Measles: symptoms and treatment

Measles, also called rubella, is a viral infection that is one of the most contagious infectious diseases in the world. The disease is characterized by symptoms similar to a cold, as well as a characteristic red rash. Between 2000 and 2010, the global incidence of measles decreased by 66% and mortality due to the disease decreased by 74%, according to a report in The Lancet. Less than two decades ago, measles was almost eliminated in the United States thanks to vaccines.

But recently, the virus has experienced a resurgence. Overall, the number of cases jumped by 30% due to hesitation to vaccination. According to Dr. Deepa Mukundan, a specialist in infectious diseases in children at the University of Toledo Medical Center, Ohio, more than 760 cases of measles have been reported in the United States between January 1 and May 3, 2019. According to the Centers for Disease Control and Prevention (CDC), this represents 372 cases throughout the year 2018 and 120 cases on the whole of the year 2017.

Is it contagious?

Measles is caused by Measles morbillivirus, a virus of the paramyxoviridae family. According to the CDC, the measles virus sits in the mucus of the nose and throat of an infected person. When a person infected with the virus coughs, sneezes or exhales, the virus is transmitted through the air and can be transmitted to other people.

"The virus can stay in the air for long periods of time," Mukundan told Live Science. "You can get measles just by being in a room where a person has been infected with measles, even up to two hours after leaving."

Indeed, the virus is incredibly contagious: 90% of people who are not vaccinated against measles will be infected if they share the space with a person infected with the virus.

"Another reason for its equally effective transmission is the fact that measles, the rash, does not manifest until several days after a person is contagious," said Dr. Jennifer Lighter, Disease Specialist. Infectious infections in children at New York University, Langone Health. Therefore, infected people can transmit the virus for several days before realizing that they are sick. The contagious period lasts approximately four days before and four days after the onset of rash.

A person with measles is likely to infect between 5 and 18 unvaccinated people, according to a 2019 study published in the journal Emerging Infectious Diseases.

Symptoms and diagnosis

Most cases of measles are a combination of cough, runny nose, red eyes, high fever and tiny white to bluish spots in the mouth, said Dr. Aileen M. Marty, Professor of Infectious Diseases at the College. Dr. Herbert Wertheim of Florida International University. In Miami. As the infection progresses, the characteristic red rash will develop. The rash usually looks like big red spots and flat on the skin.

To test for measles, a doctor will examine the patient for telltale symptoms, such as spots inside the mouth and rashes. If in doubt, the doctor may request a blood test to confirm the infection, according to the Mayo Clinic.

Treatment and recovery

Almost all cases require treatment by a doctor. "It is a disease where complications are common – complications such as otitis (acute otitis media), diarrhea and dehydration, pneumonia, encephalitis, and even death," he said. Marty at Live Science. "In the United States, one to three out of every 1,000 people infected will die as a result of [measles] complications – which is better than in the third world, where two to 15 people infected in 100 die from measles and its complications. "

Young children are much more susceptible to the virus. According to the Mayo Clinic, measles kills 100,000 people a year, most of whom are under the age of five. Pregnant women and people with compromised immune systems also risk serious complications.

There is no specific medicine to treat measles. Instead, doctors treat the symptoms. "This means that we provide / advise hydration, antipyretics (eg, acetaminophen) for comfort and control of fever, humidification of the airways in patients with impaired airways, "said Marty. Although unauthorized in the US for the treatment of measles, some pediatricians have used ribavirin, an antiviral drug, to treat severe pneumonia caused by measles, added Marty.

To protect people who have been exposed to the virus but have not been vaccinated, a doctor may request a post-exposure vaccination. If administered within 72 hours of exposure, vaccination can prevent measles. Although this does not prevent the disease, the vaccinated patient will only have one mild case of measles, according to the Mayo Clinic. Another way to protect people at risk is to inject them with immune serum globulin (antibodies or proteins derived from the blood of immunized donors against measles) within six days of exposure to the virus. Like vaccination, this treatment can prevent or reduce measles.

For many people, curing measles involves resting at home until the symptoms disappear. It is important for patients to drink plenty of fluids to replace fluids lost during fever. According to the Mayo Clinic, it may also be helpful to use a humidifier to relieve congestion and block bright lights that can interfere with sensitive eyes. Once the disease has run its course, the person will be immune to the virus.

However, according to Lighter, the immune system could be significantly weakened up to 2 years after its measles cure. During this period, people may be more susceptible to secondary viral and bacterial infections, which may cause more complications than the original measles infection.

The measles vaccine

The best way to prevent measles is vaccination. The CDC recommends 2 doses of the vaccine; the first for 12-15 years and the second for children from 4 to 6 years old. The vaccine is 97% effective for those who receive both doses and about 93% for those who receive one.

Being vaccinated protects not only the recipient of the vaccine, but also those who can not be vaccinated: people who are allergic to certain components of the vaccine, those whose immune system is compromised or who are too young to receive it .

"Vaccines are one of the most effective tools we have to protect public health and prevent deaths around the world," said Dr. Scott Lillibridge, an infectious disease expert and professor at the Faculty of Public Health. Texas A & M Health Science Center.

According to Mukundan, about 94 percent of the US population is vaccinated against measles, although there are pockets of people delaying or refusing vaccines. Unvaccinated groups of people make it difficult to control the spread of measles, she said.

"All measles outbreaks in the United States begin either with an international traveler infected with measles, or with an unvaccinated US resident returning from an international trip with measles infection," said Mukundan. The infection is then pbaded on to other unvaccinated community members.

According to the CDC, most cases of measles occur in localities with unvaccinated individuals. In 2000, the United States reported that measles was effectively eliminated in the country. But since then, the disease is back, probably because of anti-vaxxeurs.

"The anti-impax movement represents only a small percentage of the population, but they are strong and attract a lot of media attention," Lighter said. Anti-vaxxers are motivated by emotions rather than the science behind vaccines, she said.

The modern opposition to vaccines is largely fueled by religious beliefs and the unjustified concern that vaccines are somehow related to autism, among other reasons, according to the initiative. Measles and rubella, a collaboration of the world's largest health organizations aimed at eliminating measles and rubella.

Before the measles vaccine was approved in 1963, it is estimated that 3 to 4 million people in the United States contract measles each year, and 400 to 500 die from it, according to the CDC. The introduction of the vaccine has resulted in a reduction of more than 99% in measles cases in the United States. Many studies have confirmed that there is no relationship between vaccines and autism and have repeatedly validated the safety of measles vaccine.

"Protect yourself and your loved ones by making sure they're up-to-date with measles vaccine," said Mukundan. "Preventing, that is, vaccinating, is always better than cure."

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Additional report by Alina Bradford, contributor of Live Science.