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Facts and advice about measles. Written by pediatricians for parents. Measles is one of the world’s most contagious diseases. The disease is rare in Sweden, thanks to vaccinations. Measles had nearly been eradicated in several countries a few years ago; however, due to incomplete vaccination coverage, the disease made a resurgence.
Measles transmission and incubation period
Fortunately, most of us are not receptive. For individuals born prior to the 1970s, this can typically be attributed to their prior exposure to the disease. Once exposed, the immune system forms an immunologic memory that forms life-long protection against new disease. Of those born from the late 1970s onwards, most are vaccinated against measles, and therefore cannot become infected with the disease.
The measles virus is airborne and enters the body via the respiratory tract or eyes. An individual susceptible to measles can contract the virus by simply entering a room where a person infected with measles has been present within the past two hours. Even after the infected person had left. It has been estimated that when a person with measles only encounters susceptible individuals, they, on average, infect 15 to 18 other people. The incubation period is 10-21 days. You can become infected and for 10-21 days seem ‘healthy’, before you show symptoms and infect others.
Symptoms of measles
The first symptoms of measles are mild fever, red eyes and dry cough. At this stage, transmission is at its highest. You can also see grain-like rashes in the oral mucosa on the inside of the cheek, also known as Koplik’s spots. After 3-7 days, the fever rises and the typical spots appear on the skin.
What should I do if I think my child has measles?
If you’re in Sweden, call Medical Information 1177 and tell them that you suspect that your child has mealses. Otherwise, go to a medical center. They’ll guide you in the right direction. They’ll probably contact, or provide contact details for, a children’s emergency room or infection emergency department, where you may attend for examination, sampling and care.
It is important not to go into a hospital with a suspected measles-infected child yourself. If you go to the emergency room, let an adult enter and inform staff first so that staff can direct you through the right entrance to avoid further transmission.
If your child is very ill and needs hospital treatment, you will receive it. There is no danger for vaccinated staff to provide care for your child, provided that they have received two doses of the vaccine. The important thing is that measles sufferers have their own isolation room where you do not risk infecting others.
Is measles dangerous?
In four out of five sick children, measles only lasts one to two weeks with fever, rash and sore eyes. However, one in five children have complications. Common complications include pneumonia, diarrhea and otitis that require antibiotic treatment or hospitalization for a few days or longer.
One in 1,000 children suffer from acute measles infection in the brain, measles encephalitis. It is a disease that can both cause permanent brain damage and can lead to death.
A feared complication to measles is called Subacute Sclerosing Panencephalitis. This occurs five to thirty years after the measles disease, but usually around 10-12 years afterwards. It means that the sufferer gradually loses brain function and dies. There is no cure. This complication has previously been perceived as extremely rare. But recent research suggests that about 1 in 1,300 sufferers will receive it. Among children who suffer from measles before the age of 12 months, the risk is even higher.
Although the vast majority of people who get mealses survive, deaths can occur in countries with modern health care. Roughly 1 in 500 individuals who contract measles succumb to the disease, with a higher risk observed among infants.
Globally and historically, measles has been one of the major child killers. While an increasing number of children now survive due to vaccinations, improved access to clean water, and better nutrition, it remains a sobering fact that 245 children around the world lose their lives to measles each day. All these deaths could be avoided if the whole world were vaccinated against measles.
Babies and measles transmission
Only people who have not had measles and are not vaccinated, can get the disease if they encounter the virus. In addition, certain types of cancer treatment or other medical treatments that suppress the functions of the immune system, may erase a previous protection against measles.
Most people who are not vaccinated against measles are children under 18 months of age. The children vaccination programme in Sweden provides the MMR vaccine at 18 months of age. You can get the vaccine earlier if you are going to a country with a measles epidemic. In several county councils you have to pay for the vaccine yourself if you want a vaccination before 12 months. In some counties you may also go to a vaccination agency to do so. If you vaccinate before 12 months then you need to vaccinate again at 18 months to ensure lasting protection.
Vaccination against measles started in Sweden during the 1970s. First, one dose of the vaccine, and then in 1982 with two doses. The second dose was introduced because one dose did not provide full protection in all vaccinated people. If you have not had measles and were born before 1981, it may be worthwhile having an extra dose as an adult, to ensure that you are fully protected. If you have not had measles and have not received a vaccine as a child, for example because your parents chose to abstain, it is a very good idea to have the two doses of vaccine. Go to a vaccination agency.