelids;
• lacrimation;
• dry, persistent cough;
• conjunctivitis (purulent inflammation of the eye mucosa);
• loose stool;
• hoarse voice;
• photophobia;
• stomach ache;
• Children under one year of age often experience a decrease in body weight.

3. The main symptoms of measles in children (almost three weeks after the first signs of the disease):

• grayish-whitish small rashes (the size of a poppy seed) in the mouth, on the mucous membrane opposite the molars;
• after another 5 days, bright, merging spots appear (size - up to 10 mm), slightly rising above the skin: they begin to appear first behind the ears, on the forehead, then on the rest of the face, neck, then throughout the body, in lastly - on the arms and legs;
• small pink spots rapidly increase in size, merge, and take on an awkward, irregular shape;
• 3 days after intense rashes, the temperature rises again (in most cases) to 40.5°C.

The rash covers the child’s body for an average of 4 to 7 days; at first, it leaves brownish pigment spots that begin to peel off; after another couple of weeks, the skin completely clears. The rash disappears in exactly the same order as it appeared - from the face to the extremities. This is how measles manifests itself at different stages of its development: you need to know about this so as not to confuse the disease with other infectious diseases (with the same cold), not to self-medicate, and to show your child to the doctor in a timely manner.

Classification

Measles can be very severe and require emergency care. It is important to know that the disease can be not only typical, but also atypical:

1. Mitigated (weakened) measles. The disease develops in people who were administered anti-measles gamma globulin at the very beginning of the incubation period for the purpose of prevention. It is less common in previously vaccinated individuals who have not developed a full immune response. In this form of the disease, intoxication and catarrhal symptoms of measles are mild, the rash is faint and not abundant, Belsky-Filatov-Koplik spots are often absent.
2. Abortion measles. It begins in the same way as a typical form of measles. But the temperature lasts no more than two days. Skin rashes are observed only on the head and torso and do not affect the limbs.
3. Hemorrhagic measles. An extremely severe form of the disease that can be fatal. It is characterized by a rise in body temperature to very high values, severe intoxication, and the appearance of hemorrhages on the skin and mucous membranes. Blood may appear in the urine - hematuria.
4. Hypertoxic measles. Body temperature rises to 40–41°C. The general condition is rapidly deteriorating. Signs of cardiovascular failure appear and increase - decreased blood pressure, a sharp increase in the number of heartbeats, pale skin, cold sweat. It is possible to develop neurotoxicosis - a toxic lesion of the central nervous system. Its signs are headache, nausea, repeated vomiting, disturbances of consciousness, and convulsions³.

Measles can be very severe and fatal. Photo: PHIL CDC

Abortive form

The abortive form of measles in a child is one in which, after a catarrhal period, all symptoms disappear by themselves. The rash appears only on the face, sometimes on the neck. There is a latent form of the disease, when the rash does not appear at all, and catarrhal symptoms are mild.

A feature of measles is its ability to become more severe due to the addition of complications. Complications of measles in children occur when bacterial flora is attached. The respiratory tract is most often affected. Pathologies of the respiratory system include purulent tracheitis, laryngitis, bronchitis and pneumonia.

Anomalies during the recovery period

Here, diseases of the nose, oral cavity and neighboring parts are in the foreground.

Instead of the usual measles runny nose, dry swelling develops on the nasal mucosa, which, like a syphilitic runny nose, causes wheezing during nasal breathing.

In other cases, copious, purulent secretions flowing from the nose are accompanied by ulceration near the nostrils and in their circumference, which can be extremely persistent and is accompanied by prolonged fever.

The resulting ulcerations become covered with a greasy coating and become diphtheritic in nature.

From the nose or actually from the back wall of the pharynx, the process through the Eustachian tube can move to the middle ear. The temperature rises again, children become very restless, sleep poorly, clutch their heads, refuse to swallow; older children complain of tingling in the ears or headaches. Pressure on the tragus is very painful, and otoscopy clearly reveals otitis media.

In the oral cavity, stomatitis aphthosa or ulcerosa is observed, to which noma can join. The measles process provides particularly favorable conditions for such ulcerative processes, which is why stomatitis with measles requires especially careful care and treatment.

Inflammatory swelling of the mucous membrane of the larynx can already in the first days of illness lead to the so-called false croup with severe difficulty breathing. The voice, which was already hoarse before, becomes completely silent, and signs indicating difficulty in accessing air to the upper respiratory tract become more and more prominent.

Forced inhalations, made with the assistance of the auxiliary respiratory muscles, are not able to deliver a sufficient amount of air through the narrowed larynx; The negative pressure in the chest cavity formed as a result of inspiratory movements is not equalized by filling the lungs with air, so external atmospheric pressure acts on the chest wall, causing retractions in pliable areas, in the epigastric region and jugular fossa.

The resulting danger of asphyxia requires the same measures as for diphtheria croup. But here we are dealing with a different anatomical process, since the narrowing of the lumen of the larynx is not caused by films, but by severe hyperemia and inflammatory swelling of the laryngeal mucosa.

But not only the mucous membrane is inflamed, but also the submucosal layer, perichondrium and adjacent connective tissue. This severe inflammation is accompanied by severe pain in the larynx, which is often detected by touch and almost always by light pressure.

If real croup is observed with measles, that is, narrowing of the larynx due to the formation of films, then it is always explained by a mixed infection with real diphtheria.

The same process that leads to the development of measles false croup in the upper respiratory tract can, of course, affect the lower respiratory tract and cause more or less widespread inflammation of large or small bronchi, i.e., lead to bronchitis, bronchiolitis and bronchopneumonia.

In children, during or after a rash, the following is observed:

• very severe shortness of breath,
• they become cyanotic and restless,
• the fever does not subside or intensifies again and exhibits an abnormal remitting character,
• the general condition is seriously disturbed.

The danger that this post-measles lesion of the respiratory system entails depends, firstly, on the spread of the process itself, on the size of the respiratory surface and, finally, on the age of the child.

The greatest danger is caused by bronchiolitis, which affects the smallest bronchi and quickly eliminates a significant part of the respiratory surface. This danger is especially great in young children, in whom the small lumen of the small bronchi can be blocked more quickly than the relatively larger lumen in older children.

It must be remembered that in very young children, bronchi that cannot actually be considered the smallest branches of the bronchial tree can become blocked due to inflammatory swelling. Each blockage of such a branch of the bronchi excludes a relatively large area of ​​the respiratory surface, and the higher the obstacle to breathing lies, the larger part of the lungs is excluded.

Another form of this disease seems less dangerous, in which certain areas of the lungs are affected, while others remain unaffected, and if affected, it is very weak.

In such cases, in one part of the lungs there are limited nests of bronchiolitis and bronchopneumonia, which, merging into large nests, then make it possible to clearly recognize the phenomena of pneumonic infiltration during physical examination of the patient.

If this process is moderately widespread and other severe complications do not occur, then the prognosis is relatively favorable. But it goes without saying that it becomes darker when the pneumonic process spreads to a more or less significant surface, for example, to several lobes.

In this case, a picture of the disease is obtained that is consistent in nature with severe fibrinous pneumonia: remitting, irregular fever becomes high and constant, intense and accelerated breathing, as well as a painful cough are painful.

There is delirium, and sometimes convulsions occur in young children. Almost always the pleura is also affected at the same time.

The mucous membrane of the digestive organs, namely its lymphatic apparatus, is also always affected in severe cases of measles.

Sometimes this complication can dominate the entire picture of the disease:

• vomiting and very severe diarrhea appear,
• difficult to treat and disappearing only with blanching of the rash.

In other more frequent cases, along with a decrease in fever, an intestinal disease develops, representing all the essential signs of enteritis; Frequent but not profuse bowel movements are observed, containing cloudy, purulent mucus and blood.

Such measles enteritis is mostly benign and goes away after a few days, but sometimes it happens that a persistent intestinal disorder of a typhoid or enteric nature develops, which in itself is life-threatening and is also dangerous in the sense that it contributes to the development of sepsis.

Disorders of intestinal activity are especially unpleasant in cases where other complications of measles already make the therapeutic task more difficult, for example, when lung diseases place great demands on the patient’s strength.

Finally, it should be noted that the measles process reduces the ability of both the respiratory and digestive apparatus to resist specific secondary infections.

The nervous system is rarely so affected that it dramatically affects the course of the disease. The phenomena observed in many febrile infectious diseases, such as delirium, drowsiness, etc., do not in themselves have any special significance.

As for convulsions, which are observed especially in young children, those that appear in rare cases before the rash usually do not have a poor prognostic value; on the contrary, convulsions that occur with the appearance of a rash almost always indicate a very severe course of the measles infection itself.

Complications

One of the distinctive features of the measles virus is its ability to suppress the immune system, which can cause many complications from a variety of systems and organs. Most often, opportunistic microflora is activated, which was always present in the child’s body, but was successfully suppressed by his immune forces.

Complications can be early and late, caused both by the virus itself (primary) and resulting from the superposition of a bacterial infection (secondary).

Complications from the respiratory system:

• pneumonia;
• bronchitis;
• bronchopneumonia;
• laryngitis;
• pleurisy.

Primary complications caused by the measles virus:

• early measles giant cell pneumonia;
• encephalitis;
• meningoencephalitis;
• subacute sclerosing panencephalitis.

Complications from the central nervous system:

• encephalitis;
• meningitis;
• polyneuritis;
• meningoencephalitis.

Complications from the digestive tract:

• stomatitis (inflammation of the oral mucosa);
• enteritis (inflammation of the small intestine);
• colitis;
• stool disorder due to increased activity of pathogenic microflora.

Complications from other organs and systems:

• conjunctivitis;
• otitis;
• blindness;
• myocarditis.

Complications from the genitourinary system:

• pyelonephritis;
• cystitis.

Unfortunately, some complications, especially from the central nervous system, can be fatal.

Stages of rashes

The rash appears 3–5 days after the first signs of the disease. It is found first on the face in front and below the ears and on the sides of the neck as uneven spots, soon mixing with papules. Within 24 to 48 hours, the rash spreads across the trunk and limbs (including the palms and feet) and begins to fade on the face.

1. The fourth day of the rash is characterized by regression of the rash elements, similar to the order of their appearance, leaving behind light brown areas of increased pigmentation, disappearing after 5-7 days. At the site of pigmentation, pityriasis-like peeling remains for some time (especially on the face).

Diagnostics

When measles occurs in its typical form, it is not difficult to diagnose the disease. The presence of clear signs of measles described above will rule out other diseases. To make a diagnosis of an atypical form of the disease, the patient should undergo a number of additional tests:

• general blood and urine tests;
• blood test for the presence of the virus or nasopharyngeal smears (virological method);
• blood test for antibodies and increasing their titer (serological method);
• carrying out a hemagglutination inhibition reaction, which can indicate the presence of an infectious lesion.

When complications develop, the doctor additionally prescribes other tests. The most common among them are electroencephalography and chest x-ray.

Atypical course of measles

There is a typical and atypical course of measles. The typical clinical picture was described above. An atypical course is as follows:

1. Erased (mitigated) form of measles. It occurs in a very mild form and occurs with the administration of gamma globulin or immediately after vaccination against measles.

2. Hemorrhagic form - accompanied by multiple hemorrhages, bloody stool and urine. The patient often dies from bleeding. With timely hospitalization and intensive care, the outcome can be conditionally favorable.

3. Hypertoxic. Observed with increased intoxication. The patient may have a very high, persistent temperature, signs of meningoencephalitis, heart failure and other symptoms. This form requires immediate hospitalization.

Complications most often occur in adults with reduced immunity and in the elderly.

How to treat measles?

There are no special treatments for measles; the body will cope with the infection on its own. Treatment of the child here is symptomatic, which will alleviate the general condition of the patient:

1. Antihistamines. Prescribed to relieve swelling of the nasopharyngeal mucosa.
2. Antipyretic. It is recommended to use drugs based on paracetamol and ibuprofen.
3. Vitamin therapy. With measles, vitamin metabolism is disrupted and the body's protective properties are significantly reduced. Your doctor may prescribe vitamin C and a vitamin complex.
4. Cool damp air in the room. Helps moisturize mucous membranes, cough becomes less dry.
5. Hygiene procedures. During the recovery period, you can take baths. It is also necessary to carry out thorough oral hygiene and wash the eyes if there is an inflammatory process.
6. Diet. After the acute period, when the temperature subsides, the child develops an appetite. Light, pureed, warm food should be offered.

During illness, it is also important to provide the child with the necessary vitamin complexes to maintain immunity, and to lubricate chapped lips with Vaseline.

A patient with measles needs bed rest while the temperature persists. If possible, give him a separate room. Wet cleaning should be carried out at least 2 times a day. It is very important that the air remains fresh at all times, so ventilate the room more often. If bright light causes discomfort, then close the curtains and in the evening turn on a table lamp instead of a chandelier. Follow a daily routine. Although sleep is disturbed and insomnia has appeared, try to go to bed on time. This is especially true for children. If it is difficult to keep your child in bed, then allow him to play quiet games, watch a little TV, or read together. But it is advisable that he sleep after lunch.

Symptomatic treatment is carried out at home under the supervision of a pediatrician. The child is admitted to the hospital department if complications begin to develop. If there are complications, therapy is supplemented with antibacterial drugs.

What is measles?

Measles (lat. morbilli) is an acute infectious disease of a viral nature, characterized by a rash, high body temperature, inflammation of the oropharynx and redness of the eyes.

Measles is a contagious disease with almost 100% susceptibility of the body to infection, the main cause of which is the entry of the measles virus into the body. The mechanism of transmission of infection is airborne droplets, through sneezing, coughing, talking at close range, sharing dishes with a carrier of the infection. Sometimes infection occurs from a pregnant woman to the fetus.

In most cases, the measles virus infects children, which is why measles is most common in children. Measles also occurs in adults, but mainly only in people with a pathology of the immune system or in those who did not have it in childhood, because After this disease, the body develops immunity to this type of virus. If the expectant mother once had measles, resistance to this virus is transmitted to the newborn baby, but only for 3 months after birth. Next, the immune system changes and becomes susceptible to the measles virus.

The acute course of measles can lead to the death of a child, so it is classified as a deadly disease. Other complications of measles include infectious diseases of the respiratory tract, gastrointestinal tract and meninges.

How is measles transmitted?

The causative agent of measles is the measles virus, which is an RNA virus of the genus Morbillivirus, family of Paramyxoviruses.

The source of infection is a person with measles who is contagious 6 days or less before the rash appears, as well as in the first 4 days after the rash appears, after which the patient is considered non-infectious.

Route of transmission of measles:

- airborne, which implies the transmission of infection through mucus released when sneezing, coughing, or talking at close range. Remember, a frequent tool for the spread of infection is a closed, poorly ventilated space, for example, premises in kindergartens, school classrooms, offices, public transport, etc. The infection very quickly concentrates in the air where its carrier is located, and if the room is not ventilated, it easily reaches the upper respiratory tract of a healthy person.

- contact household - through the use of the same utensils with a carrier of infection. Failure to comply with this simple safety rule often becomes the cause of various infectious diseases at school and at work.

- vertical route - infection of the fetus occurs from an infected pregnant woman.

How to inactivate the measles virus?

The virus is killed by boiling, treatment with disinfectants, or irradiation. At room temperature, its activity lasts no more than 2 days, at low temperatures -15-20 ° C - for several weeks.

It is important to know!

The period from contact with a person with measles to the appearance of the first signs of the disease lasts from 7 to 14 days.

Periods (stages) of measles

Stage 1 of measles (catarrhal period) appears after a period of incubation of the virus and is characterized by an acute onset. The first signs of measles are general malaise, weakness, headaches, red eyes (conjunctivitis), and loss of appetite. Body temperature also increases, which in severe cases reaches 39-40 °C. Next, a profuse runny nose appears, in which there may even be purulent discharge, dry cough, hoarseness, stenotic breathing (in some cases), photophobia, hyperemia and granularity of the mucous membranes of the mouth and pharynx, granularity of the posterior pharyngeal wall.

Measles in adults is characterized by more pronounced signs of intoxication of the body, enlarged lymph nodes, mainly cervical (lymphadenopathy), wheezing in the lungs when breathing.

One of the main signs of the catarrhal period is also Filatov-Koplik-Velsky spots, which are white, slightly protruding compactions, with red edges, located on the mucous membranes of the oral cavity, more often on the cheeks opposite the small molars, less often on the lips and gums. Before these spots, or in time with them, measles enanthema appears on the palate - small red spots, which after a couple of days merge with the general hyperemia of the mucous membranes of the oropharynx.

The duration of the catarrhal period of measles is 3-5 days, in adults – up to 8 days.

Stage 2 of measles (the period of rash) - characterized by the maximum concentration of measles virus in the blood and the appearance of a bright maculopapular exanthema, which increases as it develops, capturing healthy areas of the skin. At the beginning, the rash appears on the head - behind the ears and scalp, then, usually on the second day, it covers the upper part of the person’s torso and arms, on the third day the exanthema appears on the lower part of the person and legs, at the same time, the rash on the head begins to turn pale .

The measles rash in adults is usually stronger than in children, sometimes with the appearance of hemorrhagic elements.

The period of rash is accompanied by increased symptoms of measles and catarrhal period, as well as the appearance

attacks of tachycardia, arterial hypotension (low blood pressure).

After the first 4-5 days of the rash, the immune system produces antibodies that neutralize the virus, but the pathological process of disease development continues.

Stage 3 of measles (pigmentation period) usually occurs 4-5 days after the rash - characterized by a decrease in signs of measles, an improvement in the patient’s well-being, and a decrease in body temperature, which occurs due to the production of antibodies by the immune system that neutralize the measles virus.

The rash on the body, again, starting from the head to the lower part of the body, begins to fade, turning into light brown spots, which in turn disappear after 7 days. In their place, mainly on the face, pityriasis-like peeling of the skin appears.

After fighting an infection, the immune system weakens and slowly recovers over the following weeks and sometimes months. During recovery, the body is vulnerable to other types of infections, especially bacterial ones, and pathogenic factors.

After fighting measles, a strong immunity to this type of infection is developed, so re-infection with measles is unlikely.

Measles - symptoms

The incubation period of measles lasts about 7-14 days (on average), after which the first signs of the disease appear.

First signs of measles

General malaise, weakness, increased fatigue;

Increase in body temperature to 39 °C and above;

Runny nose with copious, sometimes purulent discharge;

Dry cough, barking in children;

Headaches, photophobia;

Conjunctivitis (soreness in the eyes and their redness, increased tearing);

Lack of appetite.

Main symptoms of measles

Rash all over the body, spreading from the head, then down to the lower body and legs;

White (like an accumulation of semolina) and red spots in the oropharynx;

High body temperature;

Cough, hoarseness, sometimes wheezing when breathing;

Conjunctivitis, photophobia;

Facial swelling;

General malaise, weakness;

Lack of appetite.

Important! Measles symptoms in adults are usually more severe than in children!

Complications of measles

Complications of measles include:

Disturbances in the functioning of the central nervous system (CNS);

Respiratory diseases

tonsillitis, laryngitis, tracheitis, bronchitis, pneumonia (pneumonia), croup, pleurisy, sinusitis;

Diseases of the gastrointestinal tract (GIT) – hepatitis;

Other diseases - lymphadenitis, otitis media, meningitis, encephalitis,

panencephalitis, stomatitis, blepharitis, keratitis, blindness, cystitis,

pyelitis, pyelonephritis, enteritis;

Cerebral coma, death.

Treatment of measles

How to treat measles? Treatment for measles currently focuses on suppressing symptoms and strengthening the immune system. There is no specific medicine against the measles virus yet (as of 05.2017). At the testing stage, ribavirin showed its effectiveness against the measles virus, but it is not currently used in treatment against this disease. Also, some specialists use interferon-based drugs to treat measles.

Treatment of measles includes the following:

Bed rest;

Symptomatic treatment;

Detoxification therapy, drinking plenty of fluids;

Strengthening the immune system;

An uncomplicated form of measles is treated at home, a complicated form is treated in a hospital.

1. Bed rest

Bed rest for severe infectious diseases is aimed at accumulating the body's forces necessary to fight the infection. In addition, the patient must be isolated from other people who have not previously had measles, therefore, at the first signs of measles, the child must be kept from going to kindergarten or school, and the adult must refrain from going to work.

In the room where the patient is located, you need to dim the light a little.

2. Symptomatic treatment (medicines for measles)

Important! Before using medications, be sure to consult with your doctor. Remember, medications have a number of side effects, so extreme self-medication is not recommended.

ATTENTION! When the first signs of the disease appear, it is necessary to call a local doctor at your place of residence. For questions regarding the disease, you can get advice by calling 96-93-00.

Hospitalization of children with measles in the city of Lugansk will be carried out in the infectious diseases department of the State Institution "Lugansk City Multidisciplinary Hospital No. 15" of the LPR, adults in the State Institution "Lugansk City Multidisciplinary Hospital No. 4" of the LPR, in other regions of the Republic in the infectious diseases departments of each city and district.

Consequences of measles

The consequences of measles can be quite unexpected. For example, some medical professionals believe that the measles virus can provoke in the future the development of diseases such as lupus erythematosus, rheumatoid arthritis, multiple sclerosis, systemic scleroderma, encephalitis and others.

Preventing measles

Prevention of measles includes the following preventive measures:

Vaccination – measles vaccination is given to children 2 times, at the ages of 1 and 6 years. Recently, live measles vaccine (LMV) - Ruvax, MMR, MMRV - has been used as a vaccine against measles;

If there are contraindications to vaccination, immunoglobulin is administered;

The source of infection is isolated for as long as the virus can actively spread through it - up to 4 days of rash;

In the autumn-winter-spring period of the year, additional intake of vitamins is necessary;

Observe the rules of personal hygiene;

When a measles epidemic is announced, try to avoid being in public places, as well as other places where there are a large number of people;

More often ventilate the room in which you spend a lot of time - apartment, house, office, etc.;

When talking to other people, try not to come closer to them than at arm's length.

Material prepared by: Head of the Department for Expertise of the Quality of Medical Care, Epidemiology and Infection Control Anna Aleksandrovna Havrel

Diet and nutrition

A few more tips to help defeat measles

1. The menu should contain a lot of vegetables and fruits, both raw and stewed and boiled. Vegetable soups with cereals in low-fat meat broth are good.
2. Ready-made dehydration solutions Regidron and Humana Electrolyte help restore water and mineral reserves. You can prepare a similar solution yourself by dissolving 1 tbsp in a liter of boiled water. sugar, 1/2 tsp. baking soda and 1 tsp. salt.
3. Drink plenty of fluids. The norm for an adult is 2.5-3 liters per day, and for a child 100-150 ml/kg per day. Compliance with this rule helps to remove harmful waste products of viruses from the body, reduce allergy in the body and prevent complications from occurring. You can drink clean water, compotes, juices, fruit drinks, teas.
4. Food should be warm, but not hot, so as not to irritate a sore throat. For the same reason, it is desirable that the dishes be pureed and semi-liquid (mashed soups or milk porridges). Such food is easy to swallow without irritating the mucous membrane of the mouth.
5. Any semi-liquid porridge is suitable as a side dish: rice, buckwheat, millet.
6. Fermented milk products, especially kefir, narine and homemade yoghurts, improve immunity well.
7. To strengthen the immune system, you need protein dishes made from lean pureed meat and fish (steamed cutlets, pate or soufflé). As well as omelettes, cottage cheese in its natural form or in a casserole with cereals and berries.

Diagnosis

The diagnosis of measles is not difficult. The peculiar course of the disease, the almost regularly lasting 11 days incubation period, the prodromal stage lasting three days with its sharp catarrhal symptoms, and finally, the characteristic rash - all this makes it possible to make a diagnosis very easily.

But, it goes without saying that there are many cases in which the situation is not so simple.

In some of them, almost no phenomena are observed in the prodromal period, in others, instead of catarrh of the mucous membrane of the respiratory tract and eyes, a disease of the pharynx and tonsillitis develops, which at first is misleading.

Then the rash may be uncharacteristic, resemble scarlet fever, etc.

On the other hand, serum or drug rashes can be so similar to a typical measles rash that it is sometimes difficult to decide what is going on. In such cases, the solution to the issue depends on various studies.

Preventive measures

Prevention of measles in children includes several important points.

1. Vaccination. The most effective protection is a vaccine. It can be single-component or multi-component (MMR, or measles, mumps, rubella). The vaccination is carried out at 1 year, then again at 6 years. Up to 10% of vaccinated children may develop a mild form of infection with a minor rash and fever. At this point, children are considered not contagious. Due to the massive refusal of vaccinations in Russia, cases of measles have become more frequent. According to statistics, 80% of children who suffered from this disease were not vaccinated.
2. Taking immunoglobulin, or passive immunization. If it is known that the child had contact with a carrier of measles or was in an outbreak of the disease, immunoglobulin can be used, which provides immunity from infection for one month.
3. Quarantine. In the children's group where a case of measles was recorded, anti-epidemic measures and daily preventive examination of children are carried out. A child is considered contagious several days before the first symptoms appear, as well as for 5 days after the first skin rash appears. Staying in a children's group is prohibited. Quarantine is carried out only for unvaccinated children under 17 years of age.

Recurrence of measles occurs in extremely rare cases. After an illness, immunity is lifelong. After vaccination, stable immunity remains for 15 years.

Measles in an adult and a child - differences

The clinical picture of measles in children and adults differs in characteristic features, which are presented in Table 2.
Table 2. Differences in the clinical picture of measles infection in children and adults³.

Measles in children occurs in a milder form than in adults. So far, experts cannot clearly explain this phenomenon. Perhaps it is associated with the peculiarities of the child’s immune response. In children, the thymus gland actively functions, in which the differentiation of special cells - T-lymphocytes - occurs. They play an important role in protecting the body from various microorganisms, including viruses. But after 5–6 years, the activity of the thymus gland decreases, and by 30–40 years it is almost completely replaced by adipose tissue and ceases to perform its functions.

In addition, in young children the number of lymphocytes in the blood prevails over the number of neutrophils. At the age of 5–6 years, the so-called crossover of the leukocyte formula occurs. As a result, the content of neutrophils in the blood increases and the number of lymphocytes decreases. Neutrophils provide protection against bacterial infections, and lymphocytes provide protection against viral infections. Perhaps this circumstance is associated with a more severe course of measles in adults.

Lifetime immunity

“Children who have had measles or received a full course of vaccination develop lasting immunity to this disease.”
Vanina Yulia Evgenievna

expert

Children's clinic "RebenOK", pediatrician

Source of infection

The source of measles can only be a sick person. Even if the incubation period has not yet ended and the patient has not shown any symptoms of the disease, he may already pose a threat to the release of the virus and thereby the possibility of infection for others. People who are asymptomatic are also considered contagious. Persons after vaccination do not pose a danger to others, even if their temperature rises or rashes appear.

Measles transmission route

As already noted, measles is a disease that can only be spread by humans. It is the source of the virus in the last days of the incubation period.

The disease can be transmitted in two ways:

• aerogenously through coughing, sneezing, talking, crying or screaming;
• transplacentally, when the virus is transmitted from a sick mother to a child, but this route is very rarely encountered in the practice of doctors.

Measles is a highly contagious disease. When communicating with a sick person per day, about 40% of all people around him become infected, and with three-day contact, the disease affects 80%.

The average incubation period of the virus in the body is 9-11 days, but in medical practice it is not uncommon when such a period can vary from 7 to 28 days. Sometimes people suffer from infection asymptomatically, revealing the presence of the virus in a blood test during concomitant diseases and examinations.

Apart from the epidemiological situation, which is the result of imported outbreaks of measles, epidemics of this infection occur in the regions approximately every 8-10 years. Epidemic outbreaks become possible due to a high percentage of the population that has not been vaccinated and has not recovered from the disease. The most common places of concentration of measles patients can be considered school and preschool institutions.

Since the temperature for maintaining the viability of the virus outside the human body is about 15 degrees, the ideal periods for its spread are spring or summer.