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Measles is an infectious disease, usually benign, immunized, caused by a virus from the family of paramyxoviruses (genus morbillivirus), affecting mainly children and is transmitted directly. Measles are fever, rhinitis and conjunctivitis, cough, presence of small white spots on cheek mucosa (Koplik sign characteristic measles) and red rash, first on the face, then the entire body. This was the origin of infectious disease epidemics (like chickenpox). Measles is fatal but in some countries the population suffers from malnutrition. Thus, in some countries of tropical Africa, measles is one of the causes of mortality in children under 4 years.
The incubation period of measles virus lasts 10 days. The virus is found only in humans and is usually transmitted directly, through droplets of saliva or nasal secretions, and conjunctival swabs of the patient. It can transmit the virus through coughing or sneezing. There are rare cases of indirect transmission of the virus through contaminated objects with secretions from the patient. Before the introduction of measles, measles epidemics occurred every 2 -3 years, especially in preschool and school age children.
A woman who has had measles or been vaccinated against the disease transmitted antibodies child will have immunity from the first year of life, to the vaccine. Signs and symptoms Measles symptoms occur after 7 -14 days after infection and consist of high fever, inflammation of the nasal passages (rhinitis), fits of coughing, inflammation conjunctivelor (membrane lining the inside of the eyes and the inside of the eyelids), and runny nose associated with . Sometimes, the child is sensitive to light. After 2 -4 days, small spots inside the cheeks, white – sign Koplik, characteristic of the period of invasion of measles. These small spots similar to grains of sand are white and are sometimes accompanied by inflammation of the lining of the pharynx and larynx, trachea and bronchi.
Rash appears first on the face side of the neck and behind the ears, in the form of red patches with irregular shape, quickly becoming relief. Over the next two days, the rash spreads to the trunk, arms, hands, legs and feet, while the spots on the face disappear. In some people with a severe form of measles, petechiae or ecchymoses can be observed, which correspond to small purple spots. Purpura is an abnormal effusion of blood to the skin and mucous membranes: it shows red or blue spots. The rash is sometimes accompanied by pruritus (itching).
Symptoms regress in less than a week. Evolution and complications In 3 to 5 days, fever gradually diminished and the patient feels relief from their symptoms. Instead, the cough persists for 1 to 2 weeks. Rash becomes less visible, gets a brown stain, then blistered. In general, children with good health and nutrition, measles is serious.
Complications are frequent respiratory infections, which is manifested by rhinitis (inflammation of nasal passages). Other complications include: laryngitis (inflammation of the larynx), pharyngitis, otitis media (middle ear inflammation) or bronchitis (inflammation of the bronchi) due to a bacterial superinfection. Complications due to bacterial superinfection meet especially in immunosuppressed patients who may develop pneumonia. Touching is sometimes accompanied by pulmonary interstitial pneumonia or a bronchopneumonia with prognosis. Another complication that can occur is thrombocytopenic purpura (purpura associated with a decrease in blood platelets, which occurs rapidly and is accompanied in many patients of severe bleeding).
Encephalitis occurs in 1 in 1000 -2000 cases, usually 2 -3 weeks after the rash and fever, headache or coma. In pregnant women, measles can cause a miscarriage in the first trimester of pregnancy, or premature birth. Generally, measles during pregnancy is a risk of fetal malformation. Treatment and Prevention There is no specific treatment for measles, except symptomatic treatment (of fever, cough, rhinitis and conjunctivitis). Acetaminophen (Tylenol) or ibuprofen (Nurofen, Advil, etc.
. ) Are prescribed to reduce fever, and if a secondary bacterial infection, an antibiotic is administered. Quarantine is required for the duration of the disease. Prescription vitamin A to children Africans aged between 6 months and 2 years, suffering from malnutrition deaths decreased significantly in children with severe measles. Measles vaccine is given to children between 12 and 15 months, but can be done as early as 6 months during an epidemic of measles.
Children and adults exposed to measles, who have not developed immunity to the disease, may be vaccinated within 3 days of exposure. The vaccine is administered to patients with generalized malignancy (leukemia, lymphoma), immunosuppression disease, those undergoing treatment with cortisone, alkylating agents or antimetabolites or radiation performed. Vaccination should not be performed during pregnancy, or in patients with untreated tuberculosis. The vaccine is not recommended for pregnant women and children under 1 year. Instead, for these categories is preferred immunoglobulins (antibodies), administered within 2 days after exposure to the virus.
Making measles vaccination is performed with rubella and mumps. It is ORR vaccine (measles-mumps-rubella), given the age of 1 year.