Measles

A rise in measles infections is making the news here in the U.S.  Cases of the disease have been seen in several states, particularly Ohio.  Many of the individuals who have caught the disease had recently traveled to the Philippines where there are currently thousands of cases.  Others were never vaccinated for the virus due to personal or religious reasons.   

We do not see a lot of measles cases in the United States anymore due to effective vaccination.  The measles vaccine was introduced in 1963, improved in 1968, and was available as a combination vaccination (MMR) in 1971.  World-wide there are 30 to 40 million cases each year and close to one million deaths as a result of measles infection.    

Measles (rubeola) is caused by a virus.  It is a highly contagious respiratory infection that is transmitted from person to person via respiratory droplets from coughing and sneezing.  The virus primarily infects cells in the back of the throat and within the respiratory tract.  

In susceptible individuals, signs and symptoms of measles usually develop around ten days after exposure to the virus.  They include high fever, dry cough, runny nose, inflammation of the eyes, sensitivity to light, sore throat, and lesions on the inside of the mouth called Koplik‚Äôs spots.  A rash usually begins two to three days into the illness.  It begins on the cheeks and face and eventually spreads down the entire body to the feet.   

Since the disease is caused by a virus, there are no antibiotics that can treat the infection.  However, some complications of the measles do respond to antibiotic treatment.  These include ear infections and pneumonia.  Approximately one in ten children will develop an ear infection and one in fifteen individuals will develop pneumonia.  

Other respiratory complications include bronchitis, laryngitis, and croup.  More rare complications are encephalitis (inflammation of the brain) and thrombocytopenia, a low platelet count.  Platelets are blood cells essential for blood clotting.

Measles, like most viral infections, usually lasts about ten to fourteen days.  Aside from the complications listed above, treatment is aimed at relieving the primary symptoms.  Fever reducers and pain relievers can be used to keep the individual comfortable until the body fights off the virus.  

Due to the highly contagious nature of the infection, individuals with the measles should be isolated from others, especially those who are not immune.  An individual is considered to be contagious from four days before the rash appears to four days after.  Pregnant women should be particularly careful because the measles virus can cause miscarriage, premature labor, or low birth weight babies.

Obviously, the most important consideration in the fight against this disease is prevention.  Before the development of the measles vaccine there were in excess of 400,000 cases of measles each year in the U.S. and 450 measles-related deaths.  Immunization has decreased cases by more than 99 percent.  

Children are given the first vaccination at age 12 to 15 months.  A booster is given between four to six years of age.  Individuals who have not received two doses of MMR vaccine are urged to get a booster.  Most of the outbreaks seen in the United States develop in communities that have a high rate of unvaccinated individuals.  

The content in this column is for informational purposes only.  Consult your physician for appropriate individual treatment.  Dr. Reynolds practices Family Medicine in Chesterfield.

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