December 19, 2012
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The first descriptions of measles have appeared in ancient times. The disease is widespread in the world today, however, it usually affects children. Previously named as measles German measles , But now such a designation is not used, not to be confused with the disease Rubella . Most seriously, the disease occurs in immunocompromised children. Therefore, to date in developing countries, measles is often the cause of child deaths.
Spreading
Measles is a very contagious disease: As the findings of physicians, the susceptibility to the virus close to 100%. Typically, the armature is diagnosed in children aged from 2 to 5 years. Much rarer disease affects adults who are not ill with measles in childhood. In newborn infants, there are so-called colostral immunity That the child goes to mothers who previously had been ill with measles. Such immunity protects the baby's first three months. After the man had been ill with measles, he formed a strong immunity, and the disease does not develop again. However, such cases are still documented in the photos and described by experts.
As a rule, children are ill with measles in the winter and spring, and every 2-4 years an increase in the number of cases. Today, in countries where mass vaccination, measles in adults and children is rare, or takes place a mini-epidemic disease.
The disease is an RNA virus of the family paramyxoviruses . Outside the human body, he quickly dies due to the impact of various external factors. Measles is transmitted between humans by airborne droplets. Sick people shed virus with mucus when sneezing, coughing.
Thus, the source of infection - a person with measles. Contagious to other people, he is on the last two days of the incubation period before the fourth day of illness with rash. Starting from the fifth day of the rash, the patient is already considered non-contagious.
The infection enters the body through the mucous membranes of the upper respiratory tract and sometimes the gates are the conjunctiva. During the incubation period, the body still has a relatively small number of viruses, so they can be neutralized by introducing measles immunoglobulin . Such preventive measure practiced by those who are in contact with patients with measles to 5 days of illness.
In humans, the virus affects mainly the upper respiratory tract, conjunctiva, also suffers slightly gastrointestinal tract.
Symptoms of measles
Home catarrhal period, the patient is always going badly. The patient complains of a manifestation of general malaise, severe headache. He is disturbed sleep and decreased appetite. The body temperature increases, and, in severe measles it can reach 40 ° C.
In adult patients with intoxication it appears much more pronounced than in children. Already in the first days of illness in humans indicated a strong rhinitis with mucous secretions, which are sometimes transformed into mucopurulent. A child or an adult concerned about a constant dry cough. In children, it becomes rough, and the observed hoarseness , Stenotic breathing. In addition, the child's symptoms are concerned eyelid edema, conjunctivitis, and oozing pus. Sometimes, as a result of this phenomenon in the morning the baby wakes up with cobbled together centuries. The patient was very annoying glare.
Examining sick child, doctors determine the presence of facial puffiness, graininess in the back of the throat, hyperemia of the mucous membrane of the oropharynx. At the same time, in adult patients symptoms such measles faintly expressed, but they observed lymphadenopathy present dry rales in the lungs and breathing hard. Sometimes there is also a short time mushy stools.
After 3-5 days, the patient's state of health is getting a little better, fever decreases. But after a day of intoxication and catarrhal syndrome again intensified, and rates of body temperature rise again significantly. It was at this time, you can find a cardinal clinical sign of measles - appearance Koplik spots Filatova-Belsky, mucosal cheek near the small molars. Sometimes these spots also appear on the mucous membrane of the gums and lips. This white spots, projecting a little while surrounded by a thin rim of hyperemia. A little before or simultaneously with these spots on the mucosa of the sky arises enanthema measles. This red spots with irregular shape. Their size is approximately equal to the head of a pin. After a few days they merge with a total surface of congested mucous.
Children catarrhal period duration is 3-5 days in adults it can be up to 8 days.
After completion of the catarrhal period, it is replaced during eruptions. At this time, the patient's body appears bright rash maculopapular, which gradually merges. Between the spots there are areas of healthy skin. On the first day of the period observed a rash behind the ears, under the hair on his head. Later in the day, it covers the face, neck and upper chest. On the second day the rash moves to the upper arm and torso. On the third day a person starts to be cleaned, but the rash appears on the feet and hands of the distal parts.
In the process of diagnosis of the disease is descending sequence of eruption is considered the most significant sign to differentiate measles. More abundant rash typical for adult patients, and if the disease is very difficult, it can manifest hemorrhagic elements.
In the second period of measles catarrhal phenomena become more intense: there is a strong cough and runny nose, constant watering, photophobia. Fever and pronounced intoxication. If the patient examined during this period, he has found the symptoms tracheobronchitis As well as moderate hypotension and tachycardia .
There are also other variants of measles, if there is an atypical form of the disease. At mitigirovannaoy measles Which manifests itself in people who received active or passive immunization against the disease, or have previously suffered from it, the incubation period is longer. Current lung disease, intoxication expressed little catarrhal period shortened. There are also no-Koplik spots Filatova-Belsky. The rash can be ascending or occur throughout the body simultaneously.
Another atypical form of measles - abortive measles . Its top is the same as in the typical form of the disease. But after 1-2 days after it was suspended. The rash is noted only on the face and body, the temperature increased only on the day the rash appears.
There are also types of measles subclinical, but they can be diagnosed only during serology of paired sera.
Complications of measles
The most common complications of measles pneumonia occurs. Children may also manifest itself false croup Sometimes stomatitis . In adults between pigmentation can develop meningitis . meningoencephalitis and polyneuritis . The most serious complication - measles encephalopathy m, but it happens very rarely.
Diagnosis of measles
When measles diagnosis is based on the presence of characteristic symptoms described above. One of the determining factors in the process of diagnosis is the presence of recent contact with a sick person who is diagnosed measles.
In the process of diagnosis is a general analysis of the blood in which is determined in the case of measles lymphopenia and neutropenia . Produced as a secret laboratory study of smears taken from the respiratory tract. When the diagnosis is also important to determine the titer of antibodies produced by the measles virus.
It should be differentiated from disease scarlet fever . Rubella . pseudotuberculosis . dermatitis and other diseases which are characterized by a skin rash.
Treatment of measles
A sick child or adult should be isolated, it is recommended to comply with bed rest. The room should be aired as often as possible, as it is important every day prodelyvat wet cleaning. The patient should drink plenty of fluids, a special diet is not required. What is important is a careful eye care and oral. For the comfort of the patient to protect him from the glare.
Practiced symptomatic treatment of measles: used antitussives, vasoconstrictive nose drops, paracetamol at high temperature. Appointed as antihistamine drugs. In the eyes buried a 20% solution sodium sulfatsil .
If the patient has an uncomplicated form of the disease, it is most often treated at home. In a hospital stay, patients who observed severe measles and complications of the disease. Also, patients are hospitalized for epidemiological indications.
If diagnosed with measles encephalitis, patients received high doses prednisolone and antibacterial medications.
Prevention of measles
As a preventive vaccination of children is carried out. Special vaccine Which protects against measles, it was produced in 1966. Vaccination against measles is for children aged 1 year and 6 years old. To ensure active immunization, live measles vaccine is used. Today is actively used as a complex vaccine that prevents not only measles but parotitis , and rubella . Vaccination with a live vaccine against measles carried children still do not recover from measles, from the age of 12-15 months. Re-vaccination is similar to before the child is given to the school. The response to the vaccine, most children are not marked.
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