Measles, also known as rubella, is a highly contagious viral infection caused by the measles virus, a member of the Paramyxoviridae family. Despite being preventable through vaccination, measles continues to affect millions of people, particularly in regions with low immunization coverage. Here we will know the causes, symptoms, complications, and treatment options for measles in detail.
Overview of Measles
Measles is an airborne disease that spreads through respiratory droplets from infected individuals. It primarily affects children but can also occur in unvaccinated adults. Before the widespread use of the measles vaccine, the disease caused millions of deaths globally. While significant progress has been made in controlling measles, outbreaks still occur, especially in areas with inadequate healthcare infrastructure.
Causes of Measles
The primary cause of measles is the measles virus. This virus is highly contagious and can survive for several hours in airspace or on surfaces. Infection occurs when a person inhales respiratory droplets containing the virus or comes into direct contact with infected secretions.
Risk Factors:
- Lack of Vaccination: Individuals who are not vaccinated or have not received two doses of the measles vaccine are at higher risk.
- Weakened Immune System: People with compromised immunity, such as those with HIV/AIDS, cancer, or malnutrition, are more susceptible.
- Travel to Endemic Areas: Traveling to regions with ongoing measles outbreaks increases the risk of exposure.
- Crowded Living Conditions: Overcrowded environments facilitate the spread of the virus.
Symptoms of Measles Disease
The symptoms of measles typically appear 7–14 days after exposure to the virus and progress through different stages:
Incubation Period: This phase lasts 7–14 days during which there are no symptoms as the virus multiplies in the body.
Prodromal Stage (Early Symptoms):
- High Fever: Often the first sign, which may exceed 104°F (40°C).
- Cough: A persistent, dry cough is common.
- Coryza: Nasal congestion and a runny nose.
- Conjunctivitis: Red, watery eyes sensitive to light.
- Koplik Spots: Tiny white spots with bluish-white centers appear inside the mouth, usually on the inner lining of the cheeks. These are a hallmark sign of measles.
Exanthem Stage (Rash):
- A red, blotchy rash appears 3–5 days after the onset of initial symptoms.
- The rash typically starts on the face and spreads downward to the trunk, arms, and legs.
- It may merge to form large patches.
- As the rash fades, it often leaves brownish discoloration and peeling skin.
Complications of Measles Disease
Measles can lead to severe health complications, particularly in young children, pregnant women, and individuals with weakened immune systems. Common complications include:
- Ear Infections: Otitis media can occur, leading to pain and potential hearing loss.
- Pneumonia: A leading cause of death in measles cases, particularly in children.
- Diarrhea: Severe dehydration can result from persistent diarrhea.
- Encephalitis: Inflammation of the brain can lead to seizures, hearing loss, or cognitive impairments.
- Subacute Sclerosing Panencephalitis (SSPE): A rare but fatal neurological condition that can occur years after infection.
Diagnosis of Measles
Measles is diagnosed based on:
- Clinical Symptoms: The presence of a characteristic rash, fever, and Koplik spots.
- Laboratory Tests: Blood tests can detect measles-specific antibodies (IgM and IgG) or the virus itself through PCR (polymerase chain reaction).
Prevention
Vaccination: The measles vaccine, often combined with mumps and rubella (MMR), is the most effective way to prevent measles. The vaccine is administered in two doses:
- First Dose: At 12–15 months of age.
- Second Dose: At 4–6 years of age or later.
Herd Immunity: Achieving a vaccination coverage rate of 95% or higher is crucial for preventing outbreaks.
Other Preventive Measures:
- Avoid close contact with infected individuals.
- Practice good hygiene, including frequent handwashing.
- Wearing masks during outbreaks.
Treatment Measles
There is no specific antiviral treatment for measles, but supportive care can alleviate symptoms and prevent complications. Key aspects of treatment include:
Symptomatic Relief:
- Fever Management: Paracetamol or ibuprofen can reduce fever and relieve pain.
- Hydration: Maintain fluid intake to prevent dehydration.
- Rest: Adequate rest is essential for recovery.
Vitamin A Supplementation:
- Vitamin A has been shown to reduce the severity of measles and prevent complications. Two doses are usually administered 24 hours apart.
Antibiotics:
- Used to treat secondary bacterial infections like pneumonia or ear infections.
Hospitalization:
- Required in severe cases, particularly for patients with complications or those who are immunocompromised.
Global Impact and Challenges
Epidemiology: Despite the availability of an effective vaccine, measles remains a significant public health challenge in many parts of the world. According to the World Health Organization (WHO),
- Measles caused over 140,000 deaths globally in 2018, mostly children under five.
- Large-scale outbreaks occur in regions with low vaccination coverage, such as parts of Africa, South Asia, and Eastern Europe.
Barriers to Elimination:
- Vaccine Hesitancy: Misinformation about vaccine safety has led to declining immunization rates in some communities.
- Healthcare Inequities: Limited access to vaccines in low-income regions.
- Political Instability: Conflicts and displacement disrupt vaccination campaigns.
Recent Advances and Future Directions
- Improved Vaccines: Efforts are underway to develop more heat-stable vaccines to ensure efficacy in tropical regions.
- Outreach Programs: Global initiatives like Gavi, the Vaccine Alliance, aim to improve vaccine access in underserved areas.
- Enhanced Surveillance: Better diagnostic tools and data collection systems can help detect and respond to outbreaks more effectively.
Measles is a preventable but potentially deadly disease that continues to pose a threat to global health. Vaccination remains the cornerstone of prevention, and concerted efforts are needed to address barriers to immunization. By combining public health measures, education, and research, the goal of measles eradication can be achieved, ensuring a healthier future for all.
