As autumn is upon us and winter approaches, we start to see our children being struck-down by what seems to be one illness after another. Thankfully measles is fairly uncommon due to the uptake of the Measles, Mumps and Rubella (MMR) vaccine, however there has been a recent increase in cases of measles as a result of children not being vaccinated following the controversy around the vaccine and the speculation about a possible link between autism and the MMR.
Although measles is uncommon, we have seen some outbreaks such as the 2013 outbreak in Swansea whereby more than 1200 cases were reported. The MMR vaccine has been one of the most successful public health initiatives and it is estimated to have prevented 20.3 million deaths between 2000-2015, reducing deaths from measles by 79% (WHO 2017).
What is Measles?
Measles is a highly infectious viral illness that, as well as being thoroughly unpleasant, can also have serious complications. The virus is airborne and is spread in water droplets from coughing, sneezing, close personal contact or through direct contact with nasal or throat secretions. It is reported that 1 in 5000 cases in children will result in death but most people who get measles will make a full recovery after 7-10 days of symptoms. Respiratory symptoms are the main cause of death in babies and nervous system complications are the main cause of death in older children (Tinsey 2017; NICE 2013).
Prevention of Measles
Measles can be prevented by having the MMR vaccine. It is given in 2 doses as part of the NHS childhood immunisation programme. The first dose is given at around 13 months of age and the second dose is given around 3.5 yrs of age before the child starts school. The vaccine can be offered at any age if a person has not started or completed the full MMR immunisation course.
Symptoms of Measles.
Symptoms of measles tend to develop around 10 days after exposure to the measles virus and these include:
*A fever as high as 40 degrees C (104f).
*cold like symptoms such as a runny nose, cough and sneezing.
*Sore red eyes that maybe sensitive to light.
*Small greyish white spots on the insides of the cheeks known as Koplik’s spots.
From 2-4 days after the initial symptoms are seen, a brown, blotchy rash appears that usually starts at the head and neck before spreading down through he trunk of the body and the extremities. The rash consists of flat, red lesions and raised lesions and usually start to fade within 5 days. If you suspect your child has measles it is really important to report it to your GP. Measles is a notifiable disease so the GP will need to confirm the diagnosis and report it to the Public Health Department.
How to Treat Measles.
NICE 2013 and Public Health England 2014 advise parents to try the following home remedies to relieve the symptoms:
*Paracetamol or ibuprofen to relieve fever, aches and pains
*Plenty of oral fluids to avoid dehydration
*Close the curtains to help reduce light sensitivity
*Apply damp cotton wool to clean the eyes.
When to Attend A&E.
Parents should be advised to attend A&E or call an ambulance if their child develops any of the following symptoms (NICE 2013):
*Shortness of breath
*Pleuritic chest pain, characterised by sharp chest pain, particularly when taking a deep breath.
*coughing up blood
*Febrile convulsions or seizures
*lethargy or confusion.
Complications of Measles
For the majority of people with measles, symptoms will pass without complications in 7-10 days however the disease can lead to serious and life threatening complications which are usually respiratory or neurological in nature.
The MMR Vaccine and Autism.
In 1998, a study was published alleging a link between the MMR vaccine and the development of autism spectrum disorder (ASD). The research has since been discredited and two major studies have been published that fail to show any links between the MMR and ASD. The most recent study in 2008 showed that there was no association between the measles vaccination and ASD