Measles

What is it?

– Measles is a virus disease that nobody should die from. And yet an estimated 134,000 people did in 2015, mostly children in developing countries. That’s because the measles vaccine, which works well, is cheap, and gives lifelong protection, still doesn’t reach all of the world’s children.

The measles virus is a member of the Paramyxoviridae family.

 

A vaccination campaign against measles and rubella in Paraguay, 2014. Credit: PAHO

 

What are the symptoms?

– Measles symptoms, which usually start 10 to 12 days after someone is exposed to the virus, include a high fever, a runny nose, and red eyes. The most recognizable symptom, however, is the rash, which often starts a few days after the other symptoms, beginning with the face and neck but eventually spreading all over the body. It usually starts fading within a week.

– Complications and deaths from measles are rare in rich countries. In the developing world, malnutrition and a lack of adequate health care often lead to complications, including blindness, encephalitis (an infection of the brain), diarrhea, ear infections, and pneumonia. In some populations, up to 10% of measles cases end in death. Children under five, pregnant women, and people with impaired immune systems (such as AIDS patients) are most at risk of severe complications and death. Measles can also lead to miscarriage or early delivery of the baby.

– Once you have had measles, you’re protected against it for life.

 

How does it spread?

– Measles is one of the most infectious human diseases. It spreads very easily when someone who’s infected coughs or sneezes. Close contact with a patient isn’t even necessary; the virus can stay alive in the air, or on surfaces, for several hours.

– Measles spreads fast in countries where not everyone has been vaccinated. Most cases and deaths occur in sub-Saharan Africa, South Asia and Southeast Asia. But Europe has measles outbreaks as well, sometimes with thousands of cases. The Americas have eliminated measles completely, but sometimes an “imported cases” triggers a small outbreak.

A child with measles. Credit: Dave Haygarth, Creative Commons

 

How is it treated?

There are no drugs specifically for measles. Good supportive care can help avoid complications however. That includes good nutrition and avoiding dehydration. WHO also recommends that children with measles in developing countries take two doses of vitamin A supplement, given 24 hours apart, to prevent eye damage and blindness and reduce the risk of death. Antibiotics can be given to treat eye and ear infections.

 

How can it be prevented?

– The measles vaccine, developed in the 1950, is highly effective and cheap: It costs around $1 to vaccine a child against measles twice in many developing countries. If 95% of the population has been vaccinated, measles has virtually no chance of spreading, even among the 5% who are unprotected. (This is called ‘herd immunity’.)  If vaccination coverage drops, the risk of outbreaks increases.

– By stepping up vaccination campaigns, measles deaths have been reduced by 79% between 2000 and 2015, according to WHO. Indeed, the vaccine works so well that measles can be eliminated from entire countries. Some people have suggested that measles should become the next human disease to be eradicated globally. (That has so far happened to only one disease, smallpox; polio and guinea worm disease are very close to eradication.)

– The measles vaccine is often combined with vaccines against mumps and rubella, two other virus diseases, in the ‘MMR’ vaccine. (Another combination is MR, for measles and rubella.)

– Some people claim that the MMR vaccine causes autism, which has some parents in the western world worried. But the claim is wrong. The claims stem from a scientific study that was later shown to be fraudulent. Many studies have shown the MMR vaccine to be very safe.

 

U.S. president Donald Trump has claimed, incorrectly, that vaccinations cause autism. Credit: CNN 

 

What’s the outlook?

– Great strides have been made in measles control. Between 2000 and 2015, the percentage of children worldwide who had received a dose of measles vaccine by their first birthday rose from about 73% to 85% worldwide, and an estimated 20 million lives were saved.

– All six ‘regions’ of WHO have established goals to eliminate measles by 2020. That may be a tall order, and major obstacles remain. But there is no doubt that with increased funding, political commitment, and international collaboration, measles can be beaten back even further.

Contact a measles expert.

Resources

WHO’s measles page.

The Measles & Rubella Initiative.

An interactive measles & rubella map

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