Measles cases be­com­ing more com­mon

Bray People - - LIFESTYLE - DR MICHELLE COOPER’S

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.

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