Measles – causes, symptoms & therapy

Measles (Morbili) is one of the highly contagious infectious diseases that primarily breaks out in childhood. This disease should by no means be dismissed as a harmless childhood disease, as it can cause significant complications.

Measles is a notifiable infectious disease and can be detected by antibodies in the blood. Once the disease has been overcome, there is immunity.

While the number of cases of the disease in Europe has largely fallen due to consistent vaccination, measles is still a major risk in Africa.

causes

Measles are transmitted by droplet infection. If the droplets hit the mucous membrane or the conjunctiva of another person, for example when an infected person speaks or coughs , they become infected. The measles break out in 99 percent of those infected.People with measles are contagious (virulent) five days before and up to four days after the onset of the disease.

The measles virus is specific to humans and primarily affects the immune system and nervous system.

The viruses first multiply in the lymph nodes and then spread through the entire bloodstream. After spreading in the body, the skin and respiratory tract are attacked by the measles, until the typical skin rash finally breaks out.

The time that elapses between transmission and the onset of measles (incubation period) is between 8 and 14 days. There is a risk of complications from measles, especially in immunocompromised people.

symptoms and course

Measles cause a number of typical symptoms. These include fever , a weakening of the general condition and the red spots (exanthema) typical of measles.

In measles, two successive stages are differentiated: the precursor stage of measles has symptoms of influenza , in which exhaustion , slight fever and fatigue as well as headache and abdominal pain are characteristic.

The stage of the rash in measles is characterized by characteristic skin changes, which are manifested by an irregular and dark red rash. The typical rash starts behind the ears and then spreads over the face and neck. After three days, the arms and torso are covered. The palms and soles of the feet remain uncovered.

Various complications such as pneumonia , conjunctivitis or meningitis can also occur. Meningitis can leave serious damage even after the disease has ended. The course of measles is often difficult, especially in adolescents and adults.

When to the doctor?

If the child shows classic symptoms of measles, the pediatrician should be consulted as soon as possible. Persistent tiredness , fever, headaches and stomach aches and the typical flu symptoms must be clarified quickly in order to avoid serious problems and complications. The doctor can recognize the disease based on an optical examination and quickly make a diagnosis.

If there is a suspicion that the child is infected with the measles virus, for example if the child’s classmates are already ill, you can also go to the doctor as a preventative measure. At the latest when the child shows changes in behavior and, for example, eats less than before, medical advice is required.

Children with a weakened immune system and chronic diseases that could jeopardize a positive healing process should also be presented to a doctor quickly.

In addition to the pediatrician or family doctor, measles are diagnosed by internists and specialists in viral diseases. In consultation with the doctor, the advice of a non-medical practitioner can also be requested in order to enable the child to recover quickly.

Diagnose

The diagnosis of the disease measles should always be made by the family doctor or the responsible pediatrician. Since the symptoms point quite clearly to the disease, the diagnosis is easy to make. The doctor will ask about the course of the disease and examine the external symptoms. Typical of measles are a double increase in fever, so-called two-peak fever curve, and the skin rash ( exanthema ), which is considered characteristic of the disease.

Measles is a so-called “childhood disease”, but adolescents and adults can also become ill. Diagnosis is difficult in these age groups. A blood test can also be carried out to confirm the suspicion of measles. Antibodies against the disease are detected in the blood. The body produces these special proteins to defend itself against viruses. They can be detected in the patient’s blood four days after the onset of the disease . Based on the examination, treatment against measles with appropriate medication can then be initiated.

complications

Measles can cause various complications if the infection is not treated or is treated inadequately. Initially, being bedridden can lead to circulatory problems and infections. As a result of diarrhea and vomiting, a lack of fluids often develops, which is associated with tiredness and difficulty concentrating. If smallpox is scratched, scars can remain.

The measles virus itself can cause various complications. The lungs can be affected, which can result in pneumonia. Measles croup can also occur, which causes severe pain and other complications. In the worst case, it comes to encephalitis, which is accompanied by severe fatigue and seizures and can ultimately lead to the death of the child. Measles encephalitis can cause permanent damage to the nervous system.

An infection with measles represents a significant burden on the immune system. During the disease, there is an increased susceptibility to bacterial diseases. Many children develop gastrointestinal complaints, middle ear infections and pneumonia during the measles infection.

Measles can also cause long-term effects such as subacute sclerosing panencephalitis, which occurs six to eight years after measles infection and damages the nerve cells in the brain and spinal cord. As a result, various brain functions are damaged before the patient finally dies.

treatment and therapy

There is no therapy that fights the measles virus. Therefore, treatment of measles is limited to the symptoms of the disease. Strict bed rest is recommended, preferably in a cool, darkened room if eye inflammation is present.

Drugs can be given to treat symptoms such as fever and cough. Basically, if you have a fever, you should drink plenty of fluids. Calf wraps can also be helpful, but care should be taken to ensure that the hands and feet of the person suffering from measles are at a sufficient temperature. If there is an additional bacterial infection (superinfection), this is usually treated with an antibiotic .

The World Health Organization recommends the administration of vitamin A for areas in which there is a vitamin deficiency or a high mortality rate from measles (mortality rate) . Even if there are no studies on this yet, the administration of the drug ribavirin has also proven to be effective.

In individual cases, passive or active vaccination ( immunization ) can be advised, which can weaken the course of the measles disease. For this purpose, antibodies are administered to the patient. Measles viruses can also be self-administered before the onset of measles.

prevention

The most important prevention against measles is vaccination. Vaccination reduces the risk of contracting measles by 99 percent.

When vaccinating against measles, the live vaccine is usually administered in combination with the mumps and rubella vaccine, or the mumps, rubella and chickenpox vaccine .

The vaccination should be carried out between the 11th and 14th month of life. Only over 90 percent of those vaccinated are immune the first time they are vaccinated, so a second vaccination should be carried out after at least four weeks to ensure almost 100 percent vaccination security.

People with measles should be isolated to avoid infecting other people.