Description
The measles, the most contagious infectious disease known to exist in humans, continues to be one of the leading causes of death in children all over the world. Every 1,000 people who contract the disease die from measles, even in highly developed nations. Measles has no known cure, although vaccination has been a reliable method of protection since the 1960s. Despite the measles' high global morbidity and death, there has been substantial progress. Measles killed an estimated 777,000 people annually worldwide just ten years ago, in 2000. Only 160,000 people died from measles in the entire world in 2010—a tribute to the vaccine's broad use.
Summary Listen
- Measles is a recurring global health concern due to inconsistent elimination efforts. Recent outbreaks are linked to disruptions in routine childhood vaccinations during the COVID-19 pandemic, leaving millions vulnerable. In 2021, there were 9 million cases and 128,000 deaths worldwide, with India reporting a significant number of cases.
- Measles is caused by a highly contagious RNA virus, predominantly affecting preschool children. Transmission occurs via respiratory droplets from nasal and oral secretions, making it easily spread. The virus enters through the respiratory tract or conjunctiva, leading to systemic symptoms such as fever and rash after an incubation period of 6 to 21 days.
- Clinical features include a prodromal phase with fever, malaise, and respiratory symptoms, followed by the appearance of Koplik spots on the buccal mucosa. A characteristic erythematous maculopapular rash starts on the face and spreads downwards. The rash eventually fades in the same order it appeared, with desquamation occurring.
- Different presentations of measles include classical measles, modified measles (in partially protected individuals), atypical measles (rare, associated with killed virus vaccines), and severe measles in immunocompromised individuals. Complications arise from mucosal damage and immunosuppression, making secondary infections, pulmonary issues, ocular problems, and neurological issues a concern.
- Neurological complications are particularly serious, including encephalitis, acute disseminated encephalomyelitis (ADEM), and subacute sclerosing panencephalitis (SSPE), a fatal degenerative disease occurring years after infection. Diagnosis is primarily clinical, but laboratory confirmation involves serum anti-measles IgM antibody testing and RT-PCR for measles RNA in respiratory samples.
- Treatment for measles is mainly supportive, involving antipyretics, hydration, and calorie intake. Vitamin A supplementation is crucial to prevent ocular complications. Ribavirin may be considered for severe pneumonia cases.
- Prevention relies on vaccination with the MMR vaccine, which is recommended at 9 months and 15 months. Vaccination is crucial for immunocompromised children. Post-exposure prophylaxis with immunoglobulin can be used in immunocompromised individuals. Infection control measures include hand washing, masking, and isolating infected individuals to reduce transmission.
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About the Speakers
Dr. Ramya Bevoor
MBBS,DNB( Family Medicine), Consultant Physician, Diabetologist , Faculty at CMC, Vellore
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