Measles
Measles is a highly infectious viral disease. At its onset in a child this disease looks like a severe attack of common cold. The child develops high fever, running of a nose, a dry hacking cough and red watery eyes. A rash appears on the fourth day of illness and along with the temperature rises sharply to as high as 40c. Tiny pinkish spots of rash appear behind the ears, on the forehead, face and neck. Within the next three days the rash spreads over the entire body and becomes more pronounced, giving the skin blotchy look. After about three days of the onset of the rash, those over the face starts fading.
The fading progresses downwards, leaving a brownish discoloration. The child temperature starts dropping the fifth day of his illness and usually touches normal by seventh or eighth day. Throughout this period, the child is very ill, irritable and restless. He also suffers from lack of appetite and an annoying hacking cough. But within a day or two after his fever has gone he shows a sudden improvement and starts feeling better.
Myths about Measles
Measles is probably the most misunderstood illness in India, even among the educated. Some of these beliefs are positively harmful. For instance, measles is believed to be the manifestation of a goddess called mata or mariama in different parts of the country. The faithful believe that any medical interference with the child during the course of this illness is a sin against the deity and harmful to the child.
As such, many seriously ill patients with measles, especially in the rural areas of India, are denied medical assistance. Many educated parents also believe that the administration of allopathic medicine causes undesirable suppression of the rash in measles. The lack of measles rash is wrongly rash in measles. The lack of measles rash is wrongly presumed to be highly injurious to the child. Some even recommend magic potions to bring out the rash. It is hence extremely important that parents should understand the true nature of this condition.
The Facts
Measles is a self-limiting viral disease and it passes off without causing serious harm in most healthy children. Many serious complications can, however, develop during the course of the disease, particularly in malnourished children. If not handled promptly, these complications can lead to several permanent disabilities in the affected child or may even be fatal. An attack of measles, however, provides lifelong protection and a second attack of this disease hardly ever occurs. There are several viral infections which cause a rash in children, with or without much fever and they are wrongly labeled by parents as second or third attack of measles.
What to Do?
A child with measles requires total attention and care till he fully recovers. The sick child should rest in bed. His room should be comfortably warm, but not cool. While he should be protected from the strong light because of discomfort to his eyes, his room must not be made dark. Bathing his eyes with lukewarm water with moistened cotton thrice daily will provide some relief to his sore eyes. The child should brush his teeth and have regular mouth washes. His body should be kept clean and his clothes and bed lines changed daily.
Covering him with heavy warm clothes should be avoided. Although the child does not feel hungry make sure he takes sufficient fluids by providing him small frequent drinks. A light, bland diet may be supplemented with home made desserts like kheer, custard sweets, ice cream and other palatable preparations. His fever, body aches and general discomfort should be eased by giving him paracetamol and sedatives as advised. Some children may occasionally need tepid water sponging water to lower their fever. Steam inhalation given for 10-15 minutes each, three to four times a day will provide relief to his voice and cough.
Ordinarily a child with measles does not require any antibiotics. It may become however necessary to use them judiciously, if the child develop pneumonia, middle ear infection or some other infection elsewhere in the body.
When Should You Consult the Doctor Again?
The progress of a child must be watched very closely and if any one of the following features are noticed a doctor must be consulted without delay:
1. Usually the child’s temperature comes down after three to fourth day after the first appearance of rash. If the child develops fever again after having it’s settled down or the fever continuous beyond the eight day of the beginning of disease, a doctor must be consulted. He may have developed pneumonia or secondary bacterial infection elsewhere. The child may then need antibiotics as an essential part of his treatment.
2. Unduly fast breathing or labored breathing, combined with in drawing chest will suggest that the child may have developed pneumonia or some other respiratory tract complications. This must be attended to promptly.
3. A child may develop severe diarrhea complication measles. Do not delay treatment as it can be life threatening. The child may need intravenous fluids and other drugs for the control of diarrhea.
4. Consult the doctor if the child complains of pain in the ear or he develops an ear discharge. These symptoms suggest middle ear infection and perforation of the ear drum. He will then need prompt treatment with antibiotics.
5. Very rarely a child develops swelling of brain following an attack of measles. This complication generally develops towards end of the original attack of measles. The child may develop fever again, become drowsy and start having fits. He would need hospitalization, start having investigations and intensive treatment.
How to Prevent the Spread of Measles?
Isolating a child with measles is of no practical benefit in preventing its spread to other children in family. This is because a child with measles is most infective and passes his infection to others much before he himself develops the rash and his own disease gets recognized. Special protection is needed for another child in the family who is suffering from a long standing illness is on poor health and who has not had the measles vaccine or suffered from measles. Such a child needs to be protected by giving him an intramuscular injection or gamma globulin. This either prevents measles or child may develop measles in mild form. He would subsequently need administration of regular measles vaccine for 3 months later in order to provide him long term protection.
Preventing Measles
A dose of measles vaccine is recommended for administration to children at 9 months of age as part of routine immunization schedule. It prorides them life long protection against this disease. This vaccine is now available free of cost in government hospitals and child welfare centers. For details, see the section in immunization.
German measles (Rubella)
German measles is mild viral disease and although similar in name it is entirely different form measles. This disease starts in a child like an attack of mild cold. The child develops a runny nose, a sore throat, and a temperature of around 38c. A rash pinkish spots appears on the face on the second or third and quickly spread over the whole body. The child also develops a few small painful swellings due to enlarged lymph nodes behind the ears and at the back of the neck. The rash fades in two days but the swellings may persist for about a week. Since the illness does not cause much discomfort it is often missed or ignored.
What to Do?
The child does not need much treatment. Give him paracetamol if temperature rises above 38c and do not send him to school for a week from the time the rash first appears. More important he must come in contact with pregnant woman.
While this illness is not serious so far as the child is concerned, it is of crucial significance to any pregnant woman who comes in contact with him. If she acquires this infection during the first four months of her pregnancy, she is very likely to pass on the infection to her baby in the womb. In that event the infected baby may be born with serious birth defects like deafness, mental retardation, blindness and heart defects.
It is therefore; absolutely necessary that the child with German measles should not allowed coming in contact with pregnant woman especially she is an early stage of her pregnancy. If this happens inform her of your child’s infection so that she can promptly get proper medical advice regarding the continuation of her pregnancy.
