Measles is a highly infectious disease. If a person has had measles, then a strong immunity is formed.
The causative agent of measles is an RNA-containing virus. The source of infection is a sick person. The most infectious patient in the early days of the disease.
Measles is transmitted by airborne droplets. Getting to the mucous membranes of the respiratory tract, the virus through the bloodstream spreads through the body.
Since in adults the disease is more severe and the risk of complications is high, it is imperative that you vaccinate.
The national immunization schedule provides for compulsory vaccination of adults under 35 years of age, as well as persons working with children regardless of age.
Vaccination ensures the formation of immunity in humans, which guarantees protection against measles for about 20 years.
You can get vaccinated in both state and commercial clinics. At the moment, one-, two- or three-component vaccinations can be vaccinated (measles, measles-parotitis, measles-parotitis-rubella). The feasibility of each of these vaccinations is determined by the doctor individually.
Vaccination is carried out twice with an interval of 3 months.
Complications after vaccination
The most common complications of measles vaccination in adults are:
- temperature rise for 5-15 days (sometimes up to 40 degrees), which lasts up to four days. It can be shot down with antipyretic drugs such as paracetomol.
- In addition to fever, rhinitis, cough, and a small rash can be of concern.
Since the vaccine contains antibiotics and egg white fragments, an allergic reaction may develop (provided that there is an allergy to these components before).
Exacerbation of chronic diseases is also possible.
Severe complications are rare.
Both domestic and foreign vaccines are transferred equally.
During the course of the disease there are four periods:
- period of rash;
- recovery period.
Typical course of measles
During the incubation period there are no clinical manifestations. It usually lasts from 7 to 14 days, rarely up to 21 days.
Clinical signs of measles appear during catarrhal manifestations. The catarrhal period is characterized by the following symptoms:
- general weakness, body aches;
- increase in body temperature from 38 to 40 degrees;
- runny nose with copious mucous discharge;
- viral conjunctivitis (inflammation of the mucous membranes of the eyes);
- agonizing dry cough;
- enlarged cervical lymph nodes;
- sore throat when swallowing;
- on the second day, the appearance of whitish spots with a red rim – spots on the mucous membrane of the cheeks Belsky-Filatov-Koplik.
The period of catarrhal manifestations lasts up to 5 days, at the end of this period the patient’s well-being improves, the symptoms of intoxication decrease.
But after about a day, the patient’s body temperature rises again and his state of health worsens. The period of rash begins.
For the period of rash is characterized by the appearance of a rash, rash – maculopapular, lesions lesions prone to fusion.
At the beginning of the rash appear on the head, neck, upper chest.
Later, the rash spreads to the whole body, limbs.
A rash on the patient’s body lasts for three days, then the elements of the rash turn pale.
When the rash on the body is paler, the patient begins to recover. In place elements of the rash appear patches of skin pigmentation. Body temperature is normal.
This pattern is typical of a typical measles course, sometimes an atypical course is found.
The atypical forms of measles include the following:
When mitigated form in a patient
- light catarrhal phenomena appear;
- the temperature rises to subfebrile level (up to 38 degrees);
- elements of rash single and pale.
This form of measles can develop when gamma globulin is administered to a patient, in individuals with weak measles immunity.
For hypertoxic form
- the presence of high body temperature (febrile),
- severe intoxication of the body,
- manifestations of acute cardiovascular insufficiency (shortness of breath, cyanosis of the nasolabial triangle and fingertips),
- manifestations of meningoencephalitis (severe headache, movement disorders, sensitivity disorders).
For hemorrhagic forms of general intoxication and the appearance of multiple hemorrhages on the skin, mucous membranes, the appearance of blood in the urine, feces. This form is very difficult and often leads to the death of the patient.
Diagnosis is primarily based on:
- carefully collecting the patient’s history
- characteristic rash and spreading through the body (the beginning of the process from the head),
- the duration of the period of rash (in most cases, 3 days).
To confirm the diagnosis, the following laboratory tests are performed:
In the early stages of the disease, you can donate blood from a vein and determine immunoglobulin M (IgM, early antibodies) for the measles virus. Detection of this type of antibody indicates the initial stage of measles virus infection. The body has already begun to fight the disease.
When infected with measles, there is an increase in IgM titer (antibodies) against the measles virus four or more times. A blood test is performed when clinical signs appear and after 2-3 weeks, this is a reliable criterion for measles infection.
Late antibodies to measles virus (immunoglobulin G, IgG ) does not need to be determined during diagnosis, as they are formed both after vaccination and after the disease. The production of G-immunoglobulins occurs 1-2 months after suffering a measles infection. If a person has never been vaccinated against measles, then their appearance suggests that he once suffered measles. The presence of IgG protects a person from reinfection.
If signs of disease appear, it is necessary to consult a general practitioner, a dermatologist or an infectious diseases specialist.
If the patient has no signs of measles complication, then the patient is treated on an outpatient basis. Persons with a complicated course of measles are hospitalized, if it is impossible to isolate the patient (living in a hostel, military units).
Patients are hospitalized in the infectious disease ward.
There is no specific treatment for measles.
The measles gammaglobulin is used only with established contact and no vaccination during the incubation period.
Treatment of measles is only symptomatic.
If the patient has a body temperature of more than 38.5 degrees, antipyretic drugs are prescribed:
Antiviral drugs are prescribed:
In case of rhinitis, vasoconstrictor agents are prescribed:
To relieve inflammation in the oropharynx is used:
- gargle with chamomile, sage, calendula.
Antibacterial therapy is prescribed only with the development of bacterial complications (for example, pneumonia, otitis). Antibiotics for measles are prescribed only after identifying the pathogen and taking into account its sensitivity to these antibiotics.
In most cases, the disease proceeds favorably, recovery without negative consequences. However, older people experience measles much more heavily than children, and this increases the risk of complications.
The following effects of measles carried in adulthood are possible:
- bacterial complications ( bronchitis, pneumonia, otitis media );
- hearing loss;
- corneal ulcers, keratitis ;
- damage to the intra-abdominal lymph nodes (manifested by abdominal pain);
- encephalomyelitis, is the cause of death of the sick;
- thrombocytopenic purpura (the presence of bleeding in the oral cavity, in the intestine, urinary tract);
- rarely – ascending and transverse myelitis.
To prevent the development of complications must be vaccinated. Since even if a person becomes sick, the disease will be mild and without complications.
- Vaccination with a live vaccine (possibly as part of a combination drug) to healthy children from 12 months of age. Revaccination is indicated to children before they enter school. During the first three days after contact with the patient, vaccination is used as an emergency prophylaxis (preferably within the first 72 hours after contact with the patient). In individuals for the introduction of a live vaccine (on the 4-5th day after the injection), the development of a symptom complex that looks like the erased version of the disease is possible (these children are not dangerous for others).
- The alternative prophylaxis after contact with the patient (the first 5 days) is a normal human immunoglobulin (0.25 ml / kg, not more than 15 ml) for children under 1 year old, immunodeficient patients and pregnant women.
- Children from organized groups are separated for 17 days, with the introduction of immunoglobulin – on the 21st day after isolation of the first patient.
- Quarantine does not apply to vaccinated, previously experienced measles and adults.
Vaccine administration to persons who have previously had measles is not indicated (due to the development of persistent post-infectious immunity).