Who can get measles

measles

Brief overview

  • What is measles? Highly contagious viral infection that is spread around the world. It is one of the "childhood diseases", although adolescents and adults are also increasingly suffering from it.
  • Infection: Droplet infection, direct contact with infectious nasal or throat secretions from patients (e.g. through sharing cutlery)
  • Symptoms: In the first stage, flu-like symptoms, a first bout of fever and whitish spots on the oral mucosa (Koplik spots). In the second stage, the typical measles rash (red patches flowing into one another, starting from the ears) and a second bout of fever.
  • Treatment: Bed rest, rest, possibly anti-fever measures (such as anti-fever medication, calf compresses), cough suppressants, antibiotics (if there is an additional bacterial infection)
  • possible complications: e.g. otitis media, pneumonia, bronchitis, diarrhea, pseudo croup (croup syndrome), brain inflammation (encephalitis); Long-term consequences: chronic encephalitis (subacute sclerosing panencephalitis, SSPE)
  • Forecast: Measles usually heal without any problems. Complications occur in 10 to 20 percent of patients in this country. About one in 1,000 people can die.

Measles: contagion

On the one hand, the measles virus is transmitted through Droplet infection: Infected people distribute tiny droplets of saliva containing viruses into the surrounding air when they speak, cough and sneeze. Other people can breathe these in: As soon as the viruses in the droplets of saliva come into contact with the mucous membranes in the respiratory tract, they can infect the new "victim". By the way: measles viruses can survive in the air for up to two hours!

On the other hand, measles can also be dealt with through the direct contact with infectious secretions from the nose and throat of infected people. This happens, for example, when you use a patient's cutlery or drinking glass.

Measles viruses are extremely contagious! Of 100 people who have not yet had measles and have not been vaccinated against it, 95 fall ill after coming into contact with the measles virus.

How long are measles patients contagious?

Anyone who has been infected with measles is contagious three to five days before the typical measles rash occurs and up to four days afterwards. Infectiousness is greatest just before the rash breaks out.

Measles: incubation period

The time between infection with a pathogen and the appearance of the first symptoms is called the incubation period. It is usually eight to ten days for measles. The typical measles rash (second stage of the disease) usually appears two weeks after infection.

To vaccinate or not? The fact check

  • Vaccination discussion: the long-running hit

    In Germany it is a long-running issue - the discussion about the benefits and risks of vaccinations. Few health issues are fought out with such passion as those seconds piks, which are supposed to arm the immune system against the attack of potentially life-threatening viruses in the long run. But what is really true of the arguments against the vaccine - and what speaks in favor of the immune booster from the laboratory? We have put together the most important points.
  • Better Immune System?

    Unvaccinated children have a better trained immune system, say those who oppose the vaccination. In doing so, they forget that the vaccines give the immune cells in the body the same alarm signals as pathogenic viruses. But they are not infectious. Since the vaccine serums are also highly specific, the immune system of vaccinated children comes into contact with thousands of other pathogens every day, against which they have to defend themselves.
  • It used to work without it!

    "Lucky", one could say. Infections with so-called childhood diseases do not always end well. Lung infections or inflammation of the brain and meninges are common complications of measles. And: Young men can become sterile from mumps, for example. Incidentally, unvaccinated adults are one Particular danger for children: So-called vaccine picking is often to blame for the fact that epidemics can suddenly spread again.
  • Avoidable Risk?

    In fact, vaccinations also put stress on the very young organism of infants. But some infections - for example measles, whooping cough or Haemophilus influenzae - pose a particularly high risk for them. Early protection can save lives. Incidentally, there is no evidence that infants tolerate vaccinations less well than older children.
  • Vaccinations make you sick

    Many vaccines consist of weakened (e.g. measles vaccine) or killed viruses. In this way, the immune system is stimulated - the defense reaction often manifests itself in more or less pronounced symptoms of the disease. However, it is extremely rare for vaccines to actually make you sick with modern preparations.
  • More allergies?

    Some studies even seem to support the fact that vaccinations promote the development of allergies. However, it is difficult to prove an actual connection because many parents of those who oppose the vaccination also keep other potentially allergenic factors away from their children by taking a more critical stance, for example on nutritional issues. On the other hand: In the former GDR, where vaccination was compulsory, particularly few children suffered from allergies.
  • Hazardous additives

    To make them more durable or to make them more effective, some vaccine serums actually contain formaldehyde, aluminum, mercury or other potentially toxic substances. However, in extremely low concentrations and below defined toxic limit values. Nonetheless, the industry has responded to the discussion and has now developed mercury-free vaccines.
  • Antibiotics instead of vaccinations?

    Many diseases are easier to treat with modern drugs than they were 30 or 40 years ago. However, antibiotics are not effective against viruses - in measles and the like, they can only fight those bacteria that, as so-called opportunists, exploit the weakness of the immune system and cause complications. And with some bacteria, such as those responsible for tetanus meningitis or whooping cough, antibiotics have hardly any effect.
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    Editor-in-chief and human medicine

Measles: symptoms

Measles has two stages of the disease with two attacks of fever and other symptoms:

Precursor stage (prodromal stage)

The illness begins with a moderate fever, runny nose, sore throat, and dry cough. The face is puffy. Fatigue, headache and abdominal pain, constipation or diarrhea, and conjunctivitis with photophobia are also possible symptoms. Typical measles in the early stages are the so-called Koplik spots on the oral mucosa: These are circumscribed, small, red spots with a white center ("lime splatter spots"). From the 2nd or 3rd day of the disease, they develop primarily on the cheek mucosa in the area of ​​the molars. From the 3rd day on, the entire mucous membrane of the mouth and throat becomes red. In addition, the fever rises sharply.

The precursor stage lasts for about three to four days. Towards the end the fever initially drops again.

Main stage (exanthema stage)

In this phase of the illness, the fever rises sharply again. The typical measles rash develops: irregular, three to six millimeters in size, initially light red spots that flow into one another. They form behind the ears first and then spread all over the body. Only the palms and soles of the feet are left out. Within days, the spots turn darker, brownish-purple.

After four to seven days, the mase spots fade again in the same order in which they appeared (starting from the ears). This fading is often associated with flaking. At the same time, the other complaints also subside.

It takes about two weeks for the patient to recover. The immune system is weakened even longer: for around six weeks, there is an increased susceptibility to other infections.

Mitigated measles

In newborns who still carry measles antibodies from the mother, a measles infection is usually weakened. Such "mitigated measles" can sometimes also be observed in other people. This includes, for example, patients who have not received the full measles vaccination and therefore have weak, incomplete vaccination protection. In mitigated measles, the typical rash is not fully developed. This can make diagnosis difficult. Yet those affected are contagious.

Measles: complications

Occasionally, measles infection has complications. Due to the weak immune system that lasts for several weeks, other pathogens such as bacteria have an easy time of it. It is most commonly associated with measles Otitis media (Otitis media), bronchitis, lung infection (Pneumonia) and Diarrheal diseases.

Severe inflammation of the larynx lining is also possible. Doctors also speak of Croup syndrome or pseudo croup. Those affected have attacks of dry, barking coughs and difficulty breathing (or even shortness of breath), especially at night.

Are rare foudroyant (toxic) measles: The affected patients get a high fever and bleeding from the skin and mucous membranes. The mortality rate from this measles complication is high!

Another rare but dreaded complication is one Encephalitis (Encephalitis). It manifests itself around four to seven days after the onset of the measles rash with headache, fever and impaired consciousness (up to a coma). Around 10 to 20 percent of patients die. In another 20 to 30 percent, measles-related encephalitis causes permanent damage to the central nervous system.

Very rarely, on average, six to eight years after the measles infection, a fatal late complication occurs - a chronic inflammation of the brain known as subacute sclerosing panencephalitis (SSPE) What is called: Measles viruses that have penetrated the brain multiply, causing irreversible nerve damage. First of all, changes in behavior become apparent. In the further course, neurological disorders such as muscle twitching and seizures as well as nerve failures also occur. In the final stage, all brain functions fail - the patient dies.

Four to eleven out of 100,000 measles patients will get an SSPE. Children under the age of five are particularly susceptible to this fatal sequela of measles. In this age group, there are an estimated 20 to 60 SSPE cases per 100,000 measles patients.

In people whose immune system is suppressed by medication or another disease (immunosuppression) or has a congenital defect, the measles can be very weak externally. The measles rash may be absent or look atypical. However, there is Risk of serious organ complications. This includes a progressive form of pneumonia (Giant cell pneumonia). Sometimes a special type of encephalitis also develops (Measles Inclusion Body Encephalitis, MIBE): It leads to death in about three out of ten patients.

Measles weaken the immune system for years
Measles in itself is no trivial matter. Even more: they apparently weaken the immune system for years - sometimes with fatal consequences. From Christiane Fux

Measles: causes and risk factors

Measles is caused by the highly contagious measles virus. The pathogen belongs to the paromyxovirus family and is distributed worldwide.

The disease is of particular importance in developing countries in Africa and Asia: measles are among the ten most common infectious diseases and are often fatal.

In Germany, the number of measles has fallen since the measles vaccination was introduced. For some years now, it has mostly been less than 2,000 cases per year. However, there are always regional or nationwide measles outbreaks for a limited time. In addition, it has been observed for some years that more and more adolescents and (young) adults are suffering from "childhood disease".

Measles: examinations and diagnosis

The symptoms of the disease, especially the rash, give the doctor important clues about measles. However, there are some medical conditions with similar symptoms, namely rubella, rubella, and scarlet fever. In order to avoid confusion, a laboratory test must therefore confirm the suspicion of measles. Various tests can be used, with the detection of antibodies against measles virus being the most common:

  • Detection of specific antibodies against the measles virus: fastest and safest diagnostic method. The patient's blood is used as sample material (if brain inflammation is suspected, nerve water = liquor). The test is usually positive as soon as the typical measles rash shows up. Sometimes the antibodies cannot be detected beforehand.
  • Detection of the viral genome (measles virus RNA): For this purpose, a urine sample, saliva sample, tooth pocket fluid or a throat swab is taken. The viral traces of genetic material found in it are reproduced by means of the polymerase chain reaction (PCR) and can thus be clearly identified.
  • Growing measles virus: For this purpose, sample material (urine sample, saliva sample, etc.) is exposed to optimal growth conditions in order to cultivate the pathogens it contains. This is how they can be identified. This procedure is very time-consuming and is only used in special cases (for example in patients with a suppressed immune system).

Measles are notifiable!

Measles is one of the notifiable diseases. As soon as the first symptoms indicate measles, the doctor should be consulted. The doctor must report the suspicion, the actual illness and also the death from measles to the responsible health department (with the name of the patient).

If measles is suspected or has a proven infection, those affected must stay away from community facilities (schools, day-care centers, etc.). This also applies to employees of such facilities. Patients may be admitted again at the earliest five days after the measles rash broke out.

Read more about the examinations

Find out here which examinations can be useful for this disease:

Measles: treatment

There is no specific therapy for measles. But they can alleviate the symptoms and support the healing process. This includes bed rest in the acute phase of the disease and physical conservation. If the patient's eyes are sensitive to light, the hospital room should do something darkened - direct incidence of light on the patient should be avoided. Also make sure the space well ventilated and is not stuffy.

Experts recommend measles patients enough to drink - especially with fever and sweating. Instead of a few large servings should be spread over the day several small meals to be consumed.

Help against the fever, for example Calf wrap and if necessary antipyretic drugs. However, you should first discuss the use of the medication with a doctor. The same is true if one Cough suppressants (Cough remover or cough blocker) would like to use.

The fever and pain reliever acetylsalicylic acid (ASA) is not suitable for children. In connection with febrile infections, the rare but life-threatening Reye's syndrome can otherwise develop!

If there is an additional infection with bacteria (for example in the form of otitis media or pneumonia), the doctor usually prescribes Antibiotics.

If the measles cause croup syndrome or encephalitis, is one Treatment in hospital necessary!

Measles: disease course and prognosis

Measles heals easily in most patients. However, complications occur in 10 to 20 percent of cases. Children under the age of five and adults over the age of 20 are particularly affected. Such measles complications can also be fatal under certain circumstances. This is especially true for brain inflammation that develops either shortly after the infection or as late complications years afterwards.

According to the World Health Organization (WHO), the total death rate from measles in developed countries such as Germany is up to 0.1 percent (1 death per 1,000 measles patients). It can be significantly higher in developing countries, for example due to malnutrition.

Measles is not a harmless childhood disease - it can even be fatal. The example of Berlin shows how common serious complications are. From Varinka Voigt

Lifelong immunity

You can only get measles once in your life: Anyone who has survived an infection is protected from being infected again with measles virus for life. In the event of an infection, the immune system produces specific antibodies against the pathogen. Some of it remains in the body even after healing. If there is later contact with the measles virus, the antibodies are activated immediately and eliminate the intruder.

Pregnant women who have antibodies against measles also transmit them to the unborn child via the umbilical cord. The maternal antibodies remain in the child's body for a few months after birth and thus prevent infection. This so-called nest protection lasts until about six months of age.

Measles vaccination

A measles disease can cause permanent damage to the nervous system and even lead to death - in 2018 around 140,000 people worldwide died of measles, most of them children under the age of five. This is why the measles vaccination is so important:

It is generally recommended for all infants and toddlers: You should be vaccinated against measles twice within the first two years of life. If the offspring is to attend a community facility such as a daycare center, the measles vaccination has even been mandatory since March 1, 2020 (unless the measles disease they have experienced can be proven with a medical certificate).

The measles vaccination is either recommended or even prescribed for other groups of people. You can read more about this as well as about the implementation and possible side effects of the vaccination in the article Measles vaccination.

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