Measles may be serious disease

Donya Betancourt, Pediatrician, drdonya@hotmail.com

A common question about the MMR vaccine is whether it should or should not be given to babies. When I hear this question it makes me wonder if parents realize how serious a measles infection is or what can happen if an infected child has an outbreak.

Here are some facts about measles:

* Measles is a potentially serious disease.

* Measles is due to a virus that is easily spread.

* Measles can be complicated by ear infections, pneumonia or encephalitis.

* Measles infection of the brain (encephalitis) can cause convulsions, mental retardation and even death.

* Measles in pregnant women can cause miscarriages or premature delivery.

* Measles can be prevented through vaccination.

* Each person not immunized against measles is at risk for measles and puts others at risk.

As any parent with a child in school knows, children can pick up a lot of things there apart from learning. They bring home all kinds of illnesses. Colds, coughs, the flu, even measles, mumps and rubella.

How does measles spread? The answer is with ease. The measles virus is, in fact, spread principally by small droplets from the nose, throat and mouth of someone who is in the early stages of the disease.

These droplets are sprayed out during sneezing and coughing. Measles can also be passed through direct contact with nasal or throat secretions of infected persons or objects contaminated with the measles virus.

Measles is among the most readily transmitted of all infectious diseases and measles epidemics occur every two to three years in areas of the world without effective immunization programs.

These outbreaks often occur among nonimmunized preschoolers or other nonimmunized people.

Measles, for one, is not a trivial disease. It is commonly complicated by ear infections, pneumonia and sometimes encephalitis, or inflammation of the brain. Measles encephalitis is a particular worry since it can cause convulsions, mental retardation and even death.

What are the symptoms? A typical case of the measles begins with fever, runny nose (coryza), a hacking cough and red eyes (conjunctivitis).

The very characteristic spots within the mouth, called Koplik's spots, appear two to four days later often on the inside of the cheeks (buccal mucosa) opposite the first and second upper molars, and look like little grains of white sand surrounded by a red ring.

Measles starts in the first three or four days with a bad cold that becomes worse. The child's eyes become red and watery. The child has a hard dry cough that becomes more frequent.

The fever usually rises each day and can go as high as 104 degrees Fahrenheit or 40 degrees Celsius. The rash appears about the fourth day when the fever is high, as indefinite pink spots behind the ears. They spread gradually over the face and body, becoming bigger and darker. The patient looks and feels sick.

The fever stays high, the cough remains frequent in spite of medicine and the child feels pretty sick while the rash comes out fully, which takes one or two days. After that, your child should improve rapidly.

The first symptoms of measles begin anywhere from nine to 16 days after exposure.

The disease is contagious from the very beginning of the cold symptoms. A person with measles can transmit it beginning two to four days before the rash appears until the time that the rash fades and clears.

You may suspect a complication if the fever stays high for more than two days from the time the rash begins, or if the fever comes down for a day or more and then returns.

Complications can be serious, and unlike measles, some complications can be successfully treated, while others cannot.

What complications can occur with measles? We will discuss them next week.