In Ukraine, more and more patients with measles. An outbreak of the disease occurs every 5-6 years. Measles virus enters the body through the respiratory tract and the mucous membrane of the eyes. Gets into local lymph nodes and begins to multiply in them. Who is at risk and how to protect against measles?
History of the measles epidemic
Before the Second World War, in our country, as well as in all European countries and in the United States, everyone necessarily got measles. Some earlier, others later, but measles hit everyone. This continued, in fact, until the mid-60s, when, after the creation of measles vaccines, the situation began to change rapidly. And before the introduction of vaccinations, measles every year 1.5-2 million children were ill. Just 15 years ago, measles annually gave from 20 to 30 percent of all infectious diseases, second only to influenza and acute respiratory diseases .. The disease was often accompanied by a variety of complications that are so typical of measles. Measles was a very dangerous disease: every third, every fifth sick child died of it.
Dr. Komarovsky on the history of measles and its prevention
How does the measles virus spread
The virus enters the body through the respiratory tract and the mucous membrane of the eyes. Gets into local lymph nodes and begins to multiply in them.
On the third day after infection, large quantities of the virus begin to continuously enter the blood. The man is still healthy, and he has millions of viruses in his blood.
Studying this phase of the disease, virologists have established a very interesting fact: measles viruses are not in the serum, but are firmly associated with leukocytes. If such white blood cells are removed from the blood, washed thoroughly and injected in the form of a suspension to a susceptible person, he will definitely get sick. It turns out to be a paradoxical situation: a white blood cell, designed to protect the body from germs, a cell that produces interferon to fight viruses, has become something like a horse for a rider – a measles virus, which, having “ridden” white blood cells, is now spreading throughout the body. Moreover, the virus even multiplies inside leukocytes.
The blood carries the measles virus to virtually all organs. It is immediately embedded in the cells of the lymph nodes, lymph and blood vessels and begins to multiply in them. The body’s defenses cannot prevent the spread of measles viruses, as they do for most other viruses. The measles virus inside a leukocyte, like inside a tank, overcomes all obstacles. Particularly affected are the lungs, digestive tract and brain. Damage to the lungs caused extensive inflammatory changes, and severe pneumonia developed. They used to be the main cause of death from measles.
The virus in the brain leads to inflammation of the brain tissue: encephalitis develops.
In the past, it occurred in many patients, and this was accompanied by the development of the most unpleasant measles complications – ‘mental retardation. Examination of children with measles already in our time with the help of special devices – electroencephalographs, which make it possible to judge the functional activity of the brain, shows that almost half of the patients experience a marked change in brain function. Sometimes the measles virus lingers in the central nervous system of ill children for a long time. It seems to disappear, disguised there for many years. And only in 3-7 years it is activated again and unexpectedly causes a fatal exacerbation – panencephalitis.
In a child, and more often in a teenager, the coordination of movements suddenly breaks down, then it becomes difficult to read, he gradually becomes stupid, falls into childhood and dies in a few months. Fortunately, this is extremely rare.
One of the very dangerous complications of measles there was also inflammation of the middle ear, after which the child remained partially or completely deaf. Sometimes inflammation of the heart muscle began – myocarditis. Measles caused ulceration of the cornea of the eyes, as a result of which the child lost his sight, became blind. All this happened in our country relatively recently, some 50 years ago.
How can you get measles
The measles virus is the most volatile and most contagious of all known on earth.. It is enough for a child who has not yet hurt, or for an adult to get into the same room as an infected person, as he is sure to get sick. Measles spread instantly to all rooms where the infectious patient was located. It was so easy to break out of windows and doors that cases of infection of children on another floor of the building were repeatedly described. The measles virus literally flew through the window of the room where an infected child was playing or lived, and was drawn into other rooms with a current of air, infecting there all children and adults who were not sick and who were susceptible to measles.
Almost until the middle of this century, there were no medical devices or specific drugs for treating measles. Only after the invention of penicillin and other antibiotics, did doctors receive the means to combat many of the complications of measles. Finally, the doctor has ceased to be a contemplator of the disease, powerless to at least somehow influence it.
After the war, medical gamma globulin was obtained, which doctors began to use for both prevention and treatment of measles. Now the doctor could alleviate the severity of the disease and to some extent reduce the spread of infection in a child with a new illness, after the appearance of the rash.
Gamma globulin is prepared from the blood of the donor by special purification and concentration. The result is a fluid with a high content of various antibodies, including antibodies against measles.
If gamma-globulin is administered to healthy children in the first days after their contact with measles-sick patients, it prevents the development of the disease or weakens it significantly.
However, the duration of the prophylactic action of gamma globulin is small: only three to five weeks. Therefore, if it is used to protect against possible infection, then with each new threat of the disease, repeated administration of gamma globulin will be required, which is almost impossible, because the production of the drug depends on the amount of blood of donors.
After the invention of antibiotics and therapeutic gamma globulin, measles mortality was drastically reduced, but the number of children who were sick every year was still huge. In the fall, an increase in the incidence began in all countries, and once in three years there were vast epidemics. Fortunately, the measles virus is one around the globe. This was confirmed by virologists in different countries. They isolated viruses from patients, then sent them to each other and compared them in their laboratories. Using the most advanced research methods, they found that both “American” and “Russian”, and any other measles viruses have exactly the same proteins and nucleic acids. “Viruses are absolutely identical in antigenic terms,” the scientists eventually wrote.
At any point on Earth, in any country in Europe, the measles virus causes the same diseases as in Africa, Asia, and America. Such a discovery was particularly important for scientists who set themselves the task of creating a vaccine against measles. It was possible to work literally with any virus, and if a vaccine preparation can be made, it can be used in any country, on any continent of the earth.
The task seemed especially tempting, because, as established by doctors, having had measles, people receive lasting immunity for life. For the second time, no one ever had measles. True, there were separate reports that described cases of recurrent measles, but all these data were very doubtful. And when examining blood by serological methods, that is, when antibodies were detected, it was always possible to establish that such repeated measles was not really measles. The disease has been associated with the rubella virus, herpes virus or is caused by some other cause.
A harmless and effective live vaccine could be obtained only by weakening the measles virus isolated from patients to such an extent that it lost the ability to cause dangerous symptoms of the disease in vaccinated children. Initially, many different strains of the measles virus were isolated from sick children, and they all went a long way of training them to one or another tissue culture. As a result, weakened viruses were obtained, which caused intensive antibody formation when administered to laboratory animals, and in particular to monkeys. It would seem that after testing on animals, the vaccine is ready for use in humans. But it was at this stage of the research that the authors of the vaccine had the most responsibility. They had to conduct experiments in such a way as to reliably check and guarantee the safety of the vaccine for people, or rather, for very young children about a year old who have not yet had measles. This age is the most dangerous.
By the end of the first year of life, maternal antibodies disappear from the blood of the child, which protect it against measles during the first months of life. It is here when a child contacts a measly sick child and becomes infected, and therefore in past years most of the children were ill at the very age of one – three years.
Symptoms of measles
The incubation period lasts 9-11 days.
- The disease begins with an increase in body temperature to 38-39 o C, the development of a runny nose, rough ("barking") cough, hoarseness, photophobia, headache, general weakness and sleep disturbance. Appears puffiness of the face, eyelids, bright red conjunctiva and oral mucosa.
- On the 2-3rd day of the disease, rashes appear on the cheek mucosa in the form of small, about 1 mm in size, white spots, slightly standing over the red mucous membrane (Belsky – Filatov – Koplika spots). Usually they are arranged in groups, never merge with each other and in appearance resemble semolina. Persist for 1-3 days, then disappear.
- On the 4th day of the disease, behind the ears and on the nose bridge, then within 24 hours pink or red spots appear on the skin of the entire face, neck and upper chest, which after a few hours increase in size, turn into large purple spots, have uneven edges merge. The rash is usually abundant. The appearance of the skin between the elements of the rash is normal.
- On the 5th day, the rash spreads to the body and arms, to the 6th – to the legs. The rash is usually abundant. Especially a lot of her face, a little less on the body, even less on the legs. As a result of the merger of the rash on the face, it becomes puffy, the eyelids thicken, the facial features grow coarser, and the appearance of the face changes dramatically.
The period of rash is characterized by an increase in body temperature up to 40 degrees, increased inflammation of the airways and deterioration of the patient’s general condition. The body temperature reaches a maximum on the 2-3rd day of rash, and then quickly decreases to normal, and recovery occurs. The rash persists for 3-4 days, then begins to turn pale and acquire a brown or yellowish tint in the same order in which it appeared. The flowering of the rash may be accompanied by flaking of the skin.
Complications. Inflammation of the lungs, ear, paranasal sinuses, damage to the cornea, nervous system.
Disease Recognition. The diagnosis of measles is confirmed by the results of a blood test that is taken from a vein.
Patients with light and moderate uncomplicated forms of measles are treated at home under the supervision of a local doctor. Patients with severe and complicated forms of these diseases are sent to the hospital.
Treatment of the patient with measles is carried out as patients with acute respiratory viral infections. In case of severe inflammation of the conjunctiva of the eyes, for the lower eyelids, 20% solution of sodium sulfacyl should be instilled 2 drops 3-4 times a day, the patient should be given a comfortable position in bed so that light does not fall into the eyes. Isolation of the patient stops after 5 days from the onset of the rash.
Disease prevention. Vaccination is a reliable method of preventing measles.
Why you should get vaccinated for measles
The best way to protect against measles is to get vaccinated. According to the recommendations, measles vaccination is carried out twice: at the age of 12-15 months and at the age of 6, before the child goes to school. The second vaccination is needed to protect those children who have not previously been vaccinated, as well as those who have not developed a stable immunity after the first injection.
Currently, both monovaccines and combination vaccines are used for measles. The latter, for example, are often used in the USA (MMP II – against measles, rubella and parotitis).
How effective are vaccines?
According to medical data, over 90% of people are protected from measles after the first dose of vaccine. Up to 95-98% of people are protected after the second vaccination. Notably, vaccinating a person not only protects himself or his child from measles, but also prevents the spread of the disease.
Measles vaccination began in 1969, and people born before that time have a low chance of getting infected, as they seem to have had measles.
Who should not be vaccinated?
Some people can not be vaccinated against measles. At the same time, it is important that family members and close people are vaccinated. This will help protect the person from the disease. Currently, according to international protocols, measles vaccines cannot be given to the following categories of the population:
- Pregnant women.
- Persons with serious problems with immunity (for example, patients receiving treatment for cancer).
- Persons allergic to gelatin or the antibiotic neomycin.
Vaccine adverse reactions
All types of measles vaccines have a high safety profile. According to research and observations, the likelihood of developing any adverse reactions during the second vaccination does not increase. Large-scale studies with combined measles, rubella and parotitis vaccines have shown that the use of these vaccines has nothing to do with bowel disease or autism. These vaccines do not contain mercury in their composition.
Adverse reactions are extremely rare. A very small proportion of people after vaccination may experience very mild adverse reactions in the form of an increase in body temperature of up to 38 degrees. Very rarely, conjunctivitis and a slight rash can occur.
As for the complications, they are extremely rare. Among them are:
It should be noted that the possible complications after vaccination occur much less frequently than after natural measles, and in much lighter manifestations.
Measles Vaccine and Pregnancy
What should pregnant women do if they are not vaccinated against measles? In this case, note the following information:
- If you are not immunized against measles and are pregnant, the risk of miscarriage, premature birth and low birth weight babies increases with infection with measles.
- If you have not been immunized before pregnancy, you should not receive additional doses of vaccine during pregnancy. In this case, it is imperative that the people around you are immunized and not endanger your health.
- If you were immunized against measles shortly before your pregnancy, then you are almost immune to measles. However, you still need to ensure that the people around you are vaccinated and do not carry a danger to your health.
- Pregnant women who think they have measles or those who have been in contact with an infected person should contact their doctor as soon as possible for help.
- Women who have recently been vaccinated against measles should avoid planning a pregnancy for a month after vaccination.
Unvaccinated and not sick with measles children communicating with a patient are not allowed into the children’s team for 17 days. Within 2 days after contact with the patient, they are vaccinated to prevent the disease or immunoglobulin is administered at a dose of 0.25 ml / kg for 5 days after contact to prevent or alleviate the course of the disease.
Call the doctor at the first suspicion of your child having measles and strictly follow his recommendations and prescriptions.
in the morning and in the evening (at least) measure the temperature of the child’s body
as much as possible, give the child fluids (water, juice, tea, lemonade)
limit the time you watch TV, read books and complete school assignments
Remember! Once the signs of the disease have manifested, measles gammaglobulin is not effective. Antibiotics also “do not work” against the measles virus.
Children affected by measles are particularly susceptible to infectious diseases, especially the ear and lungs. If this happens, antibiotics are prescribed to effectively fight the bacterial infection.