Measles cases becoming more common

MEASLES is an infection that mainly affects children but can occur at any age. It is rare in the Ireland, due to immunisation. The illness is unpleasant but most children fully recover.

Measles is a highly infectious illness caused by a virus. The virus lives in the mucus of the nose and throat of infected people. Physical contact, coughing and sneezing can spread the infection. In addition, infected droplets of mucus can remain active in the environment where they have been spread and can then be passed on by touching for around two hours. This means that the virus can live outside the body - for example, on surfaces and door handles.

SYMPTOMS

Once you are infected with the virus, the virus multiples in the back of your throat and in your lungs. It then spreads throughout your body. The following are the most common symptoms of measles:

- A high temperature (fever), sore eyes (con- junctivitis) and a runny nose – these symptoms usually occur first.

- Small white spots can develop inside the mouth a day or so later. These can persist for several days. - A harsh dry cough is usual. - Going off food, tiredness and aches and pains are usual.

- Diarrhoea and/or being sick (vomiting) is common.

- A red blotchy rash normally develops about 3-4 days after the symptoms first appear. The rash usually starts on the head and neck area and thereafter usually spreads down along the body, taking 2-3 days to cover most of the body. The rash often turns a brownish colour before gradually fading over a few days.

- Children are usually quite unwell and miserable with measles for at least a 3-5 day period. After this, the fever tends to ease and the rash subsequently fades.

Most children are better within 7-10 days of developing symptoms. An irritating cough may persist for several days after other symptoms have resolved. Because the immune system makes antibodies during the infection which fight off the virus and then provide lifelong immunity, it is rare to have more than one bout of measles.

Some people mistake rashes caused by other viruses for measles. Measles is not just a rash that appears and soon dissipates. The measles virus causes an unpleasant and sometimes serious illness. The rash is just one part of this illness.

TREATMENT

There is no specific medicine that kills the measles virus. Treatment aims to ease symptoms until the body’s immune system clears the infection. For most cases, rest and simple measures to reduce the high temperature (fever) are all that are needed for a full recovery. Symptoms will usually disappear within 7-10 days.

The following measures are often useful:

- Children should drink as much as possible to prevent dehydration. Ice lollies are a useful way of providing children with extra fluid whilst also keeping them cool.

- Paracetamol or ibuprofen can be taken in order to ease fever, aches and pains. It is important to note that children should be kept cool but not cold.

- Antibiotics do not kill the measles virus and so are not normally given. They may be prescribed if a complication develops, such as a secondary bacterial ear infection or a secondary bacterial lung infection (pneumonia).

- Vitamin A supplements have been shown to help prevent serious complications arising from measles. Supplements are generally recommended for children living in a country with a high prevalence of a vitamin A deficiency. This is rare in Ireland, but common in the developing world.

Measles is very infectious. It is passed on by coughing and sneezing the virus into the air. It takes between 7 and 21 days (most commonly 10-12 days) to develop symptoms after being infected. (This is the incubation period). You are infectious and can pass it on to others from four days before to four days after the onset of the rash. Therefore, children with measles should not mix with others and should stay off school during this timeframe.

IMMUNISATION

Immunisation is routine in the Ireland as part of the measles, mumps and rubella (MMR) vaccine. Two doses are usual - the first dose is administered to children aged 12 months and the second booster dose is then administered when children are aged 4 to 5 years. Immunisation gives excellent protection and so measles is now rare in Ireland. However, unfortunately, measles is becoming more common again in children, due to some children not receiving the MMR vaccine. Measles immunisation can be given at any age and is sometimes offered to older children during outbreaks.