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WHO warning that measles is spreading across Europe

April 2017

woman with high temperature in bed

Warnings are coming in this month from the World Health Organisation that measles is spreading across Europe.

Overall 559 cases of measles have been reported in Europe in January this year, with 474 of these reported in France, Germany, Italy, Poland, Romania, Switzerland and Ukraine.

The largest outbreaks have been in Italy and Romania, with 200 cases in Italy this year so far and Romania reporting a total of 3,400 cases including 17 deaths in the period since January 2016.

Generally two thirds of European countries have ensured children have been vaccination, but it seems in 14 countries vaccination rates are falling behind the recommended 95 per cent threshold and this is the main reason behind the increase.

WHO is saying that the records for February 2017 just coming in indicate that the rate of measles infections is continuing to rise sharply.

Measles is not something we want at any age, but we certainly don’t want it as we get older.  While it isn’t usually serious, it can be very uncomfortable, and there are potential complications that can be dangerous. These include pneumonia, hepatitis, conjunctivitis and encephalitis (inflammation of the brain, which occurs in about one in 5,000 cases). Sometimes the nervous system can be affected.

Interestingly, in general people born before 1957 are likely to have had measles, mumps, and rubella during childhood and so are assumed to be immune.  In those days children were often put in the same room as other siblings suffering from the disease so they could catch it can get it out of the way.

People born in or after 1957 should also be immune to measles because they should have been offered one or more doses of MMR vaccine. However, despite this, measles and German measles do occasionally occur in adults and when that happens, the problems can be more acute.

So it is worth knowing a little about it all. Also, for those with grandchildren, it is worth knowing what the threat is and how to deal with it.

First, while both measles and German measles (rubella) share a common name, they are in fact quite different viruses.


Measles

Measles is caused by a virus that is spread by droplets. The virus is passed on through direct contact with someone who's infected, for example by touching or kissing them, or through breathing in contaminated air. It's fairly easy to catch if you haven't been vaccinated and come into contact with someone who has the infection.

Symptoms can take up to 10 or more days to develop after exposure to the virus (the incubation period). Early symptoms are like a cold, with possibly a runny nose, cough, conjunctivitis and fever. 

The measles’ rash appears a day or two later, often starting behind the ears or on the face and spreading down across the body. It's a fine red rash which becomes blotchy and can be extremely irritating. One problem that occurs in measles is secondary infection caused by scratching, and sometimes this can also leave pot mark scars on the skin. The rash lasts for several days. There may also be abdominal symptoms such as nausea and vomiting, abdominal pain and diarrhoea. 


German Measles 

German measles, or rubella, is in many ways similar to measles but it is caused by an entirely different virus and generally it causes milder symptoms. The name rubella comes from the Latin word meaning “little red”, probably with reference to the pink rash that is associated with the virus.

Like measles, it can be passed from person to person via droplets in the air, expelled when infected people cough or sneeze, but the virus can also be present in urine, faeces and on the skin.

People with the disease are contagious for about a week or more before any outward signs – sometimes rubella can be so mild that the person doesn’t even notice they have it. But sometimes it causes flu-like symptoms plus a pink or light red rash which can be itchy and spread down the body. Usually the rash disappears within just a few days with no staining or peeling of the skin. Other symptoms can include a slight fever or swollen glands, headache, conjunctivitis and joint pains. In older patients the symptoms are usually more severe and there is a higher likelihood of arthritic type symptoms.

However, the disease is usually quickly over, lasting only a few days.

For adults, the usual treatment for both measles and German measles is to alleviate the symptoms, drink plenty of fluids and rest. If there are any complications, then of course see your doctor at once.

For grandchildren, the treatment is pretty well the same. They should be kept away from others during the first four days at least from when the rash starts to appear as this is when they are at their most infectious, even if they don’t feel too bad. Paracetamol or ibuprofen can be used to reduce high temperatures and aches and pains, and it is important to ensure the child drinks a lot to keep hydrated.  Eyes can become sticky and any crustiness can be gently removed with cotton wool soaked in tepid water.



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