“Measles in Children” is a common disease in young children under 6 years old. If complications occur, it can cause serious harm up to death. Many families have never known why children get sick with this disease. Dr. Thitior Nakboonnam, a pediatric infectious disease specialist at the Child Health Center, Phyathai 3 Hospital, will talk about this disease.
“Measles” is one of the respiratory infectious diseases that can cause child death
Measles is a respiratory infectious disease caused by a virus that can spread and transmit through the air or direct contact with the mucus and saliva of an infected person. The virus enters through the respiratory tract first, then spreads throughout the body. It mostly occurs in young children and is one of the leading causes of child mortality, even though there is a vaccine available.
Fever, fatigue, rash may be symptoms of measles
Measles is a viral infection of the respiratory system caused by the measles virus, which only infects humans. After infection, symptoms include fever, fatigue, cough, runny nose, and conjunctivitis. On physical examination, a characteristic rash called Koplik spots can be found inside the cheeks, along with red spots on the body.
The incubation period is 7-21 days. The rash usually appears about 14 days after infection. The rash starts from the head and spreads to the trunk, arms, and legs. The infectious period begins 4 days before the rash appears and lasts 4 days after the rash appears. However, in immunocompromised patients, the rash may not appear.
Common complications of measles
The most common complications include middle ear infection, pneumonia, bronchitis, and diarrhea.
- 1 in 1,000 patients may develop acute encephalitis
- At a rate of 1-2 per 1,000 cases, death may occur from respiratory and neurological complications
- Subacute sclerosing panencephalitis (SSPE) is a very rare condition that generally occurs 7-10 years after measles infection, causing behavioral problems, intellectual decline, seizures, dementia, and can lead to death
Who is at high risk for complications
- Infants and young children < 5 years old
- Adults > 20 years old
- Pregnant women
- Immunocompromised individuals, such as those with leukemia and HIV infection
Be cautious when exposed to measles patients because it is contagious
Measles is highly contagious. 9 out of 10 people who have close contact with an infected person can contract the disease through direct contact, droplets, mucus, saliva, coughing, and sneezing. The measles virus can survive on surfaces, in the environment, and in the air for up to 2 hours after an infected person has left.
Prevention with measles vaccine
Measles can be prevented by vaccination, which is included in the combined measles, mumps, and rubella (MMR) vaccine. The first dose of the vaccine can prevent measles about 93%, and two doses increase effectiveness to 97%.
Vaccination schedule for measles prevention in Thailand
MMR
- First dose at 9-12 months
- Second dose at 2 1/2 years – 6 years
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- The first vaccine dose is given at 9-12 months of age, and the second dose at 4-6 years. Early vaccination (at 9 months) should be considered in areas with many measles cases in children under 1 year old, and delayed vaccination (at 12 months) in areas with fewer cases in children under 1 year old.
- The second dose may be given as early as 2 1/2 years according to the Ministry of Public Health’s operational plan.
- In case of an outbreak or exposure, the second dose may be given earlier than 4 years old, but must be at least 3 months after the first dose.
How is it treated?
There is no specific antiviral treatment for measles. Medical care focuses on supportive treatment to relieve symptoms and reduce complications, such as secondary bacterial infections.
Dr. Thitior Nakboonnam
Pediatric Infectious Disease Specialist
Child Health Center, Phyathai 3 Hospital
Tel. 0-2467-1111 ext. 3419
References
cdc.gov
Vaccination schedule, Pediatric Infectious Disease Society, 2019
