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How to save ourselves from measles


Date Posted: 11/29/2013 2:33:07 AM

Posted By: jvk  Membership Level: Silver  Total Points: 330

How to save ourselves from Measles (Morbili, Rubeola)
This is an acute and highly contagious disease that mainly affects children. Measles is a major cause of child mortality in less developed countries such as Kenya. Together with pneumonia it accounts for about a quarter of all deaths occurring in hospitals in Kenya.

Non-immunized and malnourished children under the age of three years are at high risk of contracting measles. The severity of measles is related to the viral load one gets from the source. That is, children who live in overcrowded dwellings and who are in close contact with the index case for the whole infective period obtain a high dose of the virus. Such children develop severe measles with high case fatality rates.

Mode of Transmission.

The measles virus spreads through invisible droplets secreted from the respiratory tract of an infected person. Measles spreads very easily and fast. The virus infects the skin and the layer of cells that line the lungs, gastrointestinal tract, eyes, mouth and throat. In addition, the measles virus weakens the child's immune system for many weeks after the onset of the illness, leaving the child at risk of other infections.

Clinical Features.

The clinical features of measles depends on the nutritional status of the affected child. The skin rash of measles is characteristic and is said to 'match' from one region of the body to another in a systematic way. It begins on the face and neck, then spreads to the chest and abdomen after 24 hours. On the third day, the rash spreads to the arms and lower limbs. Depending on the nutritional status of a child, measles can either be complicated or uncomplicated.

Uncomplicated measles generally occurs in well-nourished or slightly underweight children. It presents with the following signs and symptoms:
• Fever.
• Conjunctivitis.
• Rhinitis.
• Coughing.
• Koplik's spots.
• Stomatitis.
• Skin rash.
All these may

disappear after a few days with or without treatment. Complicated measles occurs in malnourished children and those who are underweight. It presents with the following signs and symptoms:
• Nasal flaring.
• Rapid respiration (pneumonia).
• Dyspnoea.
• Hoarse voice (laryngitis)
• Barking cough.
• Inspiratory stridor.
• Skin rash.
• Loss of interest to feed.
• Vomiting (this causes malnutrition)..
• Diarrhoea (gastroenteritis).
• Dryness of eyes, hazy cornea (keratitis).
• Photophobia (encephalitis).
• Convulsions.
• Ear discharge (otitis media).

The diagnosis of measles is usually based on the following signs and symptoms:
• WHO Diagnostic criteria: rash of three or more days, fever of 38°C or higher and presence of 3Cs: coryza, cough and conjunctivitis.
• Febrile xanthema in which there are red eyes and a cough.
• Typical skin rash ('matching' skin rash).
• Koplik's spots.
Uncomplicated measles is usually treated on an outpatient basis. You should advise the mother to give the child adequate fluids, a light nutritious diet, and paracetamol for pain and fever.
Give a single dose of vitamin A 200,000 IU in order to speed up recovery from measles and prevent the development of complications. Also, advise the mother to bring the child to the clinic every day for follow up. In the case of complicated measles, you should admit the child to hospital and give them a balanced diet to improve their nutritional status.
You should watch out for the following complications and treat them accordingly.
• Convulsions: give anti-convulsants.
• Gastroenteritis: give oral rehydration.
• Xerophthalmia: give vitamin A 200,000 units.
• Meningitis, pneumonia, conjunctivitis, otitis media: give broad spectrum antibiotics .
• Fever: give antipyretics and apply fever reduction measures such as tepid sponging.

Prevention and Control

The only successful method of preventing measles and its serious complications is immunization. This should be given to all children from the age of nine months; both the healthy and the sick who have not been previously immunized.

Next: How Kenyans are misusing antiretroviral drugs (ARVs).
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