Recent news headlines have been filled with mentions of measles outbreaks, and parents are expressing concern about their children contracting the disease.
While most people with measles recover in about 7 to 10 days, it can be uncomfortable, and there is a risk of complications in about 30% of cases.
If you're worried about your child catching measles, it's best to be aware of the disease's progression, and how you can best support your child to get through and recover from a case of measles.
What Is Measles?
Measles is caused by a virus from the paramyxovirus family. It is passed via direct contact and through airborne droplets. The virus infects the mucous membranes and then spreads through the body. It is highly contagious and can remain active in the air or on surfaces for up to two hours. Infected people are contagious from four days before the appearance of the rash until four days after the rash has erupted.
The first sign of measles is usually a high fever, which begins about 10 to 12 days after exposure to the virus, and lasts 4 to 7 days. A runny nose, a cough, red and watery eyes, and small white spots inside the cheeks can develop in the initial stage. After several days, a rash erupts, usually on the face and upper neck. Over about 3 days, the rash spreads, eventually reaching the hands and feet. The rash lasts for 5 to 6 days, and then fades. On average, the rash occurs 14 days after exposure to the virus (within a range of 7 to 18 days).
Usually when measles is first contracted, it takes about 14 – 21 days before the first symptoms appear:
- A moderate to high fever (may reach 40C)
- Runny or blocked nose
- Sneezing and cough
- Watery or swollen eyes
- Sore, red eyes which may become light sensitive
- Aches and pain
- Lethargy and tiredness
- Lack of appetite
- Tiny white spots with greyish centers on a red background inside the mouth or cheek (Koplik's spots)
The characteristic measles rash appears around 2 to 4 days after the initial symptoms. People will feel most unwell on the first few days the rash appears. It begins spreading from the head and neck downwards and is made up of small reddish brown, flat or slightly raised spots. These may join together into larger blotchy patches and can be slightly itchy. The rash fades after about a week from bottom to top.
Complications Of Measles
Complications of measles are more likely to develop in certain groups of people, such as:
- Children under the age of 5
- Adults older than 20
- Young children with poor nutritious status, particularly those deficient in vitamin A
- Children with weakened immune systems due to disease
The most common complications of measles occur in about 1 in 15 children:
- Diarrhoea and vomiting
- Middle ear infections
- Laryngitis (inflammation of the voice box)
Rarely, more severe complications can occur. These include:
- Infections of the airways and lungs (pneumonia, bronchitis or croup)
- Febrile seizures due to rapidly increasing temperature
- Inflammation of the brain (encephalitis)
- Liver infection (hepatitis)
- Nerve or muscle damage to the eye, causing a squint.
In very rare cases, measles can lead to:
- Heart problems
- Infection of the optic nerve which can lead to loss of vision
- SSPE, a central nervous system disease which occurs several years after measles infection and is fatal (occurs 1:25,000 cases)
A report from WHO Europe looking at 2011 statistics of measles shows 26,000 cases of measles with 9 deaths from severe complications, which is 1 death per 2888 cases. The World Health Organization states more than 95% of measles deaths occur in low-income countries with poor health systems. In the US, from the period of 2012 to 2013, there were 1153 cases of measles with no deaths.
What Are The Treatments For Measles?
There is no conventional treatment available to kill the measles virus once it has been contracted. If your child has been infected with measles, there are some simple measures you can take to ensure they are comfortable and to avoid complications.
- Resting as much as possible
- Darken the room to avoid light for sore eyes
- Ensure plenty of fluids are taken to avoid dehydration
- Use a humidifier for runny or congested nose
- Fever is a sign of the body working to fight infection. If your child is very uncomfortable or has a history of febrile convulsions, paracetamol or ibuprofen can be given.
Vitamin A And Measles
Vitamin A supplements have been shown in studies to help prevent complications such as pneumonia from measles infections, particularly in children with low vitamin A levels.
In a review of clinical trials, it was found two doses of vitamin A reduced mortality by over 60%.
Vitamin A is essential in the healthy functioning of your body. It supports your vision, skin, cell growth and your immune system. Vitamin A is a fat soluble nutrient, which needs to be consumed with fat to have the best absorption. There is a difference between plant and animal sources of vitamin A. Plant sources of vitamin A are carotenoids and animal sources are retinoids.
Animal sources of retinol is bioavailable, which means the body can utilise it immediately. The vitamin A from plant sources must be converted into retinol to be useful in the body. This means you need to eat a lot of the plant source to convert enough useful retinol.
Sources of bioavailable vitamin A are:
- Liver from any animal, preferably grassfed animals
- Fermented cod liver oil
- Egg yolks from free range or preferably organically raised chickens
- Butter and heavy cream from grassfed cows
In areas where children are more likely to have vitamin A deficiency, the World Health Organization and UNICEF recommend vitamin A be administered to all children diagnosed with measles. The recommended oral dose is 100,000 IU for children under 12 months of age and 200,000 IU for older children.
Complications from measles infections are rare, and in most cases, children make a full recovery if they are given careful treatment during the early stages. There are no conventional treatments available for measles, but ensuring an adequate intake of vitamin A can help prevent more serious complications.
If your child has a very high, prolonged temperature, has breathing difficulties, chest pain, is coughing up blood or confusion, seek immediate emergency assistance.