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Measles Is Highly Infectious But Not Invincible: What Parents Need To Know
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  • All over the world, people are worried about COVID-19. But parents are worried about more than just that. What if their child gets sick with something else, like dengue, or pneumonia, or tuberculosis? With this pandemic, it’s hard to imagine how to bring a child to a doctor, or to get vaccinated against such diseases.

    Measles is a very infectious disease, and it can be deadly.

    Nine-month-old Nur Salima had a fever for about six days before her mother, Nurata, was able to bring her for treatment in Kutupalong hospital, in Bangladesh. Medecins Sans Frontieres, also known as Doctors Without Borders (MSF), found that the baby had measles. Nur Salima was barely conscious when she arrived in the emergency room.

    The doctors gave the baby oxygen to help her breathe, and antibiotics to fight secondary infections. After five days in the isolation ward, Nur Salima improved and was finally strong enough to be discharged.

    In more than 70 countries around the world, Doctors Without Borders is racing to respond to COVID-19, while still addressing the needs of those affected by infectious diseases—like measles, which is a preventable disease. Here’s what you should know. 

    What is measles?

    Measles is a viral disease that affects young children. The measles virus is closely related to the one that causes swine fever and cattle plague. But unlike other viruses, the measles virus hasn’t mutated, and has retained the same structure for many years. This means that the vaccines developed back in the 1960s are still effective today.

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    Unfortunately, measles can often be confused with two other diseases: mumps and rubella. Though they have some similarities, these are actually three different diseases caused by different viruses. 

    Measles starts with a fever, cough, runny nose, conjunctivitis (pinkeye), and a red, pinpoint rash that starts on the face and spreads to the rest of the body. If the virus infects the lungs, it can cause pneumonia. Measles in older children can lead to inflammation of the brain, called encephalitis, which can cause seizures and brain damage.

    The mumps virus usually causes swelling in glands just below the ears, giving the appearance of chipmunk cheeks. In men, mumps can infect the testicles, which can lead to infertility.

    Rubella is also known as German measles. It can cause a mild rash on the face, swelling of glands behind the ears, and in some cases, swelling of the small joints and low-grade fever. Most children recover quickly with no lasting effects.

    But if a pregnant woman gets rubella, it can be devastating. If the infection happens during the first trimester of pregnancy, there's at least a 20% chance the child will have a birth defect such as blindness, deafness, a heart defect, or intellectual disabilities.

    How do children get measles?

    Measles is a highly contagious airborne disease. It has a ‘basic reproduction ratio’ (also called R0) of 12-18. This means that one infected person can infect 12 to 18 other people. 

    Measles spreads by coughing, sneezing and saliva. The virus can spread to surfaces and remain transmissible for up to two hours. That means that, even if there is no direct person-to-person contact, you can get measles.

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    For 10 to 14 days after the start of infection, the disease exhibits no symptoms.

    What does measles do to your body?

    The virus lodges in the respiratory tract, multiplies, and then enters the bloodstream where it can reach the body's organs: the spleen, lymph nodes, lungs, and liver. This is when the symptoms start: high fever, runny nose, cough, conjunctivitis and sometimes diarrhea. This is also when the infected child is the most contagious.

    A distinctive sign of measles is Koplick’s spots, which are small spots that appear inside the mouth.

    Then a rash breaks out. Within four days, small spots appear, first on the face, then spreading to the rest of the body. The spots look like tiny grains of white sand, each surrounded by a red ring. The rash then fades three to four days after appearing, and the skin does not always peel off as it usually does after a rash.

    Severe respiratory infections and difficulties breathing are common complications in critical measles cases. Doctors Without Borders’ Dr. Nowshad Alam Kanan describes how young children arrive at the clinic, gasping for breath. “It’s just like they’re suffocating,” he says.

    Most children will have uncomplicated measles, and will experience tiredness or fatigue for about ten days before they recover. Around 10 to 40% will have complications such as ear infection, pneumonia, or other respiratory infections.

    Can measles be deadly?

    Measles can be very severe, even fatal for children, especially those living in crowded conditions or who are malnourished or HIV positive. Combined with malnutrition or malaria, its effects can be devastating. Less common, but more dangerous, is encephalitis, a brain inflammation that occurs in one in every 1,000 cases. It is the complications that can be fatal, especially in children aged five and below.

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    How can you prevent or treat measles?

    There is no specific treatment for the measles virus; treatment focuses on preventing complications and treating symptoms. Paracetamol is given for headaches, and ointment for eye infections. Antibiotics are only necessary if the patient has a secondary bacterial infection such as pneumonia or an ear infection. In children younger than five, antibiotics can be given to avoid bacterial complications. Patients suffering from diarrhea should receive Oral Rehydration Solution.

    The best way to combat measles is through vaccination. Vaccination helps to significantly reduce the number of deaths.

    Before the measles vaccine was introduced in 1963, big measles outbreaks would occur every one to two years. It is estimated there were about 30 million cases a year. In 1980, when vaccination was not yet widespread, measles caused 2.6 million deaths worldwide. In contrast, 2018 saw around 140,000 people die from measles.

    Newborn babies receive measles antibodies from their mother through the placenta, and continue to receive them through breastmilk if they’re breastfed. This immunity fades between the age of five and 12 months. This is one of the reasons why children are usually not vaccinated against measles before they’re nine months old.

    If vaccination is successful, you’re immune to measles for life.

    Can you get measles after recovering from it?

    If a person has recovered from measles, measles-specific antibodies will be produced by the immune system, meaning he’s immune to measles for the rest of his life.

    However, measles damages the immune system so badly that people who were sick with measles remain more vulnerable to other infectious diseases for at least three years. This leads to a higher morbidity and mortality in people who’ve recovered from measles.

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    You should contact your doctor as soon as possible if you suspect that you or your child may have measles.

    You should also see the doctor if you or your child have been in close contact with someone who has measles, and you have not been fully vaccinated; full vaccination means you have had two doses of the MMR vaccine. Another reason to see your doctor after close contact with someone who infected is if you haven't had the infection before—even if you don't have any symptoms.

    Doctors Without Borders and measles

    Measles vaccination campaigns (and treatment, during outbreaks) are an important activity for Doctors Without Borders. There are campaigns every year, in a wide range of countries such as the Democratic Republic of Congo and Central African Republic. Doctors Without Borders also works to address measles outbreaks in Chad, Niger, Nigeria and Bangladesh. Since 2006, Doctors Without Borders has vaccinated some 28 million children against measles.

    Aside from vaccination and treatment, Doctors Without Borders works on improving access to vaccines. Doctors Without Borders works with governments to ensure there is sufficient supply of vaccines, and that these are available at reasonable prices.

    Doctors Without Borders works hard to deal with measles and other infectious diseases in its projects around the world. To learn more about measles and other infectious diseases, visit our website and learn more from the Infectious But Not Invincible campaign.

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