Measles

Introduction

Measles - also known as morbilli - is a typical childhood disease, but it can also occur in adults and can sometimes lead to extremely serious complications. The infectious disease is caused by viruses and is highly contagious. Typical symptoms of measles are fever, a pronounced feeling of illness and a skin rash that affects large parts of the body. High fever occurs twice during the course of the infection. Complications such as middle ear and lung infections are relatively common. The incubation period - the time between infection and the onset of the disease - usually lasts eight to ten days. Once you have contracted measles, you remain immune for the rest of your life and are protected against further measles infections. There is a vaccination that is recommended in the Swiss immunisation schedule.

Symptoms

Measles usually progresses in two stages - the so-called precursor stage and the main stage. In the precursor stage, flu-like symptoms such as fever (up to 40 °C), fatigue, tiredness, headache and abdominal pain or conjunctivitis occur. A dry cough, runny nose, sore throat or whitish-greyish patches on the oral mucosa can also occur in this phase. This stage lasts three to seven days. Subsequently, the body temperature briefly drops to a normal level.

After this fever-free interval, the second phase begins - the rash stage. Here the body temperature rises again to over 39 °C. In addition, the skin rash typical of measles appears. This usually starts behind the ears and spreads over the face, upper body and extremities. The rash turns brownish in colour as the disease progresses. This phase lasts six to seven days. After this, the fever subsides, and the rash and the other symptoms slowly subside, although the cough may persist for another 1-2 weeks. If measles is suspected, a doctor should be contacted.

Course of the disease

The course of measles can vary greatly and depends on how the person's immune system reacts to the infection. The incubation period - the time between infection and the onset of the disease - lasts eight to ten days.

A measles infection can lead to serious complications, either caused by the virus itself or by a bacterial infection. Complications caused by the measles virus can include, for example, middle ear infection or pneumonia. A dreaded complication is encephalitis caused by measles viruses. It causes impaired consciousness, convulsions, epileptic seizures or paralysis. In the majority of cases, meningitis heals completely. However, it can also be fatal and around a third of patients may suffer permanent brain damage. A very rare complication - it affects up to 170 per 100,000 measles patients and only occurs six to eight years after infection - is subacute sclerosing panencephalitis (SSPE). It cannot be cured and is fatal. Infants who contract measles in the first year of life are at the highest risk of SSPE.

Children generally contract measles more frequently than adults. However, when adults are affected by measles, they suffer complications more frequently than children.

Causes

The cause of measles is an infection with the measles virus. The virus is transmitted by droplet infection, for example through coughing, sneezing or talking. The virus enters the body via the mucous membranes of the respiratory tract and the conjunctiva of the eye.

Measles is highly contagious. Even brief contact with an infected person is enough to become infected. The greatest risk of infection is around four days before and four days after the rash appears.

Diagnosis

Treatment

Measles cannot be treated with actual therapy. Basically, only the symptoms are treated, for example, the fever can be reduced with medication if necessary. Sick people can react sensitively to light - it is then advisable to darken the rooms. Severe cases may require intensive care and may also need to be ventilated in some cases of severe pneumonia.

Prevention

There is a vaccination that prevents measles and can prevent complications, which can sometimes be very serious or even fatal. The Swiss immunisation schedule stipulates that children should be vaccinated against measles (first dose at 9 months, second dose at 12 months). This is the so-called MMR vaccination, which provides lifelong protection against measles, mumps and rubella.

As this is a live vaccination with attenuated viruses, it must not be used in infants under 6 months of age, during pregnancy, in people with immunodeficiency or immunosuppressive therapy or in people who have a severe allergy to the ingredients of the vaccination.