Measles: Prevention, Symptoms, Diagnosis and Treatment

Measles is a highly contagious viral infection that once was common in children. However, it can affect individuals of any age. Despite the availability of effective vaccines, measles remains a significant public health challenge, particularly in areas with low vaccination rates. The disease can have a profound impact on daily life, causing serious health complications, especially in young children and immunocompromised individuals.

Measles is caused by the rubeola virus and is spread through respiratory droplets when an infected person coughs or sneezes. Measles is so contagious that if one person has it, up to 90% of the people close to that person who are not immune will also become infected with measles.

Measles Symptoms

Initial measles symptoms typically include a high fever, cough, runny nose, and red, watery eyes. A few days later, Koplik's spots—tiny white spots—may appear inside the mouth. The hallmark symptom is a red, blotchy rash that usually starts on the face before spreading to the rest of the body. A measles rash is another sign that someone might have measles. 

Causes

Measles is caused by a virus that replicates in the nose and throat of an infected child or adult. Measles is so contagious that it can be contracted by being near someone infected or through contact with infected mucus or saliva.

Impact and Complications

If left untreated, measles can lead to severe health complications, including pneumonia, encephalitis, and even death. Complications are more common in children under the age of 5, adults over the age of 20, pregnant women, and those with compromised immune systems.

At risk groups

• Infants and children who are not vaccinated are at increased risk of measles.
• Pregnant women without immunity are at increased risk of measles.
• People with weakened immune systems.
• International travellers who visit areas with high measles incidence.

‘’ Measles can be serious in all age groups, but children younger than 5 years of age and adults older than 20 years of age are more likely to suffer from complications." - Centres for Disease Control and Prevention (CDC).

Diagnosis

1. Clinical assessment: A healthcare provider will usually be able to diagnose measles with a good history and physical exam. A measles rash may be visible on examination.
2. Laboratory tests: These are used to find the virus in blood samples, throat swab, or nasopharyngeal swab. Detection of measles-specific IgM antibodies in serum and measles RNA by real-time polymerase chain reaction (PCR) are common diagnostic tests.

Importance of Treatment

Seeking treatment for measles is crucial to manage symptoms and prevent the spread of the virus to others, especially those who are vulnerable to severe complications.

Treatment Options

1. Symptom management: Rest and hydration are essential. Over-the-counter pain relievers can be used to manage fever and discomfort.
2. Vitamin A: Severe measles cases among children, such as those who are hospitalised, may be treated with vitamin A.
3. Isolation: Infected individuals should stay home from work or school to prevent spreading measles to others.

Doctors and Specialists Likely To Be Involved In The Patient's Care

• Doctor appointment usually with a General Practitioner: The first point of contact, responsible for initial diagnosis and management.
• Paediatric Doctor Appointment: For cases involving children, a paediatrician may be involved in managing the disease.
• Infectious Disease Specialist: An infectious disease specialist may be consulted in severe cases or complications.
• Pulmonologist: If complications such as pneumonia occur, a pulmonologist may be involved in the patient's care.
• Neurologist: A neurologist may be consulted in rare cases where encephalitis develops.

Prevention

The most effective way to prevent measles is vaccination. The measles, mumps, and rubella (MMR) vaccine is typically given in two doses, with the first dose at 12 to 15 months of age and the second dose at 4 to 6 years of age. The MMR vaccine is usually given to all children as part of public health protection measures. Unvaccinated adults can get the MMR vaccination to protect adults from measles.

"We need to increase uptake of this vaccine, as we run the risk of measles becoming endemic." - Eleanor Draeger, sexual health doctor and medical writer.

Contagiousness and Isolation Advice

Measles is highly contagious from about four days before to four days after the measles rash appears. Infected individuals should stay home, avoid public places, and avoid contact with others to prevent disease spreading.

Related Conditions or Complications

Measles can lead to ear infections, diarrhoea, and in severe cases, pneumonia, encephalitis, and subacute sclerosing panencephalitis (SSPE).

"Subacute sclerosing panencephalitis (SSPE) is a very rare, but fatal disease of the central nervous system that results from a measles virus infection acquired years earlier." - CDC.

Outlook and Prognosis

Most people recover from measles within two to three weeks with proper medical care. However, complications can lead to more severe health issues or be fatal, particularly in high-risk groups.

Practical Tips & Coping Strategies

• Ensure measles vaccinations (MMR) are up to date
• Practise good hygiene, such as regular handwashing
• Isolate from others if infected
• Monitor for complications and seek medical care if symptoms worsen