Measles is an acute infectious disease caused by a virus. It usually occurs in children between 6 months and 3 years who have not been immunized or have been incompletely or unsuccessfully immunized. It is very infectious, from up to 7 days before to 5 days after appearance of rash.
SIGNS AND SYMPTOMS
• High fever, present BEFORE the rash appears
• Runny nose
• Cough
• Conjunctivitis
• Sore mouth
• Rash starting from head and neck, moving down over the body
• Diarrhoea
• Child is generally miserable
COMPLICATIONS
These must be looked for in all patients.
• Croup
• Vitamin A deficiency leading to xerophthalmia and blindness
• Otitis media
• Deafness from otitis media
• Bronchopneumonia
• Diarrhoea
• Malnutrition
• Activation of Latent Tuberculosis
TREATMENT
Therapeutic objectives
• To prevent death by treating any complications
• To maintain good nutrition.
Pharmacological Treatment
In well nourished children, with no complications:
• Wash eyes with clean water.
• Treat sores in and around mouth with Gentian Violet paint and encourage oral hygiene
• Tepid sponge and give Paracetamol for fever
• Continue feeding
• Give Vitamin A, oral, 200,000 units as a stat dose to children over 1 year. For children under 1 year give 100,000 units stat. Repeat dose on the second day.
• Manage diarrhoea according to severity of dehydration (Refer to section on diarrhoea)
PREVENTION
Measles is prevented by immunization. Other actions to consider include:
• Education of mothers as part of RCH programmes
• Immunize child once at 9 months of age or at any visit after this age
• If there is an epidemic, consider immunizing earlier (from 6 months of age). Re-immunize at 12 months.
• Well nourished children have less serious measles. Breast feeding and good weaning foods are important.
REFER
Patients with complications such as a black (haemorrhagic) rash, stridor, pneumonia, dehydration, malnutrition and great difficulty in eating or drinking which are not responding to treatment.
Report all cases to the District Disease Control Officer for appropriate action.