Measles/ Rubeola: How to deal with it

Measles is a febrile illness prevalent in children; however, it can occur in later years of life. One attack of measles confers a high degree of immunity.

 Measles is prevalent in peadiatric  age group. ( Image courtesy: pixabay)

Let us understand the clinical manifestations of the disease and its stages. Clinically measles can be divided into two stages: 

1) Catarrhal stage

 This stage lasts for 3-4 days. Day 1-2 of catarrhal stage is marked by the onset of fever, nasal catarrh, sneezing, redness of the conjunctivae and watering of the eyes.

Day 2+: cough, hoarsness of the voice and photophobia usually appear by the second day.

A diagnosis of measles may be made by the presence of Koplik's spot on the mucous membrane of the mouth. Koplik's spots are small white spots surrounded by a narrow zone of inflammation.

During the catarrhal stage the disease is highly infectious. Fever runny nose, lacrymation makes the child very irritable during this stage. 

2) Exanthematous stage

 Maculo-papular rash as seen in measles. (Image courtesy pixabay)

The next stage of measles is called the exanthematous stage. After 3-4 days from the onset of fever Koplik's disappears and the red macular or maculo-papular rash develops which commences at the back of the ears and at the junction of the forehead and the hair. The rash then spreads to the whole skin as the spots rapidly become more numerous they fuse to form the characteristic blotchy appearance of measles. It then fades after several days into a faint brown staining followed by a fine desquamation. Fever and malaise subside as the rash fades.

Treatment of measles

Measles is infectious and spreads due to droplet infection therefore it is advisable to isolate the child if possible and exclude from school for 10 days from the appearance of the rash. Give plenty of fluids orally. Symptomatic treatment for high grade fever should be given if needed. Antibiotics should be prescribed only for secondary bacterial complications.

Immunization

 Measles vaccine is available in association with mumps and rubella. (Image courtesy thinkstock images.)

A mother who has had measles confers passive immunity on her infant for the first 6 months of life 

Measles vaccine is usually given in association with mumps and rubella as MMR vaccine.

Doses: two doses are recommended.

1 st dose should be given shortly after first birthday.

2 nd dose should be given prior to entry at school.

Though measles is a self limiting infection it is preferable to seek the advise of your primary care provider for accurate diagnosis and managment.