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Dr Tendai Zuze
Health Matters
OVER the past few months, while we celebrated the near demise of Covid-19, measles quietly crept onto the scene and started taking lives.
Needless to say unvaccinated children experienced the worst outcomes.
Measles is a childhood infection caused by a virus which kills more than 200 000 people every year worldwide.
Signs and symptoms of measles typically include fever, dry cough, runny nose, sore throat and inflamed eyes, which are symptoms consistent with many viral infections.
What sets measles apart are tiny white spots with bluish-white centres on a red background found inside the mouth on the inner lining of the cheeks (koplik’s spots) and a skin rash made up of large, flat blotches that often flow into one another.
The infection occurs in stages over two to three weeks.
Infection and incubation
For the first 10 to 14 days after infection, the measles virus spreads in the body. There are no signs or symptoms of measles during this time.
Non-specific signs and symptoms
Measles typically begins with a mild to moderate fever, often with a persistent cough, a runny nose, inflamed eyes (conjunctivitis) and a sore throat.
This relatively mild illness may last two to three days.
Acute illness and rash
The rash is made up of small red spots, some of which are slightly raised. Spots and bumps in tight clusters give the skin a splotchy red appearance.
The face breaks out first.
Over the next few days, the rash spreads down the arms, chest and back, then over the thighs, lower legs and feet.
At the same time, the fever rises sharply, often as high as 40 to 41 degrees Celsius.
Recovery path
The measles rash may last about seven days.
The rash gradually fades first from the face and last from the thighs and feet.
As other symptoms of the illness go away, the cough and darkening or peeling of the skin where the rash was may stay for about 10 days.
A person with measles can spread the virus to others for about eight days, starting four days before the rash appears and ending when the rash has been present for four days.
How measles spreads
Measles is a highly contagious illness.
This means it easily spread to others.
Measles is caused by a virus found in the nose and throat of an infected child or adult.
When someone with measles coughs, sneezes or talks, infectious droplets spray into the air and other people can breathe them in.
The infectious droplets can hang in the air for about an hour.
About 90 percent of people who haven’t had measles or been vaccinated against measles will become infected when exposed to someone with the measles virus.
Risk factors for measles include:
◆ If you haven’t had the measles vaccine, you are much more likely to get measles.
◆ If you travel to countries where measles is more common, you are at higher risk of catching measles.
*If you don’t have enough vitamin A in your diet, you are more likely to have more-severe symptoms and complications of measles.
Complications of measles may include:
◆ Diarrhoea and vomiting can result in losing too much water from the body (dehydration).
◆ One of the most common complications of measles is a bacterial ear infection.
◆ Measles may lead to irritation and swelling (inflammation) of the airways (croup).
It can also lead to inflammation of the inner walls that line the main air passageways of the lungs (bronchitis).
Measles can also cause inflammation of the voice box (laryngitis).
◆ Measles can commonly cause an infection in the lungs (pneumonia).
People with weakened immune systems can develop an especially dangerous type of pneumonia that sometimes can lead to death.
◆ About one in 1 000 people with measles can develop a complication called encephalitis, which is the irritation and swelling (inflammation) of the brain.
The condition can be especially dangerous for people with weakened immune systems. Encephalitis may occur right after measles, or it might not occur until months later.
Encephalitis can cause permanent brain damage.
◆ If you are pregnant, you need to take special care to avoid measles because the disease can cause premature birth, low birth weight and foetal death.
Prevention of measles
The best way to prevent measles is through the measles vaccine which is sometimes given as a combined measles-mumps-rubella (MMR) vaccine.
The MMR vaccine’s two doses are 97 percent effective in preventing measles and protecting one against it for life.
In the small number of people who get measles after being vaccinated, the symptoms are generally mild.
Side effects of the vaccine are generally mild and may include fever and a sore arm where the shot has been given.
There is no specific treatment for a measles infection once it occurs.
Treatment includes providing comfort measures to relieve symptoms.
This includes rest, and treating or preventing complications.
Antibiotics are sometimes required to treat measles related pneumonia.
If you or your child has measles, keep in touch with your health care provider as you monitor the progress of the disease and watch out for complications.
Comfort measures to try
◆ Take it easy. Get rest and avoid busy activities.
◆ Drink plenty of fluids. Drink plenty of water, fruit juice and herbal tea to replace fluids lost by fever and sweating.
◆ If needed, you can buy rehydration solutions without a prescription. These solutions contain water and salts in specific proportions to replace both fluids and electrolytes.
◆ Moisten the air. Use a humidifier to a relieve cough and sore throat. Adding moisture to the air can help ease discomfort.
◆ Moisten your nose. Saline nasal sprays can soothe irritation by keeping the inside of the nose moist.
Online Reporter