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Measles / rubeola

What do you mean by measles / rubeola ? 

An acute highly infectious disease of childhood caused by a specific virus of the group myxoviruses. It is clinically characterized by fever and catarrhal of the upper respiratory tract (coryza, cough), followed by typical rash.

Measles (also known as rubeola and "10-day", "hard" and "red" measles) is a serious disease that causes fever, rash, and other complications. Measles is a highly contagious infection of the respiratory system. Do not confuse this illness with rubella which is sometimes called 'German' or '3-day' measles. Measles is caused by a virus.

History of Measles / Rubeola

The word rubeola means red spots. The earliest description of measles was given by the noted Arab physician, Abu Bacr known to the west as Rhazes Panum did classical studies on the epidemiology of measles in 1846. In 1954, measles virus was isolated by Enders and his colleagues in U.S.A . In 1958,Measles vaccine was first used in a clinical trial and in 1963, live measles vaccine was licensed for use.

Causes of Measles / Rubeola

Its specific cause is not known. Generally, it is an epidemic disease, and attack children. When adults are attacked they suffer pretty severely. It occurs 9 to 14 days after a child is exposed to another child with measles. The period which elapses between the introduction of the poison into the system and the invasion of the disease varies from 7 to 14 days.

Transmission of disease

Transmission occurs directly from person to person mainly by droplet infection and droplet nuclei, from 4 days before onset of until 5 days thereafter . The portal of entry is the respiratory tract. Infection through conjunctiva is also considered likely as the virus instilled into the conjunctiva can cause infection. recipients of measles vaccine are not contagious to others.

Incubation Period:-

Incubation period is commonly 10 days from exposure to onset of fever and 14 days to appearance of rash. when measles infection is artificially induced by passing the respiratory tract ( as with injection of live measles vaccine ), the incubation period is somewhat shortened averaging in 7 days.

SIGNS AND SYMPTOMS OF MEASLES / Rubeola

One special identifying sign of measles is Koplik's spots. These are small, red, irregularly-shaped spots with blue-white centers found inside the mouth. Koplik's spots usually appear 1 to 2 days before the measles rash and may be noticed by a doctor looking for the cause of a child's fever and cough.

Measles symptoms usually show up in two stages.

STAGE- I

• A fever at about 39ºC.
• The illness starts with a runny nose, watery red eyes, cough.
• After 2 to 4 days, a raised, red rash starts on the face and spreads down the body and out to the arms and legs.
• Grayish spots, the size of grains of sand may appear in the mucous membrane of the mouth just around the molar teeth.
• The rash usually begins around the ears and spreads to the body and the legs within a day or two.

STAGE- II

• The second stage begins after 3 to 7 days.
• The fever reaches 103 o F-105 o F, and a red blotchy rash appears.
• The rash usually starts on the face and then spreads to the chest, back, and arms and legs, including the palms and soles of the feet.
• The rash lasts for 4 to 7 days.
• Small white spots might also appear on the gums and inside of the cheeks.
• The temperature, which may run as high as 40ºC, may stay that high for a couple of days. Then it disappears together with the rash, which may leave some brown spots.
• After a week the child will be fit again.

Diagnosis of Measles / Rubeola

A detailed history should be taken including course of the disease so far, vaccination history, contact history and travel history. Observation of Koplik's spots is also diagnostic of measles. Measles can usually be diagnosed by symptoms. A blood test can confirm the diagnosis. There are laboratory tests, but these would seldom be of any practical use. The diagnosis would normally be incorrect in any febrile exhanthem in which red eyes and cough are absent. In developed countries where measles are uncommon specific IgM antibodies are being used for diagnosis.

Complication result from Measles / Rubeola :-

Measles is to often regarded as an unimportant infection, but this is not true. The most common complications are measles- associated diarrhea, pneumonia, and other respiratory complications and otitis media. Pneumonia occurs in up to 6 percent of reported cases and amounts for 60 percent of deaths attributed to measles.

The more serious are the neurological complications which include febrile convulsions, encephalitis and sub acute sclerosing pan encephalitis ( SSPE ). Sub acute SSPE is a rare complication which develops many years after the initial measles infection. It is characterised by progressive mental deterioration leading to paralyses, probably due to presistence of the virus in the brain. The diagnosis of SSPE may be made early by the demonstration of high level of measles compliment fixing anti bodies in CSF and Serum. Other complications include middle ear infections and convulsions (seizures). Encephalitis is another serious complication. The fatality rate from measles for otherwise healthy people in developed countries is low: approximately 1 death per thousand cases. In underdeveloped nations with high rates of malnutrition and poor healthcare, fatality rates of 10 percent are common.

Prevention of Measles / Rubeola :-

Maintaining the highest level of immunization against measles is the best preventive measure. Previously there was a vaccination for measles, given early in the second year of life, in the UK . There is now a vaccine, which, in the UK , is given at 12 to 15 months, along with vaccines for mumps and German measles. A booster is given before starting school. This vaccine is known as MMR . The vaccine is highly effective and one injection usually produces lifelong immunity.

When to call a doctor?

• If secondary infection develops like ear and chest problem, diarrhea, stomach pains, vomiting.
• If any infant of less than six months gets the measles.
• If fever does not subside when the rashes have fully emerged.
• Any sign of breathing difficulties or severe cough.
• If along with extreme ligh sensitivity there are signs of eye infection.
• Bleeding under the skin or from any orifices of the body.

Treatment / Home Remedies of Measles / Rubeola :-

There is no specific treatment for uncomplicated measles. Patients with uncomplicated measles will recover with rest and supportive treatment. The health-care provider can confirm the diagnosis and provide home-care instructions to relieve the discomfort of the symptoms. Persons with suppressed immune systems should not be given measles virus vaccine. This would include persons with leukemia, lymphoma, generalized cancer, or therapy with certain cancer treatment drugs, radiation, or large doses of steroids. A physician should be consulted before a patient who may be immunosuppressed is given measles vaccine. Take your child's temperature at least once each morning and each evening, and keep a record However, a person who has contact with or lives in a household with an immunosuppressed person may be given measles vaccine as usual. If fever goes above 103 degrees Fahrenheit (39.4 degrees Celsius) bring it down using nonaspirin fever medications such as acetaminophen. Encourage your child to drink clear fluids: water, fruit juice, tea, and lemonade. If immediate protection against measles is required for persons who should not get measles vaccination, immune globulin or IG should be given as soon as possible after the exposure to measles. Use a cool-mist vaporizer to relieve cough and to soothe breathing passages. Children with measles should not read or watch television while their eyes are sensitive to light. As light has a detrimental effect upon the eyes during measles, the room should have subdued light.

Home Remedies of Measles / Rubeola :-

• Apply garlic oil to any infected areas or to prevent infection.
• The juice of lemon is another remedy. It also makes an effective thirst-quenching drink in measles. About 15 to 25 ml. of lemon juice should be taken diluted with water for this purpose.
• Drink saffron and snake root tea to aid the healing process.
• The use of barley water has proved beneficial in case of troublesome cough in measles. This water should be taken frequently, sweetened with the newly -drawn oil of sweet almonds.
• Fresh Orange juice had 2 times is good.
• Turmeric is beneficial in the treatment of measles. Raw roots of turmeric should be dried in the sun and ground to a fine powder. This powder, mixed with a few drops of honey and the juice of few bitter gourd leaves, should be given to the patients suffering from measles.
• The seeds of egg plant are stimulant. Intake of half a gram to one gram of these seeds daily for three days will help develop immunity against measles for one year.

General home care:-

• If measles is suspected put the patient to bed.
• Keep the room as dimly as possible to soothe the child's sore eyes.
• Give him /her plenty of fluid to drink.
• Give the child easily digestible food.