Measles is a highly infectious viral disease which is endemic in developing countries like Nigeria with a peak of transmission from October to March. In this report by Vera Onana, mothers, aside from celebrating the independence, would get all information required to protect their children from this viral disease this October and beyond. Characterised by fever, skin rashes, cough, weight loss and several other symptoms, measles, which is caused by the measles virus is a an acute and highly contagious viral disease associated with high mortality mainly from complications like pneumonia, diarrhoea and malnutrition, experts say.
It is a major cause of vaccine preventable deaths globally despite the availability of a safe and effective vaccine. According to the AFRO Measles Surveillance Guidelines, more than 30 million people are affected by the disease each year, mostly in developing countries, particularly Africa and Asia.
According to researchers, this viral disease control still remains a challenge in sub-Saharan Africa and though the measles vaccine is administered at 9 months under the Nigeria’s Expanded Programme on Immunization (EPI) (PAN Advisory Committee on Immunization, 2012), Nigeria is still one of the 47 priority countries in the world where the burden of the disease is highest with outbreaks of this viral disease still being reported in various states.
Based on statistics, by 2011, 1.7 million Nigerian children had not received the first dose of the MCV and there were 18,843 cases of measles reported. Also, with another outbreak in 2013, where 29,000 cases of this viral disease were reported in some states in northern Nigeria, a nationwide emergency mass vaccination campaign was conducted targeting children between the ages of 9 and 59 months (Measles and Rubella Initiative, 2013).
Sadly, experts claim that measles control is yet to be achieved in Nigeria despite global efforts geared towards this viral disease elimination.
A study aimed at determining the prevalence and describing the pattern of childhoodmeasles among children presenting to the Niger Delta University Teaching Hospital (NDUTH), Okolobri, Bayelsa State, conducted by Chika Duru of the Department of Paediatrics and Child Health, Niger Delta University, Teaching Hospital, Okolobri and colleagues in 2013 advocated for a revision of the administration of the measles vaccine in the Nigerian EPI to an early 2 dose schedule in infancy. The study also recommended that governments’ commitment to improving vaccine potency and availability should be made a priority to ensure increased vaccine coverage and prevent missed opportunities.
Duru and colleagues also admonished that health education of mothers as well as training and retraining of the health workers on childhoodmeasles should be emphasized at all levels.
Based on these recommendations, this report seeks to enlighten mothers on the viral disease that could be fatal.
Signs and Symptoms
Whilemeasles is probably best known for its full-body rash, the first symptoms of the infection are usually a hacking cough, runny nose, high fever, and red eyes. Children who get the disease also may have Koplik’s spots, small red spots with blue-white centers that appear inside the mouth.
Themeasles rash breaks out 3-5 days after symptoms start, and can coincide with high fevers up to 40°C. The red or reddish-brown rash usually first shows up as flat red spots on the forehead, it then spreads to the rest of the face, then down the neck and torso to the arms, legs and feet. The fever and rash gradually go away after a few days.
Contagiousness
Measles is highly contagious. 90 percent of people who haven’t been vaccinated for measles will get it if they are near an infected person. Measles spreads when people breathe in or have direct contact with virus-infected fluid, such as the droplets sprayed into the air when someone with measles sneezes or coughs. A person who is exposed to the virus might not show symptoms until 8-10 days later.
People with measles are contagious. This means that they can spread the disease from four days before the rash appears until about four days after it does, and are most contagious while they have a fever, runny nose, and cough. It is important that mothers isolate children with measles quickly so as to protect their siblings in a home, experts’ advice.
Prevention
According to experts, “the most important thing you can do to protect your kids from measles is to have them vaccinated according to the immunization schedule as prescribed by your doctor.”
Older kids are usually immunized against measles according to state and school health regulations. For most, measles protection is part of the measles-mumps-rubella vaccine (MMR) or measles-mumps-rubella-varicella vaccine (MMRV) given when they are 12 to 15 months old and again when they are 4 to 6 years old.
Infants are generally protected from measles for 6 months after birth due to immunity passed on by their mothers. Measles vaccine usually is not given to infants younger than 12 months old. The measles vaccine sometimes causes side effects in kids who don’t have underlying health problems. The most common reactions are fever 6-12 days after vaccination (in about 15 per cent of kids vaccinated) and a measles-like rash, which isn’t contagious and fades on its own (in about 5 per cent of vaccinated kids).
The measles vaccine should not be given to these at-risk groups:
- Pregnant women
- Kids with untreated tuberculosis, leukemia, or other cancers
- People whose immune systems are weakened for any reason
- Kids who have a history of severe allergic reaction to gelatin or to the antibiotic neomycin, as they could have serious reactions to the vaccine
Since certain people cannot receive the measles vaccine for health reasons, it’s all the more important to make sure that children who can get the vaccine get it on schedule, paediatricians advice. At-risk children depend on “herd immunity.” This means a high percentage of people have been immunised against a disease, which prevents the disease from spreading in a population and helps prevent outbreaks.
Treatment
There is no specific medical treatment formeasles. To help manage symptoms, which usually last for about 2 weeks, give your child plenty of fluids and encourage extra rest. If a fever is making your child uncomfortable, you can give a non-aspirin fever medicine, such as acetaminophen or ibuprofen.
Remember, you should never give aspirin to a child who has a viral illness, as its use in such cases has been associated with the development of Reye syndrome.
Kids with measles should have their condition closely monitored by a doctor. In some cases, measles can lead to other complications, such as otitis media, croup, diarrhea, pneumonia, and encephalitis, which may require antibiotics or hospitalisation.
In developing countries, vitamin A has been found to decrease complications and death associated with measles infections. Also, all kids over 6 months old with certain risk factors — such as vitamin A deficiency, a weakened immune system, or malnutrition — might benefit from vitamin A supplementation.
Children with this viral disease should be quarantined for 4 days after their rash appears. If they have a weakened immune system, they should stay in isolation until they make a full recovery and all symptoms are gone.
When to call the doctor
Call the doctor immediately if you suspect that your child has measles. Also, it’s important to get medical care after measles exposure, especially if your child:
- Is an infant
- Is taking medicines that suppress the immune system
- has tuberculosis, cancer, or a disease that affects the immune system
Most important: remember thatmeasles, a once common disease, is preventable through routine childhood immunization.
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