Overview
Measles is one of the most contagious viral diseases among all viral diseases because it spreads easily and fast; despite an effective, safe and cost-effective vaccine being available.
Diagnosing it early, therefore is important so that the infected individual can be isolated to prevent its transmission.
Treatment is non-specific and mainly supportive unless complications develop when medications to treat the complications become necessary.
Prevention mainly relies on getting yourself vaccinated with the measles vaccine and preventing travel to areas where it is endemic.
How is measles diagnosed?
Your healthcare provider pretty much comes to a diagnosis of measles with the help of your signs and symptoms, namely the characteristic rash, the presence of Koplik’s spots, and the classic triad of symptoms namely: a high fever of sudden onset, dry cough, and coryza.
He will want to know whether you have taken the measles vaccine (MMR vaccine) and whether you have traveled recently to areas where it is commonly found, namely Africa, Asia, the Middle East, and certain parts of Europe, from where you could catch the measles virus.
Laboratory blood and tissue tests (from a throat or nose swab) can confirm the diagnosis. A urine sample may also show evidence of the virus, but the urine sample is less preferred.
The real-time Rt-PCR assay is performed on the throat or nasal swabs to detect the measles RNA and serological tests are performed on the blood serum to detect IgM and IgG antibodies.
Real-time RT-PCR
RT-PCR and Real-time RT-PCR (rRT-PCR) tests use nasopharyngeal and throat swab specimens and urine specimens, though urine specimens are less preferred.
Detection of measles virus-specific RNA in the clinical sample can provide a confirmed diagnosis of measles infection.
Although rRT-PCR is the most reliable test to diagnose measles, its optimal time for the collection of the specimen is:
- restricted to within 7 days after the symptom onset of the first symptom, or
- as late as 10–14 days after the onset of the rash, or
- immediately after the first contact with a suspected case.
Serology testing
Measles IgM antibodies can be detected in the serum and tell you whether you have a current measles infection or an infection in the recent past.
The serological serum test usually detects the IgM antibodies on the day the rash appears. They reach their peak levels 7–21 days later. Their levels then start to decline and they cannot then be detected about one to two months later.
The serological serum test for measles IgG antibodies tests positive 3-7 days after the measles rash has appeared. After about two weeks, they stabilize. IgG antibodies stay in your bloodstream for life offering you life-long immunity against measles.
The presence of detectable IgG antibodies indicates past infection with measles and shows your positive immune status. It can also mean you have been vaccinated with the measles vaccine.
Treatment
There is no specific available treatment for measles. Supportive care can make you comfortable and may offer relief. The following home measures will help and are specifically recommended for individuals infected with measles.
- Isolate yourself home.
- Take plenty of rest
- Drink plenty of fluids and water to prevent dehydration due to diarrhea and vomiting. If you are severely dehydrated, you may require intravenous fluid therapy.
- Eat bland and cold foods if you have developed painful ulcers in the mouth. Measles can cause mouth ulcers that are painful and slow to heal.
- To relieve itching of your skin rash, dab calamine lotion on the itching areas taking special care to avoid the eyes and face.
- Avoid sugary, processed, canned, oily, and spicy foods.
Vitamin A supplements are prescribed, especially in children and patients with signs of vitamin A deficiency. Those with a deficiency of vitamin A are likely to have a more severe attack of measles.
Doctors will prescribe antipyretics such as acetaminophen to bring down the fever and an over-the-counter antihistamine such as Benedryl to relieve itching.
Your healthcare provider may also prescribe antibiotics for those who develop complications such as an ear infection (otitis media) or a lung infection such as pneumonia.
Ribavirin is a broad-spectrum nucleoside antiviral drug and has been widely administered for measles.
Post-exposure vaccination may be given to non-vaccinated people, including infants, within 72 hours of exposure to the measles virus. This will offer protection and will produce milder symptoms if measles still develops.
Prevention
Getting vaccinated with two doses of the MMR vaccine (measles, mumps, and rubella) is the best way to protect yourself from measles and prevent its spread. The MMR vaccine protects you against measles, mumps, and rubella.
There is another vaccine called the MMRV vaccine, which protects you against the same conditions as the MMR vaccine but also includes protection against chickenpox.
According to sources, the measles vaccine is estimated to prevent one million deaths every year.
If you do not take the vaccine, you are at risk of getting measles. The MMR vaccine gives lifelong immunity against all strains of measles.
The efficacy, safety, and cost-effectiveness of the measles vaccine easily prevent measles from causing a pandemic.
The two doses of MMR vaccine are recommended in the following way:
- First dose: at 12–15 months
- Second dose: at 4–6 years
However, the measles vaccine should not be taken when pregnant as it contains a live weakened version of the measles, mumps, and rubella viruses. The MMR vaccine can harm you and your developing baby. However, it is not contraindicated during breastfeeding.
You can even take the vaccine if you’ve never been vaccinated before up to 72 hours after being exposed to the virus such as close contact with an infected person. This can substantially reduce your chances of getting measles and make your symptoms milder if you do get infected.
One dose of the MMR vaccine provides you with 93% protection, while two doses provide 97% protection.
The measles vaccine starts working within a few days, but it takes about 2 to 3 weeks for the body to produce a sufficient amount of antibodies to fully protect you.
Therefore, if you have not been fully vaccinated and are planning to travel to an area where measles is endemic, you should take the MMR vaccine at least two weeks or better still three weeks before your trip.
If you have not taken it and are traveling on sudden notice, you should still get one dose of the MMR vaccine even if your trip is less than two weeks away.
