Why parents should be afraid of measles, not the vaccine



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The flow of oxygen was at its peak but it was not enough to keep Aliyah alive. Her lungs damaged by measles failed in the night.

Aliyah was one of hundreds of children with measles that I attended in a special ward at Kenya National Hospital in 1972, before the measles vaccine was available. I've seen all the possible complications of measles, often fatal. They have left me a deep respect for this once-common viral infection of childhood.

As an infection specialist, I celebrated the gradual disappearance of measles cases in Canada as a result of the introduction of routine measles immunization in the mid-1970s. Today, the most doctors have never seen a case. Parents too are not familiar with measles, some doubting the need to avoid it, even considering it as a bbad disease.

Given the recent outbreaks of measles in Canada, the United States and around the world, it's good to remember what this disease looks like.

Nausea, vomiting and fever

Measles is not insignificant. It is the most serious childhood infection that used to be common. It is extremely contagious and difficult to recognize until the rash appears later in the disease.

Six decades later, I remember myself having measles while I was a child: several days fever, headaches, cold tremors and heavy sweats. I remember lying on the floor next to my bed, too sick to sit on a chair while my mother changed the sheets.

This is the normal progression of measles, which causes considerable distress to a sick child and his parents for seven to ten days, even in the absence of complications. No antiviral medication is available to treat the disease or its complications.

The infection starts in the airways, with nasal congestion, sore throat, red eyes and increasing coughing. Unlike colds, measles gets worse for several days, causing fever (often up to 40 ° C or 104 ° F) and putting children to bed with nausea, vomiting, chills and headaches.

This pre-eruption phase lasts approximately four days, during which the infected person spreads a considerable number of viruses into their environment, which explains why measles is highly contagious. A person with measles can infect 75 to 90% of sensitive members of a household by coughing and sneezing viruses in the air.

Communication skills are particularly high in groups, such as daycares and clbadrooms, but can also occur with short-term exposure to an infected person.

Contagious before the symptoms manifest themselves

Measles hides his identity. It is often not until the fifth day of illness that the characteristic rash covers the body, revealing the diagnosis of measles. Children are however contagious three to four days before the onset of the rash, when the symptoms resemble those of colds or flu.

Measles can lead to pneumonia, brain damage and other complications.
(Shutterstock)

Unlike colds and flu, measles infection extends beyond the airways and spreads through the bloodstream to the skin and other organs. The measles rash results from the "catching up" of the child's immune system and the attack of viruses in the skin.

Any delay in immune activation, as may be the case with malnutrition or immune disorders, prolongs the infection with the virus and increases tissue damage.

When the rash appears, it marks the peak of the disease and marks the beginning of recovery. The fever will soon subside, although the child remains contagious for several days and that it coughs for one to two weeks.

Encephalitis and brain damage

Hospitalization rates for measles are highest among children under five – ranging from 9% to 25% in Western countries.

Complications occur in about one in three young children with measles.

In the United States, the most common complications are middle ear infection (otitis media) in 14% of reported cases, diarrhea with a risk of dehydration of 8% and pneumonia in 9% cases, the latter being caused by the virus or an invasive bacterium.

Inflammation of the brain or encephalitis with convulsions and coma is the most feared complication, occurring in one in 1,000 cases. One in three encephalitis survivors suffers from residual brain damage. A fatal outcome has been reported in two out of every 1,000 cases of measles in the United States, mainly in immunocompromised children.

In short, measles is not innocuous. It is at best painful and at worst threatening for life. Parents should be afraid of it. The judicious alternative is to ensure that children are fully immunized against measles, given the excellent safety record and protection afforded by measles vaccine.

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