inflammation of mucous membranes, rash. It is one of the most
infectious diseases. The child may develop measles if he visited
room where 2 hours before he was sick. Almost all contacts
(98%) lead to the disease. The disease is transmitted by airborne droplets
In the environment the virus is shed in mucus when sneezing, coughing, talking. The only
the source of infection is a sick person who becomes
contagious 3 days before the rash appears within 4-5 days
Measles mostly affects children under the age of 4 years. Children
the first year of life is usually reserved immunity passed from mother
(If the mother previously had measles or been vaccinated against it), it is
It is stored in a child under the age of 1 year. After undergoing measles had been ill in the body is produced proof lifelong immunity.
Symptoms of measles
The incubation period lasts 9-11 days. prophylactic
administration of immunoglobulin it can be extended up to 15-21 days. separate
manifestations of the disease observed in the second half of the incubation period
- Reduction of the child's body weight, edema and hyperemia of the lower eyelid
(Redness), conjunctival, increasing the temperature at night, coughing,
little runny. Basic, or prodromal period characterized
increase in body temperature to 38-39 ° C, fatigue, general
malaise, loss of appetite. There is a growing cold, there
rude "barking" cough, conjunctival hyperemia pronounced. appears
enanthema measles - a small red spot located on the mucosa
shell soft and hard palate. Characteristic for measles spots
Bielsko-Koplik Filatov - they are located in the mucosa of the cheek
and are small whitish, slightly elevated above the
mucosal level spots surrounded by a narrow reddish
rim, firmly seated on the mucous membrane. In appearance spots mean
Filatov-Koplik remind semolina or bran. With the advent
exanthema (rash), they disappear. At the end of the initial period (day 3-4)
Body temperature drops, then the appearance of measles rash again
increases to higher numbers. Total intoxication and defeat
airway amplified. Measles rash (rash), characterized
Stages of precipitation: in the 1 st day of the rash items appear on the face, neck;
on the 2nd day - on the trunk, arms and thighs; on the 3rd day of the rash captures
legs and feet, and his face begins to fade. The most densely elements
rash located on the face, neck and upper torso. Eruptions
It consists of small papules (about 2 mm), surrounded by irregularly shaped
spot, the spot diameter is usually more than 10 mm. Elements rash prone
to merge, to form complex shapes with scalloped edges. However, even
with the most dense areas of the rash can be found quite normal
skin. In some cases, the background can be seen measles exanthema
hemorrhage (petechiae). After 3-4 days the rash fade elements, their
place are brownish spots - pigmentation. On-site rash
further observed pityriasis (resembling bran) peeling
face and torso.
In the absence of complications at the same time with the decrease in temperature and
blanching rash general condition of patients improved catarrhal
effects diminish and disappear, recovery occurs.
Depending on the severity distinguish mild, moderate
and severe form of measles. Especially hard measles occurs in young children
under the age of 2 years.
Infected persons who during the incubation period
prophylactically administered immunoglobulin or blood transfusions and
plasma, measles is mild. It is characterized by increased incubation
period (21 days) are usually carried out at a temperature subfebrile
(Up to 38 degrees), catarrhal phenomena from the respiratory tract
are mild, stains Bielsko-Filatova Koplik not rash in the form of
individual elements, without typical measles phasing. no complications
In 30% of cases of measles leads to complications. most often
Complications occur in children under 5 years of age and persons over 20 years
The most common complication - bronchitis, tracheitis,
laryngitis, pneumonia, otitis media and other bacterial infections, as well as
blindness, hearing injury, mental retardation. In one case,
1000-2000 measles encephalitis is recorded (usually 2-21
days after the rash appears), often starting with a temperature rise,
convulsions and coma.
The disease is dangerous for pregnant women. If a pregnant woman becomes infected
measles, the chance of miscarriage and fetal abnormalities is about 20%.
Most patients are treated at home with measles. There should be a toilet
eyes, nose and lips. Drinking plenty of fluids should meet the need
in body fluids. The food - a full, rich in vitamins, easily
digestible. Symptomatic therapy includes antitussives,
antipyretics, antihistamines. Appointed vitamin A (200
000-400 000 IU) orally for the first 2 days - all children early
age as well as older children with severe concomitant
diseases. Antibiotics are prescribed for bacterial complications:
pneumonia, bronchitis, otitis media, and others. In a grave condition of patients
used corticosteroids (prednisone, hydrocortisone), a short course
at a dose of 1 mg / kg body weight. When brain edema -
dehydrating (mannitol, Lasix) and anti-inflammatories,
drugs that improve cerebral circulation.
Currently, the main preventive measure is the active
immunizations (shots). Apply the following vaccines: measles vaccine
culture live dry; MMP II; Ruvaks.
Measles vaccination is carried out without a history of measles for children
12-15 months. The second vaccine is administered at the age of 6 years (before
school). Vaccination against measles in countries with a high incidence of
held at 9 and even 6 months, in order to protect infants
in whom the disease is especially hard.
The effectiveness of vaccination
With proper vaccination immunity is produced in 95%
vaccinated at the age of 12 months and at 98% of the vaccinated
aged 15 months to 21-28 days after inoculation. Immunity lasts
more than 25 years, only a very small number of vaccinated, he can
Most children vaccination is not accompanied by side
reactions. However, in some cases, in the period from 5 to 15 days after
vaccination may be marked increase in body temperature (typically not
above 39 C), catarrhal phenomena (cough, conjunctivitis, runny nose)
scant pale pink morbilliform rash (5% of children), children
prone to allergic reactions, it may be rash in the first hours after the
administration of the vaccine. Vaccination reactions usually disappear within 2-3
days. Outside of the child is not contagious, depending on the severity of the reaction to
What are the contraindications to vaccination
Strong reaction or complication to a previous dose of the vaccine.
- If the child has received blood products (immunoglobulins, plasma
the blood), the vaccination is carried out not earlier than 3 months after the
administration of blood products.
- Allergic reactions to antibiotics aminoglycoside
(Neomycin because contains about 25 micrograms per vaccine dose liquid
- The presence of allergic reactions to eggs in history. Reaction to
egg protein is a contraindication to the use of import
vaccines, since They are prepared using chicken embrinov. When
reaction to quail eggs, vaccination is better to import the vaccine.
- Any acute illness or exacerbation of chronic diseases.
- Active untreated tuberculosis.
- Patients receiving immunosuppressive (suppress the immune system)
therapy. After a drug or radiation immunosuppression vaccine
introduced not earlier than 3 months after application
high doses of corticosteroids - no earlier than one month. after
the end of treatment.
- Patients with diseases of the blood, leukemias, lymphomas of any type
or other malignancies affecting the bone marrow or
the lymphatic system.
- Primary and acquired immunodeficiency, including AIDS
or other clinical manifestations of infection with the virus
Human immunodeficiency. Infected with HIV (without the expressed
immunosuppression) vaccination is not contraindicated.
- Pregnancy due to the theoretical risk to the fetus.
Preferably, the introduction of the measles vaccine in the first 3 days of
the moment of contact with the patient, which is carried out without a history of measles and
vaccinated children older than 12 months, adolescents and adults. In children
aged 3-12 months is also possible in the form of urgent prevention
It is also possible administration of 1 or 2 doses (depending on the state
health and the time elapsed from the moment of contact) immunoglobulin
normal person. Used for children aged up to one year,
immunocompromised patients and pregnant women. This form of prevention
It is most effective when administered before the 4th day from the moment of contact.