Causative and risk factors
Measles is an infective disease caused by a virus known as paramyxovirus. Spread of infection occurs by coming in close contact with an already infected person. An infected person is highly contagious four days before and after the onset of the rash.
Measles can be transmitted by coming in close or direct contact with the infected person’s nasal secretion. When an infected person sneezes or coughs, this releases virus in air which can be inhaled. Putting the finger in mouth or nose after coming in contact with the infected surface can cause transmission of the virus.
However, not everyone who comes in contact with an infected person develops measles. Some people are at a higher risk of catching this infection. They are children with weak immunity, pregnant women, persons who are malnourished and those deficient in vitamin A.
Clinical presentation
The onset of symptoms occurs about 1 week after infection with the virus. The patient presents with high grade fever, malaise, coryza, cough and sore throat. Redness of the eyes may be present due to conjunctivitis. Koplik’s spot may appear as tiny bluish-white spots develop on the inner lining of the mouth.
Two to four days after the infection, characteristic rash of measles appears. Rash begins at the back of the ear, spreads to head and neck and then to entire body. Rash causes itching and changes color from red to brown before disappearing.
Complications of measles include ear infection, pneumonia, bronchitis, thrombocytopenia, encephalitis and laryngitis. Measles in pregnant women can cause miscarriage, preterm labor or low birth weight baby.
Diagnosis & Investigations
Usually your doctor can diagnose measles on the basis of your symptoms and the presence of skin rash. Measles must be differentiated from other causes of fever with rash such as chickenpox, rubella, scarlet fever and typhoid. The following tests may be needed to confirm:
- IgG and IgM antibodies to the measles virus
- Complete blood count may reveal leucopenia
- Mouth swab is performed if Koplik’s spots are present
Treatment
Treatment for measles is mostly supportive and symptomatic. There are no specific drugs that work against the measles virus. Adequate rest and plenty of fluids are advised.
Antibiotics are prescribed if secondary bacterial infections are present. Anti-pyretic drugs are given to bring down fever.
Vaccination against measles is administered to those who have not been immunized before. This helps to cut the duration of illness.
Measles vaccine is given as part of immunization schedule by the age of 9 months and then a booster dose at the age of 15 months, along with rubella and mumps vaccine.
Statistics
According to the World Health Organization, measles vaccination resulted in a 78% drop in measles deaths between 2000 and 2012 worldwide.
